Comorbid depression and diabetes and self-rated health: Can health ratings differences be explained by race and ethnicity?

Background: Self-rated health based on a single item has been found to be a strong predictor of health care utilization (Thomas, Sansing, Davis, et al., 2010) and has been examined extensively for individual chronic conditions (Benson, 2010; Maty, James, & Kaplan, 2010). However, few studies examine the predictive nature of self-rated health in the health disparities literature as it relates to African Americans and Caribbean Blacks who experience dual conditions demanding consistent health care.

Objective: To examine the effects of comorbid depression and diabetes on self-rated health.

Methods: Data from the National Survey of American Life sample of 6,082 African Americans, Caribbean Blacks, and Whites were analyzed using descriptive statistics and three logistic regression models on main effects and interaction terms.

Results: Unadjusted Odds Ratios indicated a significant association between comorbidity and self-rated health. Respondents with good health (OR=10.07; 95% CI: 2.92-34.75, P<0.000) were 10.07 more times more likely to have comorbid diabetes and depression compared to respondents with excellent or very good health. Those with fair or poor health (OR=34.17; 95% CI: 11.01-106.00, P<0.000) were 34.17 times more likely to have the comorbidity compared to those with excellent or very good health. Foreign-born individuals rated their health less favorably than native-born Americans. Significant interaction effects were observed.

Conclusions: Results suggest a strong association between comorbid diabetes and depression and self-rated health. Interestingly, analysis did not support “healthy immigrant” effect arguments. Future studies are needed to investigate additional relationships that might help social workers improve treatment access among racial/ethnic populations.