Quality of Life Research

, Volume 25, Issue 5, pp 1131–1136 | Cite as

Language bias and self-rated health status among the Latino population: evidence of the influence of translation in a wording experiment

Brief Communication



This research uses a translation experiment to assess the Spanish translation of the “fair” response in the self-rated health measure among a representative study of the Latino population in the USA.


Using a unique Latino-specific survey (n = 1200), researchers built in a split sample approach in the self-rated health status measure where half of the Spanish-speaking respondents (n = 600) were randomly given “regular” and the other half were given “Mas o Menos” in translating the English “fair” response. We first estimate a logistic regression model to estimate differences across language categories on the probability of reporting poor and fair health and then estimate a multinomial logistic regression to test whether respondents who took the survey in Spanish and given “regular” are more likely to rate their health as fair compared to English speakers and Spanish-speaking respondents who are given the “Mas o Menos” version.


From our logistic regression model, we find that Spanish-speaking respondents given the “regular” response are more likely to report poor health relative to English-speaking respondents and Spanish-speaking respondents who were randomly given “Mas o Menos.” The results from our multinomial logistic models suggest that Spanish respondents provided with “Mas o Menos” are more likely to rate their health as good relative to the base category of fair and relative to both English and Spanish speakers given “regular.


This research informs the study of racial and ethnic disparities by providing a detailed explanation for mixed findings in the Latino health disparities literature. Researchers interested in self-rated health should translate the general self-rated health option “fair” to “Mas o Menos” as our wording experiment suggests that the current wording “regular” overinflates the reporting of poor health.


Health disparities Self-reported health Language bias Latino populations Survey research 



Edward D. Vargas was supported by the NICHD Health Disparities Research Scholars Training Program Grant Number 5T32HD049302-09.

Compliance with ethical standards

Conflict of interest

The authors report no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Finch, B. K., & Vega, W. A. (2003). Acculturation stress, social support, and self-rated health among Latinos in California. Journal of Immigrant Health, 5(3), 109–117.CrossRefPubMedGoogle Scholar
  2. 2.
    Finch, B. K., Hummer, R. A., Reindi, M., & Vega, W. A. (2002). Validity of self-rated health among Latino(a)s. American Journal of Epidemiology, 155(8), 755–759.CrossRefPubMedGoogle Scholar
  3. 3.
    McGree, D. L., Liao, Y., Cao, G., et al. (1999). Self-reported health status and mortality in a multiethnic US cohort. American Journal of Epidemiology, 149, 41–46.CrossRefGoogle Scholar
  4. 4.
    Shetterly, S. M., Baxter, J., Mason, L. D., et al. (1996). Self-rated health among Hispanics vs. non-Hispanic White adults: The San Luis Valley Health and Aging Study. American Journal of Public Health, 86, 1798–1801.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Berkanovic, E. (1980). The effect of inadequate language translation on Hispanics’ responses to health surveys. American Journal of Public Health, 70(12), 1273–1276.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Carrasquillo, O., Orav, E. J., Brennan, T. A., & Burstin, H. R. (1999). Impact of language barriers on patient satisfaction in an emergency department. Journal of General Internal Medicine, 14(2), 82–87.CrossRefPubMedGoogle Scholar
  7. 7.
    Hendricson, W. D., Russell, J., Prihoda, T. J., Jacobson, J. M., Rogan, A., & Bishop, G. D. (1989). An approach to developing a valid Spanish language translation of a health-status questionnaire. Medical Care, 27(10), 959–966.CrossRefPubMedGoogle Scholar
  8. 8.
    Morales, L. S., Cunningham, W. E., Brown, J. A., Liu, H., & Hays, R. D. (1999). Are Latinos less satisfied with communication by health care providers? Journal of General Internal Medicine, 14(7), 409–417.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Shetterly, S. M., Baxter, J., Mason, L. D., & Hamman, R. F. (1996). Self-rated health among Hispanic vs non-Hispanic white adults: The San Luis Valley Health and Aging Study. American Journal of Public Health, 86(12), 1798–1801.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Bzostek, S., Goldman, N., & Pebley, A. (2007). Why do Hispanics in the USA report poor health? Social Science Medicine, 65(5), 990–1003.CrossRefPubMedGoogle Scholar
  11. 11.
    Kandula, N. R., Lauderdale, D. S., & Baker, D. W. (2007). Differences in self-rated health among Asians, Latinos, and non-Hispanic Whites: the role of language and nativity. Annual Epidemiology., 17(3), 191–198.CrossRefGoogle Scholar
  12. 12.
    Viruell-Fuentes, et al. (2011). Language of interview, self-rated health, and the other Latino health puzzle. American Journal of Public Health, 101(7), 1306–1313.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Herdman, M., Fox-Rushby, J., & Badia, X. (1997). ‘Equivalence’ and the translation and adaptation of health-related quality of life questionnaires. Quality of Life Research, 6(3), 237–247. CrossRefPubMedGoogle Scholar
  14. 14.
    Bullinger, M., et al. (1993). Developing and evaluating cross-cultural instruments from minimum requirements to optimal models. Quality of Life Research, 2(6), 451–459.CrossRefPubMedGoogle Scholar
  15. 15.
    Anderson, R. T., Aaronson, N. K., & Wilkin, D. (1993). Critical review of the international assessments of health-related quality of life. Quality of Life Research, 2(6), 369–395.CrossRefPubMedGoogle Scholar
  16. 16.
    Mutz, Diana C. (2011). Population-based survey experiments. Princeton: Princeton University Press.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Robert Wood Johnson Foundation Center for Health PolicyUniversity of New MexicoAlbuquerqueUSA
  2. 2.Center for Women’s Health and Health Disparities ResearchUniversity of Wisconsin-MadisonMadisonUSA

Personalised recommendations