Research is also needed to understand the extent to which methodological factors are contributing to some of the observed patterns of health for immigrants versus non-immigrants. For example, in contrast to the patterns of lower overall mortality than whites, Hispanics have higher rates of self rated ill health than whites.41 Immigrant Latinos also report lower levels of fair and poor health than the native born.110 Some limited evidence suggests that at least some of the observed difference between whites and Latinos, may be an artifact of the translation of the question into Spanish. In particular, the translation of “fair” (English) to “regular” (Spanish) may give that term a more positive connotation in the Spanish language than is intended in English. Research reveals that adjusting for language of interview reduces the self rated health differences between Hispanics and non-Hispanic whites.110, 122 More generally, there is a need to critically and explicitly examine the role of culture and to conceptually and empirically identify the relevant aspects of culture that may affect the health of immigrant populations.
