Do Health Preferences Vary Across Racial and Ethnic Minority Populations with Mental Health Disorders? An Exploratory Study

Few health preference studies have been conducted with racial and ethnic minorities or with individuals who have mental disorders. The objective of this study was to analyze variation in willingness to pay (WTP) and time trade-off (TTO) across Latinos, Asians and non-Latino whites using the combined NLAAS/NCS-R epidemiologic datasets. A secondary objective was to analyze whether a lifetime mental disorder was associated with health preferences. Bivariate analyses were conducted to explore the variability of the WTP and TTO measures across poor and good/fair health status categories by race and ethnicity. Stratified ordered logit models with WTP and TTO as dependent variables were used to test differences by race and ethnicity, with lifetime anxiety, affective and substance disorder as covariates. Health preferences for Latinos and Asians differed from non-Latino whites. Asians in good health were willing to pay more money and trade more time for health than non-Latino whites. Latinos were willing to pay more money for improvement in their health than non-Latino whites, regardless of health status; however, Latinos in poor health were less willing to trade time than non-Latino whites. Having a lifetime diagnosis of anxiety disorder was associated with WTP for those in better health, whereas both lifetime affective and anxiety disorders were positively associated with TTO regardless of health status. Results suggest that the commodity used to value health may be a critical factor for preferences across race and ethnicity. History of mental health disorder may influence the valuation process, particularly when using TTO.