Using "socially assigned race" to probe white advantages in health status.

OBJECTIVESWe explore the relationships between socially assigned race ("How do other people usually classify you in this country?"), self-identified race/ethnicity, and excellent or very good general health status. We then take advantage of subgroups which are discordant on self-identified race/ethnicity and socially assigned race to examine whether being classified by others as White conveys an advantage in health status, even for those who do not self-identify as White.METHODSAnalyses were conducted using pooled data from the eight states that used the Reactions to Race module of the 2004 Behavioral Risk Factor Surveillance System.RESULTSThe agreement of socially assigned race with self-identified race/ethnicity varied across the racial/ethnic groups currently defined by the United States government. Included among those usually classified by others as White were 26.8% of those who self-identified as Hispanic, 47.6% of those who self-identified as American Indian, and 59.5% of those who self-identified with More than one race. Among those who self-identified as Hispanic, the age-, education-, and language-adjusted proportion reporting excellent or very good health was 8.7 percentage points higher for those socially assigned as White than for those socially assigned as Hispanic (P=.04); among those who self-identified as American Indian, that proportion was 15.4 percentage points higher for those socially assigned as White than for those socially assigned as American Indian (P=.05); and among those who self-identified with More than one race, that proportion was 23.6 percentage points higher for those socially assigned as White than for those socially assigned as Black (P<.01). On the other hand, no significant differences were found between those socially assigned as White who self-identified as White and those socially assigned as White who self-identified as Hispanic, as American Indian, or with More than one race.CONCLUSIONSBeing classified by others as White is associated with large and statistically significant advantages in health status, no matter how one self-identifies.