Why Do Hispanics Report Poor Health?

Despite the health and survival advantages of Hispanics relative to non-Hispanic whites, Hispanics report themselves to be in worse health than whites. Prior research indicates that these ethnic differences in self-reported health (SRH), measured by a simple question asking individuals to assess their overall health status, persist in the presence of an extensive set of explanatory variables. In this paper we use data from the first wave of the Los Angeles Family and Neighborhood Survey (L.A.FANS) to test four hypotheses regarding Hispanic-white differences in SRH. We evaluate whether poorer health reports among Hispanics result from: (1) differences in meaning between the Spanish and English versions of the SRH question; (2) somatization of emotional distress by Hispanics; (3) varying levels of acculturation among Hispanics; and (4) measures of SES and health that are often omitted in other studies. Our results provide new insights into the validity of these explanations and suggest avenues for future research. First, they underscore the importance of language of interview, suggesting that translation issues between the Spanish and English versions of the SRH question give rise to some of the differences. Second, although respondents who are depressed are more likely to report poor SRH, this study provides little evidence to support the somatization hypothesis. Third, none of our measures of acculturation ? household language, age of immigration, duration of U.S. residence, and documented status ? is significantly associated with reports of poor health, although some of the models indicate that foreign-born Hispanics report poorer health than their native-born counterparts. Finally, whereas controls for health status exacerbate the ethnic discrepancies in SRH, adjustment for SES ? especially years of schooling ? narrows, but does not eliminate, the gap. The second wave of L.A.FANS incorporates new questions that are likely to permit more in-depth assessments of these hypotheses in future analyses.