Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Recorded presentation

C. Annette DuBard, MD, MPH, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Martin Luther King, Jr. Blvd, CB 7590, Chapel Hill, NC 27599, 919-643-1674, annettedubard@hotmail.com and Ziya Gizlice, PhD, Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, CB 7426, Chapel Hill, NC 27599.

Background: Over one in ten US residents speak Spanish at home, but those with low English proficiency have largely been excluded from population health surveys until recently. Our objective was to describe access to healthcare, receipt of preventive services, and health behaviors of the US Spanish-speaking adult population, and to identify disparities within the US Hispanic population according to language preference.

Methods: We analyzed population-based survey data on 8960 Hispanic adults, including 5728 Spanish-language respondents, from the 2004 Behavioral Risk Factor Surveillance System. Data from 20 states were analyzed, representing 89% of the total US Hispanic population. Twenty-five health indicators were compared between Spanish-speaking and English-speaking Hispanics.

Results: Spanish-speaking Hispanics (SSH) reported far worse access to care than English-speaking Hispanics (SSH) (age-adjusted percents: 49% vs. 20% uninsured; 25% vs. 18% unable to seek care due to cost; 51% vs. 25% without a personal doctor). SSH were less likely than ESH to receive colon, breast, and prostate cancer screening, flu and pneumonia vaccination, and dental care; but pap smear rates were similar. Smoking, binge drinking, and recommended physical activity were less common among SSH. In multivariate analysis, demographic and socioeconomic factors only partially mitigated the influence of language on these health indicators.

Discussion: Spanish-language preference marks a particularly vulnerable subpopulation of U.S. Hispanics, with far lesser utilization of the healthcare system. Priority areas for improving the health status of Spanish-speaking adults include promotion of physical activity, improvement in immunization and cancer screening rates, and increased access to affordable, timely, linguistically appropriate care.

Learning Objectives:

• Recognize that substantial healthcare disparities exist within the US Hispanic population related to language preference
• Appreciate the vulnerability of the US Spanish-speaking population in terms of access to care and receipt of health services
• Recognize language-associated differences in health behaviors and risk factors among Hispanics
• Discuss limitations of utilizing population-based health data for heterogeneous populations

Keywords: Hispanic, Access and Services

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation