title: How good is "very good"? Translation effect in the racial/ethnic variation in self-rated health status.
abstract: OBJECTIVE
  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.
authors.affiliation: Institute of Health & Environment, Seoul National University, Seoul, Republic of Korea, sue.seo@gmail.com.
authors.forename: Sukyong
authors.initials: S
authors.lastname: Seo
authors.forename: Sukyung
authors.initials: S
authors.lastname: Chung
authors.forename: Martha
authors.initials: M
authors.lastname: Shumway
mesh_terms: D000069:Acculturation; D002140:California; D005006:Ethnicity / Q000523:psychology*; D005260:Female; D006304:Health Status; D006306:Health Surveys / Q000379:methods* / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011634:Public Health; D044469:Racial Groups / Q000523:psychology*; D057566:Self Report; D014177:Translations
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