Race, heart disease worry and health protective behavior

This study links heart disease worry with self initiated changes in diet and exercise health protective behaviors (HPB), among blacks and whites. Utilizing the concept 'vulnerability', from the Health Belief Model, it is hypothesized that worry about heart disease will more readily translate into diet and exercise health behaviors for blacks than for whites. The data come from a national probability survey of families in the United States (N = 1167). The findings indicate substantial support for the hypothesis when both race and socioeconomic status (SES) are considered. Among whites, heart disease worry has no effect on health protective behavior. For blacks, worry about heart disease does have a pronounced effect on HPB, but only among lower SES blacks. A test for interaction indicates that the low SES black slope is significantly different than the slopes in the other race-SES categories. These findings contrast sharply with much of the traditional (system contact) prevention literature which depicts lower SES minority populations as less active in preventive behavior. A system barriers explanation is explored, which argues that lower SES minority persons turn to HPB as an alternative to impersonal public medicine. There was no support for this explanation; rather, lower SES blacks involved in health protective behavior express more confidence in the health care system.