Racial differences in the association between self-rated health status and objective clinical measures among participants in the BARI 2D trial.

Objectives. We explored whether and how race shapes perceived health status in patients with type 2 diabetes mellitus and coronary artery disease. Methods. We analyzed self-rated health (fair or poor versus good, very good, or excellent) and associated clinical risk factors among 866 white and 333 black participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial. Results. Michigan Neuropathy Screening Instrument scores, regular exercise, and employment were associated with higher self-rated health (P < .05). Blacks were more likely than were whites to rate their health as fair or poor (adjusted odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.38, 2.57; P < .001). Among whites but not blacks, a clinical history of myocardial infarction (OR = 1.61; 95% CI = 1.12, 2.31; P < .001) and insulin use (OR = 1.62; 95% CI = 1.10, 2.38; P = .01) was associated with a fair or poor rating. A post-high school education was related to poorer self-rated health among blacks (OR = 1.86; 95% CI = 1.07, 3.24; P < .001). Conclusions. Symptomatic clinical factors played a proportionally larger role in self-assessment of health among whites with diabetes and coronary artery disease than among blacks with the same conditions. [ABSTRACT FROM AUTHOR]