Investigation of the Predictors of Self-rated Health of Economically Disadvantaged African American Men and Women: Evidence for Sponge Hypothesis

AbstractBackground and aims: According to the sponge hypothesis, compared to men’s self-rated health (SRH),women’s SRH is more likely to reflect conditions other than chronic medical conditions (CMCs) suchas psychiatric disorders (PDs). As a result, poor SRH is a weaker predictive factor for mortality risk forwomen than men. Most of this literature, however, is done in samples that are predominantly middleclassWhite. To test the sponge hypothesis among economically disadvantaged African Americans(AAs), this study compared low-income AA men and women for the effects of the number of PDs andCMCs on SRH.Materials and Methods: This cross-sectional study recruited a non-random sample (n = 150) ofeconomically disadvantaged AA adults with PD(s). Structured face-to-face interviews were used tocollect data. SRH was measured using a single-item measure. PDs and CMCs were also self-reported.We applied linear regression models to test the interactions between SRH and the number of PDs andCMC as well as gender.Results: The number of PDs and CMCs were associated with SRH in the pooled sample of low-incomeAA adults with PD(s). However, we found a significant interaction between the number of PDs andgender. This interaction suggested a stronger association between PDs and SRH for AA women thanAA men. Gender did not alter the association between the number of CMCs and SRH.Conclusion: The number of PDs is a determinant of SRH for low-income AA women but not AA men,supporting the sponge hypothesis.