Question Context and Priming Meaning of Health: Effect on Differences in Self-Rated Health Between Hispanics and Non-Hispanic Whites

Abstract

Objectives Despite little empirical evidence, the current data collection practice recommends placing self-rated health (SRH) before specific health-related questions (hence, without a health context) to remove potential context effects. This paper examined the implications of this design on measurement comparability between Hispanics and non-Hispanics. Methods This study used two methodologically comparable surveys conducted in English and Spanish that asked SRH in different contexts: before and after specific health questions. Focusing on the elderly, we compared the influence of question contexts on SRH between Hispanics and non-Hispanics and between Spanish and English speakers. Results Results showed that the question context influenced SRH reports of Spanish speakers (and Hispanics) drastically but not of English speakers (and non-Hispanics). Specifically, on SRH within a health context, Hispanics reported more positive health, decreasing the gap with non-Hispanic Whites by two thirds, and the measurement utility of SRH was improved through more consistent mortality prediction across ethnic/linguistic groups. Conclusions Contrary to the current recommendation, asking SRH within a health context enhanced measurement utility. Studies using SRH may result in erroneous conclusions when not considering its question context.

Relationship Between Future Time Orientation and Item Nonresponse on Subjective Probability Questions: A Cross-Cultural Analysis

“…Interview language is a reflection of true cultural orientation for monolinguals and a product of convenience for multilinguals (i.e., a preferred language). Regardless, language used in survey interviews and conversations alike is shown to bring its cultural norms to the discourse (Bond, 1983; Lee, Nguyen, & Tsui, 2011; Lee & Schwarz, 2014; Lee, Schwarz, & Goldstein, 2014; Marian & Kaushanskaya, 2004; Ross, Xun, & Wilson, 2002). …”

The effects of response option order and question order on self-rated health

“…This could occur if 1) the sequence of questions communicates that SRH should summarize or globally assess the more specific health information the respondent previously provided; 2) the sequence of questions provides a common definition of health for all respondents [19]; 3) the sequence of questions activates a memory structure of beliefs, evaluations, and feelings about health which become salient when formulating an answer to the SRH question [20]; or 4) the sequence of questions helps to define the SRH response scale in a similar way for all respondents [21], reducing random error in responses and thus increasing the strength of estimated relationships. If a contrast effect occurred, the association between SRH and domain-specific health items would be smaller when SRH is administered after domain-specific health items compared to when SRH is administered before [20; 22; 23].…”

Disparities in telephone CPR access and timing during out-of-hospital cardiac arrest

“…Four out of ten Hispanics are reported to speak English less than very well, thus classified as “linguistically isolated”. 38 As the Hispanic population continues to grow and represent a larger percentage of the US population, Spanish use will continue to be used, especially among recent immigrants. CPR saves lives, but we are not getting this intervention out to all groups, leading to unacceptable disparities in care and outcomes.…”