These assumptions may reflect pragmatic issues relating to time and finance or lack of understanding of the complexities of language and culture. It is assumed that the modes of inquiry appropriate for native English speakers are applicable to other linguistic groups. In clinical and epidemiological studies questions developed for native English speakers are usually translated into other languages. Non-English speakers are often excluded from clinical trials and epidemiological studies, for reasons including the lack of valid and reliable cross cultural measurements. However, if the data are to be used to make comparisons between groups as in clinical trials and most epidemiological studies, then the questions must be conceptually and functionally equivalent and appropriate for all the groups compared.
When a measure is probing differences within a group it must be appropriate, valid, and reliable for the group concerned.
Approximately 23% of immigrants to Britain born in China, Bangladesh, India, and Pakistan have no functional skill in English, and 70% cannot function fully in an English speaking social environment. 1 Major problems exist with the reliability of such information, particularly among recent and older immigrants and refugees who may have little or no competency in English and may be at high risk of health problems. Assessment of the health and healthcare needs of ethnic minority populations, often relying on self reported data, is important in health and social services.
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