Page 7 - IJPS-5-1

International Journal of Population Studies

RESEARCH ARTICLE

What’s in a word? Language and

self-assessed health in the National

Health and Nutrition Examination Survey

Meredith Van Natta and Zachary Zimmer *
2
1
1 Department of Social and Behavioral Sciences, University of California San Francisco,
San Francisco, California, 94108, USA
2 Department of Family Studies and Gerontology, Mount Saint Vincent University,
Halifax, Nova Scotia, B3M 2J6, Canada

Abstract: This study examines the extent to which the Spanish language influences the way
in which respondents report health using the ubiquitous self-assessed health (SAH) outcome.
We account for citizenship status, ethnicity, and a series of other covariates. The study uses
the 2003-2016 national health and nutrition examination survey (NHANES) (n=39,107).
ARTICLE INFO Analyses treat SAH as non-ordered categorical and employ multinomial regressions. Results
indicate that those answering in Spanish are considerably and significantly more likely to
Received: April 4, 2019
Accepted: May 24, 2019 rate health as “fair/regular” ceteris paribus. Non-U.S. citizens and naturalized citizens are
Published: June 26, 2019 significantly more likely to rate their health favorably in comparison to U.S.-born; those
identifying as Hispanic, Black, and other/multiracial are likely to rate health less favorably
*CORRESPONDING AUTHOR than others regardless of citizenship or interview language. A model that examines only
Zachary Zimmer, foreign-born and accounts for years lived in the U.S. shows Spanish language still strongly
Department of Family Studies predicted SAH outcomes, but years spent in the U.S. did not, a finding that does not support
and Gerontology, Mount Saint notions of acculturation. The study concludes that there is a language bias in the standard
Vincent University, Halifax, SAH measure typically used national-level health surveys and national-level surveys
Nova Scotia, B3M 2J6, such as NHANES should adjust the question translation to better understand the health of
Canada. zachary.zimmer@ immigrants.
msvu.ca
CITATION Keywords: self-assessed health; citizenship status; immigrant health; National
Health and Nutrition Examination Survey; survey language
Van Natta M and Zimmer Z
(2019). What’s in a word?
Language and self-assessed 1. Introduction
health in the National Health
and Nutrition Examination This paper contributes to literature aiming to understand how language influences how
Survey. International Journal of health is reported and subsequently interpreted, and how the intersection of language,
Population Studies, 5(1):1-12. citizenship, and ethnicity shape perceptions of immigrants’ health in the U.S. Uncertainty
doi: 10.18063/ijps.v5i1.1015 surrounding health status and health-care utilization of immigrant populations in the U.S.
Copyright: © 2019 amidst today’s shifting health and immigration policies makes these issues particularly
Van Natta M and Zimmer Z. timely and salient for health researchers and policymakers alike. Because immigrants from
This is an open-access article Mexico and Central America represent the largest proportion of foreign-born individuals
distributed under the terms living in the U.S., understanding the health status and challenges facing the nation’s
of the Creative Commons
Attribution-NonCommercial Hispanic communities – one-third of whom were born abroad (Pew, 2016) – is especially
4.0 International License important. (We use the term “Hispanic” rather than Latinx, Chicano/a, or specific national
(http://creativecommons.org/ origins because it follows the ethnicity categories provided in the National Health and
licenses/by-nc/4.0/), permitting Nutrition Examination Survey (NHANES) and suits analysis of the Spanish survey
all noncommercial use, language.) Further, additional barriers to health care access may exist among foreign-
distribution, and reproduction
in any medium, provided the born Hispanics who do not speak English; yet only 34% of foreign-born Hispanics report
original work is properly cited. speaking English proficiently (Pew, 2015).

International Journal of Population Studies | 2019, Volume 5, Issue 1 1