The association of survey language (Spanish vs. English) with Health Utilities Index and EQ-5D index scores in a United States population sample

Objective: To explore whether variations in the EQ-5D, Health Utilities Index (HUI) Mark II (HUI2), and HUI Mark III (HUI3) index scores were associated with the survey language (Spanish vs. English) in the US Valuation of the EQ-5D Health States study. Methods: The EQ-5D, HUI2, and HUI3 index scores were compared across three language/ethnic groups (i.e., non-Hispanics surveyed in English [NHE], Hispanics surveyed in English [HE], and Hispanics surveyed in Spanish [HS]) using multiple regression models. Results: Of the 4,033 respondents, 568 elected to be surveyed in Spanish. After controlling for socioeconomic and health-related variables, the mean difference (standard error) in EQ-5D, HUI2, and HUI3 index scores between HS and NHE were 0.014 (0.011), 0.050 (0.012), and 0.071 (0.020), respectively. After controlling for potential confounding variables, HS were less likely than NHE to report problems/disabilities in HUI2/3 health attributes of vision, speech, self-care, emotion, pain, and cognition (range of odds ratios: 0.31-0.45, P < 0.01 for all). No important differences were found in EQ-5D dimensions between any groups or in any of the index scores between HE and NHE. Conclusion: Health researchers studying health status of culturally diverse populations should be aware that different preference-based health indices may lead to different results.