Abstract :
PURPOSE: Previous work on hormone replacement therapy (HRT) have found strong differences by race, although prescription patterns indicate a lessening of this trend in recent years. This analysis probes racial differences in current use of HRT using nationally representative data.
METHODS: Current use of HRT was obtained in both the 1999 and 2000 National Health Interview Survey (NHIS). After eliminating respondents who were male, under 40 years of age, or missing data, responses from 19,405 women were included in the analysis. A multivariate logistic model of current HRT use by race was created, controlling for age, geographic region, education, hysterectomy, self-reported health, smoking, exercise, and access and use of various types of medical care. SUDAAN software was used to produce national estimates that account for the complex sampling design.
RESULTS: White women were about twice as likely to be current HRT users (26.0%) as black women (13.9%) in bivariate analyses. Asian/Pacific Islander women were also less likely to use HRT (12.6%), while American Indians (17.6%) and women of multiple races (21.6%) were similar to white women. These associations did not vary by any of the other factors being considered in stratified analyses. In logistic models controlling for other factors, the odds ratios (OR) were virtually unchanged compared to simple age-adjusted ORʹs. The ORʹs from models stratified by education were also similar. However, women with multiple non-white race affiliations were much less likely to use HRT compared to white-only women (OR = 0.30), while women with multiple race affiliations of which one was white, were very similar to white women (OR = 1.2).
CONCLUSION: Race is a factor in the use of HRT in the U.S. This is most evident by the stable odds ratios found after controlling for many other determinants of HRT use. Detailed race definitions gave more information on this relationship, although even within this large national survey, the sample size did not allow for enough power to look at the smaller groups.
