Culture-Sensitive Question Order Effects of Self-Rated Health Between Older Hispanic and Non-Hispanic Adults in the United States

Objective: The aim of this study is to examine context effects created by the question order for self-rated health (SRH) by race/ethnicity and language. Method: Differences in SRH estimates for non-Hispanic Whites and Hispanics were first examined with multiple observational data that asked SRH in different contexts. To examine context effects by socio-demographics and health-related characteristics, we conducted experiments on SRH question order. Results: While Hispanics reported poorer health than non-Hispanic Whites, this difference, in part, depended on question contexts. With SRH asked after rather than before specific health questions, Hispanics, especially Spanish-speaking Hispanics, reported better health, while non-Hispanic Whites’ reports remained consistent. Among Spanish-speaking Hispanics, the context effect was larger for unmarried and less educated persons and those with comorbidities. Discussion: Question contexts influence SRH reports by Spanish-speaking older adults. Cross-cultural inquiries on the meaning of health and its dynamics with question contexts may explain what SRH measures for increasingly diverse populations.