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How good is “very good”? Translation effect in the racial/ethnic variation in self-rated health status

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Abstract

Purpose

To examine the influence of translation when measuring and comparing self-rated health (SRH) measured with five response categories (excellent, very good, good, fair, and poor), across racial/ethnic groups.

Methods

Using data from the California Health Interview Survey, which were administered in five languages, we analyzed variations in the five-category SRH across five racial/ethnic groups: non-Hispanic white, Latino, Chinese, Vietnamese, and Korean. Logistic regression was used to estimate independent effects of race/ethnicity, culture, and translation on SRH, after controlling for risk factors and other measures of health status.

Results

Latinos, Chinese, Vietnamese, and Koreans were less likely than non-Hispanic whites to rate their health as excellent or very good and more likely to rate it as good, fair, or poor. This racial/ethnic difference diminished when adjusting for acculturation. Independently of race/ethnicity, respondents using non-English surveys were less likely to answer excellent (OR = 0.24–0.55) and very good (OR = 0.30–0.34) and were more likely to answer fair (OR = 2.48–4.10) or poor (OR = 2.87–3.51), even after controlling for other measures of SRH.

Conclusions

Responses to the five-category SRH question depend on interview language. When responding in Spanish, Chinese, Korean, or Vietnamese, respondents are more likely to choose a lower level SRH category, “fair” in particular. If each SRH category measured in different languages is treated as equivalent, racial/ethnic disparities in SRH among Latinos and Asian subgroups, as compared to non-Hispanic whites, may be exaggerated.

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Author information

Authors and Affiliations

  1. Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea

    Sukyong Seo

  2. Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA

    Sukyung Chung

  3. Department of Psychiatry, University of California, San Francisco, CA, USA

    Martha Shumway

Authors
  1. Sukyong Seo
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  2. Sukyung Chung
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  3. Martha Shumway
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Correspondence to Sukyong Seo.

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Seo, S., Chung, S. & Shumway, M. How good is “very good”? Translation effect in the racial/ethnic variation in self-rated health status. Qual Life Res 23, 593–600 (2014). https://doi.org/10.1007/s11136-013-0522-6

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