Differences in self-reported health among Asians, Latinos, and non-Hispanic whites: the role of language and nativity.

PURPOSE: Self-reported overall health (SROH) is often used to compare the health status of multi-ethnic populations in the United States. SROH may not be comparable across cultural groups. We assessed if differences in SROH between non-Hispanic whites (NHW), Latinos, and Asians were explained primarily by differences in socioeconomic status (SES) or language and nativity.

METHODS: We used cross-sectional data on 36,660 NHW, 9399 Latinos, 1298 Chinese, 944 Filipinos, 803 Koreans, 857 Vietnamese, and 1036 "other Asians" from the 2001 California Health Interview Survey.

RESULTS: Compared with NHW, all ethnic groups were less likely to report "excellent" or "very good" health. Latinos, Chinese, Filipinos, Koreans, and Vietnamese were also more likely to report "fair" or "poor" health. Adjusting for SES attenuated these differences for Latinos but did not explain the effect of being Asian on SROH. Among all ethnicities, individuals with limited English proficiency had worse SROH than individuals who were English-proficient.

CONCLUSIONS: Differences in SROH between Asians and NHW do not appear to be mediated by SES and may be due to different perceptions of health that are rooted in culture and language. There remains a need for health status measures less susceptible to cultural bias in Asian and Latino populations.