Despite lower rates of mortality and some forms of morbidity, Latinos report worse self-rated health (SRH) than Whites. These inconsistencies have raised questions about the validity of SRH for cross-ethnic comparisons and its use as a measure of health disparities. We examine whether the translation of this measure into Spanish helps explain these patterns.
We analyzed levels of SRH under different language conditions using cross-sectional data from the 2002 Chicago Community Adult Health Study and the 2003 Behavioral Risk Factor Surveillance System.
Being interviewed in Spanish was associated with significantly higher odds of rating one’s health as fair/poor in both data sets, and adjusting for language of interview substantially reduced the SRH gap between whites and Latinos. Spanish-language interviewees were also more likely to rate their health as “fair” (“regular” in Spanish) than any other response category, after adjusting for age, sex, socioeconomic position, health conditions, and other factors. The association between being interviewed in Spanish and reporting “fair”/“regular” health was strongest when contrasted against response categories representing better health (good, very good, and excellent).
The findings support the hypothesis that the translation of the English word “fair” to “regular” induces Spanish-speaking respondents to report worse levels of health than they otherwise would in English. We recommend caution in interpreting this widely used instrument—especially when making racial/ethnic comparisons—and propose experimental research using different translations of this measure to arrive at one that better equates its meaning in Spanish and English.