English-Spanish Gap in Poor/Fair Self-Reported Health Increased for Hispanic Adults in the United States Between 1997 and 2018.

Historically, Hispanic adults that answer health surveys in Spanish report worse health than those who answer in English. This paper documents a growing English-Spanish gap in self-reported health (SRH) among Hispanic adults in the United States between 1997 and 2018. Data are from the 1997-2018 National Health Interview Survey (NHIS). The analytic sample consisted of 189,024 Hispanic adults older than 18 with valid information for the variables considered in the study. Descriptive analyses indicate that Hispanic adults who answer the NHIS in Spanish report worse health than English respondents do across the period of analysis. Multivariable logistic regression analysis was used to study the English-Spanish gap in SRH and to track its evolution over the last 22 years. At baseline, Spanish respondents exhibited significantly worse levels of SRH than those who answered in English and this gap persisted across time and older cohorts. The gap was still present when demographic/socioeconomic characteristics and assimilation are considered. In the majority of the cases, there is a significant interaction between language of interview, and period and cohort indicators. The English-Spanish gap in self-reported health is not explained by demographic/socioeconomic characteristics or assimilation. It may be possible that there are differences in how Hispanic adults understand health categories items across different languages with differences observed depending on how self-reported health is operationalized.