256436 Environmental Hazards, Chronic Diseases and Barriers to Health Care Access in Spanish Speaking Persons in Baltimore, Maryland

Tuesday, October 30, 2012

John T. Braggio, PhD, MPH , EPHT/ Environmental Health Bureau/PHPA, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Sonia Fierro-Luperini, MD , Spanish-Speaking Health Leaders and Health Service Providers of Maryland, Hunt Valley, MD
Clifford S. Mitchell, MS, MD, MPH , EPHT/Environmental Health Bureau/PHPA, Maryland Department of Health and Mental Hygiene, Baltimore, MD
Background: The Maryland Behavioral Risk Factor Surveillance System (BRFSS) does not include residents who lack a telephone or refuse to participate in a telephone survey. This project was designed to determine if Spanish speaking persons identified in a community setting and interviewed in person using similar BRFSS questions and methods differ from Hispanics who participate in the Maryland BRFSS telephone survey. Methods: The survey was conducted in a not-for-profit community service center, and was orally administered in Spanish in a face-to-face setting. There were 261 participants who were tested between June 2010 and July 2011. Results: Two thirds of the participants (66.3%) did not have a land line or a cellular telephone. Self-reported diabetes prevalence was significantly higher (12.3%) and asthma prevalence was significantly lower (3.4%) in this survey than among Hispanics in the 2009 Maryland BRFSS (4.0% and 12.6%, respectively). There were no group differences in hypertension (15.3% in this survey vs. 13.0%) or arthritis (12.7% in this survey vs. 11.2%) prevalence. Pesticides were used in homes 6.7 days (95% CI=3.7-9.6) or in yards 3.7 days (95% CI=1.7-5.6) during the preceding 12 months. Insurance coverage was significantly lower in this survey (7.7%) than in the 2009 Maryland BRFSS (61.2%). Also, 38.7% of the participants could not see a doctor because of lack of financial resources or inability to speak English. Conclusions: The Maryland BRFSS may underestimate the presence of chronic diseases and barriers to health care access in Spanish only speakers who are not included in the Maryland BRFSS.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Public health or related research

Learning Objectives:
1) Describe home pesticide use, chronic disease prevalence and barriers to health care access in Spanish speaking persons in Baltimore. 2) Compare results obtained in this community sample of Spanish speakers with results for Hispanics in the 2009 Maryland Behavioral Risk Factor Surveillance System telephone survey.

Keywords: Environmental Health, Chronic Diseases

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: 1) I have been the coordinator of the Maryland Environmental Public Health Tracking (EPHT) Program at DHMH in Baltimore for more than eight years; 2) Principal Investigator (PI) or Co-PI on many CDC EPHT cooperative agreements and other federal or state grants; 3) many publications in refereed scientific journals; 4) numerous presentations at scientific meetings in the US and Europe; 5) I have a PhD, MA, completed post-doctoral training, and an MPH in epidemiology.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.