​Using data from the 2003 and 2005 California Health Interview Surveys, the authors analyzed variations in the five-category self-rated health (SRH) across five racial/ethnic groups: non-Hispanic white, Latino, Chinese, Vietnamese, and Korean. This study examined the influence of translation when measuring and comparing SRH measured with five response categories (excellent, very good, good, fair, and poor), across racial/ethnic groups.

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 and very good and were more likely to answer fair or poor, even after controlling for other measures of SRH.

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.