Quality of Life Research

, 18:1377 | Cite as

The association of survey language (Spanish vs. English) with Health Utilities Index and EQ-5D index scores in a United States population sample

  • Nan Luo
  • Yu Ko
  • Jeffrey A. Johnson
  • Stephen Joel Coons



To explore whether variations in the EQ-5D, Health Utilities Index (HUI) Mark II (HUI2), and HUI Mark III (HUI3) index scores were associated with the survey language (Spanish vs. English) in the US Valuation of the EQ-5D Health States study.


The EQ-5D, HUI2, and HUI3 index scores were compared across three language/ethnic groups (i.e., non-Hispanics surveyed in English [NHE], Hispanics surveyed in English [HE], and Hispanics surveyed in Spanish [HS]) using multiple regression models.


Of the 4,033 respondents, 568 elected to be surveyed in Spanish. After controlling for socioeconomic and health-related variables, the mean difference (standard error) in EQ-5D, HUI2, and HUI3 index scores between HS and NHE were 0.014 (0.011), 0.050 (0.012), and 0.071 (0.020), respectively. After controlling for potential confounding variables, HS were less likely than NHE to report problems/disabilities in HUI2/3 health attributes of vision, speech, self-care, emotion, pain, and cognition (range of odds ratios: 0.31–0.45, P < 0.01 for all). No important differences were found in EQ-5D dimensions between any groups or in any of the index scores between HE and NHE.


Health researchers studying health status of culturally diverse populations should be aware that different preference-based health indices may lead to different results.


Ethnicity Health preference Health status Quality of life Hispanics Spanish 



Health Utilities Index


English-speaking non-Hispanics


English-speaking Hispanics


Spanish-speaking Hispanics



Data for this analysis were collected through a grant from the Agency for Healthcare Research and Quality (grant number: 5 R01 HS10243). Dr. Johnson is a Health Scholar with the Alberta Heritage Foundation for Medical Research (AHFMR) and holds a Government of Canada Research Chair in Diabetes Health Outcomes. An early version of this manuscript was presented to the 25th Plenary Meeting of the EuroQol Group, Hotel Dino, Baveno, Italy, September 11–13, 2008.


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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • Nan Luo
    • 1
  • Yu Ko
    • 2
  • Jeffrey A. Johnson
    • 3
  • Stephen Joel Coons
    • 4
  1. 1.Department of Epidemiology and Public Health & Centre for Health Services Research, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  2. 2.Department of Pharmacy, Faculty of ScienceNational University of SingaporeSingaporeSingapore
  3. 3.Department of Public Health SciencesUniversity of AlbertaEdmontonCanada
  4. 4.Patient-Reported Outcomes Consortium, Critical Path InstituteTucsonUSA

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