摘要：Objectives. We investigated whether racial/ethnic health disparities exist in Canada and whether socioeconomic or behavioral differences between racial/ ethnic minorities and nonminorities account for such disparities. Methods. We used data from the National Population Health Survey, conducted by Statistics Canada in 1996 and 1997. We used regression models to examine differences in functional and self-reported health. Results. Our study found no association between socioeconomic or behavioral differences and racial/ethnic health disparities. There was no clear pattern between racial/ethnic minority status and health. Conclusions. The state can play an important role in health outcomes, and public commitment to accessible health care may explain why socioeconomic status and health behaviors are weak indicators of racial/ethnic health variation in Canada. An inevitable effect of racial/ethnic stratification is inequality throughout many domains, including health risks and outcomes. Over the past several decades, epidemiologists and sociologists have conducted numerous studies that illustrate patterned disparities in the prevalence of health problems among racial/ ethnic groups. 1– 7 Previous research, primarily focused on Black–White comparisons, has shown that racial/ethnic minorities often experience more health problems than nonminorities. For example, studies of health patterns within the US population consistently show that non-Hispanic Blacks have higher all-cause mortality rates, lower life expectancies, and worse mental health than non-Hispanic Whites. 4, 8– 13 In fact, White–Black health disparities in life expectancies have widened since the 1980s, largely because of slow improvements in health status, especially heart disease, within the Black population. 4, 8 Previous research shows how race/ethnicity influences health variation through differential exposure to health risks; however, much of the research about racial/ethnic health disparities may have limited application because it is based largely on US Black–White comparisons. The association between race/ ethnicity and health disparities needs to be placed in the social context of racial/ethnic hierarchies rather than simply described in terms of biological or genetic differences Also, the sociohistorical protocols for categorizing people into racial/ethnic categories differ from country to country, which means that racial/ethnic hierarchies are defined by time and place. 16– 18 Hence, the health implications of race/ethnicity in the United States are presumably distinct from those in other countries, which places an obvious restriction on theories of racial/ethnic health variation based strictly on US Black–White differences. These theories may even have limited relevance in the US context: current research shows that non-Black Hispanics, who will displace Blacks as the largest US minority group by 2010, and other racial/ethnic minorities have health profiles that the predominant theories cannot explain. 10, 19 There are compelling arguments for a research agenda that disaggregates conventional racial/ethnic categories (or makes ethnically diverse comparisons) to uncover important distinctions in health risks and outcomes. 14, 17, 20 To help further this agenda, we compared 12 racial/ethnic groups on functional and self-reported health with a nationally representative sample (n = 67 858). We also considered whether differential socioeconomic status (SES) and health risk behaviors—2 leading theories for racial/ethnic health variation—are valid explanations for any physical health disparities between racial/ ethnic minorities and nonminorities. Finally, we examined how functional health compares with self-reported health to determine whether race/ethnicity influences perceived health status.
