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Health Education Research, Vol. 10, No. 1, 73-82, 1995
© 1995 Oxford University Press

research-article

Ethnicity, church affiliation and beliefs about the causal agents of health: a comparative study employing a multivariate analysis of covariance1

Tanja Bekhuis, Harold Cook1, Kathleen Holt2, Jane Scott-Lennox3, Richard Lennox4, Laurie Price5 and John G. Fryer6

TCB Research Boalsburg, PA 16827
1Cecil G.Sheps Health Services Research Center, University of North Carolina Chapel Hill, NC 27599
2Mt Hope Family Center, University of Rochester Rochester, NY 14607
3Applied Healthcare Research, Glaxo Research Institute Research Triangle Park, NC 27709
4Pacific Institute for Research and Evaluation Chapel Hill, NC 27514
5Department of Anthropology, Northern Arizona University Flagstaff, AZ 86004
6Department of Biostatistics, University of North Carolina Chapel Hill, NC 27599, USA

This study investigated beliefs about causal agents for health and sickness among the economically and educationally disadvantaged who suffer from chronic health problems in the rural South of the USA (n = 197). We hypothesized that the relationship between a revised Multidimensional Health Locus of Control scale for fate would be positively correlated with a new scale for God control, and that the loci for self, others, fate and God would be intercorrelated. Results confirmed our hypotheses: all Spearman correlations were positive and statistically significant. We also hypothesized that there would be cultural variation with respect to mean group differences on three of the traditional loci (self, others and fate). We compared subgroups defined by crossing ethnicity (black or white) with church affiliation (fundamentalist or moderate) and ethnicity crossed with belief (high or low) in God's control over health. A multivariate analysis of covariance of the three loci was conducted. Two-way interactions (ethnicity x church affiliation and ethnicity x belief in God's control), adjusted for the effect of formal schooling, were significant. Some of the standardized effect sizes for the adjusted mean group differences were very large. Speculative reasons for cultural variation with repect to mean group differences are discussed in terms of the social climate of the church and the transmission of beliefs via formal schooling. Suggestions for future research and program design are offered.


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