Gender differences in adult health are well documented, but only recently has research begun to investigate how race and ethnicity condition gendered health disparities. This paper contributes to this line of inquiry by assessing gender differences in morbidity across five major US racial and ethnic populations. Using data from the 1997–2001 waves of the National Health Interview Survey, the analysis examines differences in men and women's self-rated health, functional limitations, and life-threatening medical conditions for whites, blacks, Mexicans, Puerto Ricans, and Cubans. For each health outcome, we investigate the utility of socioeconomic factors in accounting for observed disparities. Contrary to finding universal excess in female morbidity, the results show that the magnitude of gender difference varies considerably by racial/ethnic group, health outcome, and comparison category. The most striking findings are the consistently higher levels of functional limitations for all women compared to men in their same racial/ethnic group and the poorer health of black women relative to both white and black men for all health measures, after adjustment for socioeconomic and background factors. The gender gap for all other health measures is more variable, and for Mexican women a difference is only evident for functional limitations and only when compared to Mexican men. Our results underscore the need for more research on the role of race and ethnicity in shaping gendered health inequalities and the mechanisms that lead to such variable patterns of difference across and within US racial and ethnic populations.
Racial and ethnic health disparities are well-documented (Hayward & Heron, 1999; Rogers, Hummer, & Nam, 2000; Williams, 2001), as are gender differences in health (Annandale & Hunt, 2000; Macintyre, Hunt, & Sweeting, 1996; Verbrugge, 1985), yet few studies pull together these strands of research to assess whether and how racial and ethnic group membership shapes differences in men and women's well-being. In an exception to this general pattern, Cooper (2002) finds that minority ethnic men and women in the United Kingdom experience much higher rates of morbidity compared to white men. Socioeconomic disadvantage accounts for much of this disparity, but fails to explain gender differences within ethnic groups.
The implications of minority group membership for gender differences in US health are even more complex because some racial and ethnic populations have health profiles that surpass the majority white population, despite their being socioeconomically disadvantaged. Mexican Americans, for example, have lower morbidity and mortality rates than non-Hispanic whites, even though they rank low on most socioeconomic indicators (Palloni & Arias, 2004). Black Americans, on the other hand, are disadvantaged both in terms of socioeconomic status and health outcomes (Hayward, Crimmins, Miles, & Yang, 2000). Whether and how these patterns vary by gender is less understood, and whether socioeconomic status differentials can account for gender differences in health—both within and across racial/ethnic groups—is also less known.
This paper examines these questions by assessing the significance of race and ethnicity for gender differences in US adult health. Using data from the 1997–2001 waves of the National Health Interview Survey, we investigate gender differences in self-rated health, disability, and life-threatening conditions across five US racial and ethnic groups: non-Hispanic whites (hereafter “white”), non-Hispanic blacks (hereafter “black”), Mexicans, Puerto Ricans, and Cubans. The analysis is guided by two questions. First, what is the magnitude of gender differences in health within racial and ethnic groups? This section of the analysis compares the health status of women to men in their same racial/ethnic group. Second, does the size of gender differences in health vary across racial and ethnic groups? This section of the analysis compares the health of women and men in each racial and ethnic group to that of white men, a group that occupies the most advantaged position in US society. In both cases, we examine the extent to which socioeconomic factors account for observed health inequalities.
