Research Article: An Analysis of Language as a Barrier to Receiving Influenza Vaccinations among an Elderly Hispanic Population in the United States

Date Published: September 1, 2011

Publisher: SAGE-Hindawi Access to Research

Author(s): William S. Pearson, Guixiang Zhao, Earl S. Ford.

http://doi.org/10.4061/2011/298787

Abstract

Background. The Hispanic population in the United States is growing, and disparities in the receipt of healthcare services as a result of limited English proficiency have been demonstrated. We set out to determine if Spanish language preference was a barrier to receiving influenza vaccinations among Hispanic persons 65 years and older in the USA. Methods. Differences in the receipt of vaccinations by language preference were tested with both Chi-square analyses and adjusted logistic regression analyses. Results. Findings suggest that elderly Hispanic persons, 65 years of age and older, who prefer to communicate in Spanish instead of English, are significantly less likely to have received influenza vaccinations when compared to their Hispanic counterparts who prefer to communicate in English. Conclusions. Influenza infections can more often be fatal in older persons and may disparately affect minority populations such as Hispanic persons. Therefore, understanding barriers to the receipt of effective preventive health measures is necessary.

Partial Text

Morbidity and mortality resulting from seasonal influenza infection continues to be a significant concern for residents of the United States, and this is especially true among the country’s elderly population [1]. It is estimated that on average there are over a quarter of a million hospitalizations and approximately thirty six thousand deaths due to seasonal influenza annually [2], and that direct medical costs due to influenza infection average $10.4 billion every year [3]. Vaccinations against influenza are recommended for people who want to reduce the risk of getting influenza or transmitting it to others, and up until 2010, were specifically recommended for at-risk groups, including persons 65 years of age and older [4, 5]. Currently, all persons six months of age and older are recommended annual influenza vaccination [6]. As the U.S. population continues to age and grow, more people, especially vulnerable populations, will be at risk for developing this costly and potentially deadly disease.

Data was gathered from three years (2005–2007) of the Behavioral Risk Factor Surveillance System (BRFSS) survey. The BRFSS, collected by the Centers for Disease Control and Prevention (CDC) since 1984, is the world’s largest ongoing, state-based, landline telephone survey used to collect information on health risk behaviors, preventive health practices, and access to and use of health care services primarily related to chronic conditions among adults aged 18 years and older with more than 350,000 completed questionnaires each year. The survey oversamples minority and elderly respondents and is weighted for making population estimates. The median CASRO response rate was 51.1% for 2005, 51.4% for 2006, and 50.6% for 2007. The median cooperation rate was 75.1% for 2005, 74.5% for 2006, and 72.1% for 2007 [21].

The stratified populations of respondents choosing English or Spanish were shown to be homogenous in most demographic measurements across all three years, with three exceptions. First, in 2005, respondents with a preference for English had a significantly greater proportion of persons reporting that they had one person that they considered their personal health care provider compared to those choosing Spanish (82.2% for English preference and 73.0% for Spanish preference, P < .01). Second, in 2006, respondents choosing English had a significantly greater proportion of persons reporting that they had any health care coverage compared to those choosing Spanish (97.8% for English preference and 93.3% for Spanish preference, P < .01). Third, from 2005 through 2007, respondents choosing English had a significantly greater proportion of persons reporting that they had completed high school or greater, as compared to respondents choosing Spanish (67.2% for English preference and 32.4% for Spanish preference, P < .01, in 2005; 67.9% for English preference and 35.3% for Spanish preference, P < .01, in 2006; and 72.9% for English preference and 37.6% for Spanish preference, P < .01, in 2007) (Table 1). Using three years of recently available state-based BRFSS data, our findings suggest that Hispanic persons, 65 years of age and older, in the United States who prefer to communicate in Spanish are significantly less likely to have received their recommended influenza vaccinations as compared to their elderly Hispanic counterparts who prefer to communicate in English. Furthermore, there was no evidence that this gap narrowed during the three-year period. It appears that language preference among a Hispanic population, 65 years of age and older, in the U.S. are associated with lower rates of influenza vaccinations, indicating a possible health disparity that could have significant public health implications for the nation.   Source: http://doi.org/10.4061/2011/298787

 

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