Beware of Being Unaware: Racial Disparities in Chronic Illness in the US
AbstractWe study racial/ethnic disparities in awareness of chronic diseases using biomarker data from the 2006 HRS. We explore two alternative definitions of awareness, and estimate a 3-step sequential model which accounts for selection along measured and unmeasured factors into: (1) participating in biomarker collection, (2) having illness (hypertension or diabetes), and (3) being aware of illness. Our findings suggest that current estimates of racial/ethnic disparities in chronic disease are sensitive to selection, and also to the definition of disease awareness that is used. Contrary to prior studies reporting that African-Americans are more aware of having hypertension than non-Latino whites, we do not find this conclusion to be true after self-selection and severity are considered. Likewise, prior studies show mixed evidence of racial/ethnic disparities in awareness of diabetes, but after accounting for selection, we find that African- Americans and Latinos are less aware of having diabetes compared to non-Latino whites. These findings are based on a widely used definition of awareness â€“ the likelihood of self-reporting disease among those who have disease. When we use an alternative definition of awareness, which considers an individual to be unaware if s/he actually has the disease but self-reports not having it, we find striking racial/ethnic disparities in awareness.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by HEDG, c/o Department of Economics, University of York in its series Health, Econometrics and Data Group (HEDG) Working Papers with number 11/11.
Date of creation: Jul 2011
Date of revision:
Contact details of provider:
Postal: HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom
Phone: (0)1904 323776
Fax: (0)1904 323759
Web page: http://www.york.ac.uk/res/herc/research/hedg/
More information through EDIRC
This paper has been announced in the following NEP Reports:
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Morenoff, Jeffrey D. & House, James S. & Hansen, Ben B. & Williams, David R. & Kaplan, George A. & Hunte, Haslyn E., 2007. "Understanding social disparities in hypertension prevalence, awareness, treatment, and control: The role of neighborhood context," Social Science & Medicine, Elsevier, vol. 65(9), pages 1853-1866, November.
- Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
- Pinka Chatterji & Heesoo Joo & Kajal Lahiri, 2010. "Beware of Unawareness: Racial/Ethnic Disparities in Awareness of Chronic Diseases," NBER Working Papers 16578, National Bureau of Economic Research, Inc.
- Anna Aizer & Laura Stroud, 2010. "Education, Knowledge and the Evolution of Disparities in Health," NBER Working Papers 15840, National Bureau of Economic Research, Inc.
- Balsa, Ana I. & McGuire, Thomas G., 2003. "Prejudice, clinical uncertainty and stereotyping as sources of health disparities," Journal of Health Economics, Elsevier, vol. 22(1), pages 89-116, January.
- Amitabh Chandra & Jonathan Skinner, 2003. "Geography and Racial Health Disparities," NBER Working Papers 9513, National Bureau of Economic Research, Inc.
- Harding, Don & Pagan, Adrian, 2006. "Synchronization of cycles," Journal of Econometrics, Elsevier, vol. 132(1), pages 59-79, May.
- Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding Differences in Health Behaviors by Education," Scholarly Articles 5344195, Harvard University Department of Economics.
- Balsa, Ana I. & McGuire, Thomas G., 2001. "Statistical discrimination in health care," Journal of Health Economics, Elsevier, vol. 20(6), pages 881-907, November.
- Hajivassiliou, Vassilis & McFadden, Daniel & Ruud, Paul, 1996.
"Simulation of multivariate normal rectangle probabilities and their derivatives theoretical and computational results,"
Journal of Econometrics,
Elsevier, vol. 72(1-2), pages 85-134.
- Vassilis A. Hajivassiliou & Daniel L. McFadden & Paul Ruud, 1993. "Simulation of Multivariate Normal Rectangle Probabilities and their Derivatives: Theoretical and Computational Results," Working Papers _024, Yale University.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Jane Rawlings).
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.