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Language and self-assessed health in the U.S

undermining the previously hypothesized immigrant health advantage. In addition to survey language, these intersecting
factors, which are difficult to measure with precision, are very likely underlying the effects we see in our models. Future
research should consider these complex factors when drawing conclusions regarding immigrant health in the U.S.

5. Conclusions
Spanish speakers are more likely than others to rate their health as “fair.” This result concurs with earlier studies that used
much smaller samples and, as opposed to our study, examined data that were either cross-sectional or spanned a short
period of time. Acculturation, or years spent in the U.S. among immigrants, does not attenuate the association. Earlier
research has indicated that being an immigrant and having limited English proficiency has negative consequences for
health. While our study does not negate this, it does suggest that some perceived health disadvantage among immigrants
could be a function of differences in the way in which health is expressed across languages.
Authors’ Contributions

Both authors contributed to all aspects of the manuscript, including conceptualization, analysis, interpretation, and writing.
Ethics

The de-identified NHANES datasets used in this paper were downloaded by the first author as de-identified, publicly
available files through the U.S. CDC and Prevention. Ethical approval for original data collection was provided by the
National Center for Health Statistics’ Ethics Review Board.
Availability of Support Data

All data files for the NHANES waves used in this manuscript are available through the National Center for Health
Statistics.

Conflicts of Interest
The authors have no conflicts of interest to disclose.

Funding
Zachary Zimmer acknowledges support from the Social Science and Humanities Research Council of Canada through
their Canada Research Chairs program.
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10 International Journal of Population Studies | 2019, Volume 5, Issue 1