Document Type: Original Article


1 School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, USA

2 Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA


Background 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) such
as psychiatric disorders (PDs). As a result, poor SRH is a weaker predictive factor for mortality risk for
women than men. Most of this literature, however, is done in samples that are predominantly middleclass
White. 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 and
CMCs on SRH.
Materials and Methods: This cross-sectional study recruited a non-random sample (n = 150) of
economically disadvantaged AA adults with PD(s). Structured face-to-face interviews were used to
collect 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 and
CMC as well as gender.
Results: The number of PDs and CMCs were associated with SRH in the pooled sample of low-income
AA adults with PD(s). However, we found a significant interaction between the number of PDs and
gender. This interaction suggested a stronger association between PDs and SRH for AA women than
AA 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.


Main Subjects