Table 3.

Adjusted Odds Ratios (ORs) for Adverse Health Outcomes Among Elderly Medicare Health Plan Members, by Race/Ethnicity, 2012 (n = 236,289)

Health Outcomes	Race/Ethnicity Group, Adjusted OR (95% CI)
Health Outcomes	White (Reference) n = 176,994	Hispanic n = 20,553	Black n = 22,729	American Indian/Alaskan Native n = 1054	Asian n = 8228	Native Hawaiian/Pacific Islander n = 729	Multiracial n = 6002
Perceived Health
Fair or poor health	1.00	1.30 (1.24–1.37)^a	1.39 (1.33–1.46)^a	1.30 (1.13–1.49)^a	1.06 (0.98–1.14)	1.07 (0.91–1.27)	1.40 (1.32–1.49)^a
Sickest Quartile VR-12 PCS and MCS Scores
Sickest quartile PCS score	1.00	0.71 (0.68–0.75)^a	0.93 (0.87–0.97)	1.16 (1.01–1.33)	0.52 (0.48–0.56)^a	0.67 (0.55–0.81)^a	1.21 (1.13–1.29)^a
Sickest quartile MCS score	1.00	1.34 (1.29–1.40)^a	1.23 (1.18–1.27)^a	1.48 (1.29–1.69)^a	1.22 (1.14–1.31)^a	1.53 (1.32–1.78)^a	1.25 (1.18–1.34)^a
Health Symptoms
Chest pain	1.00	1.35 (1.28–1.41)^a	1.40 (1.35–1.45)^a	1.48 (1.30–1.69)^a	1.38 (1.29–1.47)^a	1.80 (1.57–2.06)^a	1.68 (1.58–1.78)^a
Shortness of breath	1.00	0.98 (0.94–1.02)	1.16 (1.12–1.20)^a	1.31 (1.14–1.52)^a	0.85 (0.80–0.90)^a	1.44 (1.23–1.67)^a	1.30 (1.23–1.38)^a
Foot symptoms	1.00	1.42 (1.36–1.49)^a	1.53 (1.48–1.59)^a	1.39 (1.22–1.59)^a	1.29 (1.21–1.37)^a	1.70 (1.50–1.94)^a	1.75 (1.65–1.85)^a
Arthritis pain	1.0 0	1.10 (1.05–1.15)^a	1.15 (1.11–1.19)^a	1.13 (0.99–1.30)	0.60 (0.56–0.65)^a	0.98 (0.83–1.15)	1.05 (0.99–1.11)
Depressed mood	1.00	1.37 (1.31–1.44)^a	1.13 (1.08–1.19)^a	1.37 (1.17–1.60)^a	1.00 (0.92–1.10)	1.51 (1.20–1.89)^a	1.50 (1.39–1.61)^a
Sensory Limitations
Vision problem	1.00	1.55 (1.46–1.65)^a	1.36 (1.27–1.45)^a	1.46 (1.19–1.81)^a	1.43 (1.29–1.57)^a	1.67 (1.33–2.10)^a	1.61 (1.46–1.77)^a
Hearing problem	1.00	1.28 (1.21–1.34)^a	1.03 (0.98–1.08)	1.33 (1.11–1.59)^a	1.18 (1.08–1.30)^a	1.68 (1.30–2.17)^a	1.02 (0.95–1.10)
Risk Factors
Obese (BMI ≥30 kg/m²)	1.00	0.99 (0.94–1.03)	1.43 (1.38–1.48)^a	1.16 (1.02–1.31)	0.22 (0.19–0.25)^a	1.20 (0.99–1.44)	1.13 (1.06–1.19)^a
Current smoker	1.00	0.53 (0.49–0.58)^a	1.00 (0.95–1.06)	1.17 (0.95–1.45)	0.44 (0.38–0.50)^a	0.85 (0.68–1.06)	1.30 (1.20–1.41)^a
Functioning and Chronic Conditions
≥1 ADL impairment	1.0 0	0.92 (0.88–0.96)^a	1.11 (1.07–1.15)^a	1.37 (1.20–1.57)^a	0.63 (0.59–0.67)^a	1.06 (0.90–1.25)	1.37 (1.30–1.45)^a
>3 chronic conditions	1.0 0	0.90 (0.86–0.94)^a	1.03 (0.99–1.07)	1.04 (0.91–1.20)	0.66 (0.61–0.69)^a	1.15 (0.98–1.35)	1.16 (1.10–1.22)^a

ADL indicates activity of daily living; BMI, body mass index; CI, confidence interval; OR, odds ratio; VR-12 PCS and MCS Scores, the Veterans-RAND 12-Item Survey physical component summary score and mental component summary score (0–100 scale, 0 representing worst health, 100 representing best health). Chest pain symptoms indicates having any of 2 symptoms (chest pain when exercising or resting) in last 4 weeks versus no symptoms. Shortness of breath symptoms indicates having any of 4 symptoms (shortness of breath when lying flat, sitting, walking <1 block, or climbing 1 flight of stairs) in last 4 weeks versus no symptoms. Foot symptoms indicates having any of 4 symptoms (numbness in feet, tingling in feet, inability to feel hot/cold in feet, or nonhealing sores on feet) in last 4 weeks versus no symptoms. Arthritis pain indicates severe or moderate arthritis pain in the last 4 weeks versus mild, very mild, or no pain. Current smoker indicates smoking all or some days versus not at all. Obese indicates a body mass index ≥30, based on member’s reported height and weight. Poor physical health indicates a VR-12 PCS score in the sickest quartile of the overall PCS score distribution, or PCS ≤30.11. Poor mental health indicates a VR-12 MCS score in the sickest quartile of the overall MCS score distribution, or MCS ≤45.05. Having ≥1 ADL impairment indicates having difficulty or being unable to perform any of 6 ADLs (bathing, dressing, eating, getting in/out of chairs, walking, toileting). Having >3 chronic conditions indicates having 4 or more of any of 14 chronic conditions (hypertension, angina pectoris or coronary artery disease, congestive heart failure, heart attack, other heart condition, stroke, respiratory conditions, inflammatory bowel disease, hip/knee arthritis, hand/wrist arthritis, osteoporosis, sciatica, diabetes, and any cancer).

P <.003. Statistically significant results are indicated by bold font. A Bonferroni correction was applied to account for the testing of 14 dependent variables from the sample of Medicare beneficiaries. Thus, at the alpha testing level of .05, only P values <.003 (.05/14) were considered significant. The model adjusts for patient age, gender, marital status, education, Medicaid status, length of enrollment in Medicare health plan, and census region: New England (CT, MA, ME, NH, RI, VT); Mid-Atlantic (NJ, NY, PA); East North Central (IN, IL, MI, OH, WI); West North Central (IA, KS, MN, MO, NE, ND, SD); South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV); East South Central (AL, KY, MS, TN); West South Central (AR, LA, OK, TX); Mountain (AZ, CO, ID, M T, NM, NV, UT, WY); Pacific (AK, CA, HI, WA, OR).