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墨西哥裔美国老年人中的语言隔离与死亡率:来自西班牙裔老年人既定人群流行病学研究的发现

Linguistic Isolation and Mortality in Older Mexican Americans: Findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly.

作者信息

Zhang Donglan, Rajbhandari-Thapa Janani, Panda Saswat, Chen Zhuo, Shi Lu, Li Yan, Shen Ye, Ghimire Ramesh, Emerson Kerstin Gerst

机构信息

Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia, USA.

Department of Public Health Sciences, Clemson University, Clemson, South Carolina, USA.

出版信息

Health Equity. 2021 Jun 1;5(1):375-381. doi: 10.1089/heq.2020.0139. eCollection 2021.

Abstract

Limited English proficiency and increased language isolation are known to be associated with adverse health outcomes. It is not clear how neighborhood-level linguistic isolation may impact individual health and risk of death among Hispanic older adults. We examined the link between living in a linguistically isolated neighborhood and all-cause mortality among an older Mexican American cohort. Using a longitudinal sample of older Mexican Americans from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly, we calculated the days from the baseline interview (1993-1994) until observed death through five waves of follow-up (until 2004-2005) using Cox regression. A linguistically isolated neighborhood was defined as a census tract with more than 30% of linguistically isolated households. Our results showed that living in a neighborhood with more than 30% of linguistically isolated households predicted higher mortality (hazard ratio: 1.25; 95% confidence interval: 1.04-1.50), after adjusting for age, sex, nativity, years of education, marital status, self-reported health status, number of chronic conditions, ever smoked, ever drank, and other neighborhood-level contextual factors. Living in a neighborhood with a high proportion of linguistically isolated households predicted higher mortality among older Mexican Americans. Addressing the social capital shortage in linguistically isolated neighborhoods is one way to address health disparities in the United States.

摘要

有限的英语水平和日益严重的语言隔离与不良健康结果相关。目前尚不清楚邻里层面的语言隔离如何影响西班牙裔老年人的个人健康和死亡风险。我们研究了居住在语言隔离社区与墨西哥裔美国老年人群体全因死亡率之间的联系。利用来自西班牙裔老年人流行病学研究既定人群的墨西哥裔美国老年人纵向样本,我们使用Cox回归计算了从基线访谈(1993 - 1994年)到通过五轮随访(直至2004 - 2005年)观察到死亡的天数。语言隔离社区被定义为语言隔离家庭比例超过30%的普查区。我们的结果表明,在调整了年龄、性别、出生地、受教育年限、婚姻状况、自我报告的健康状况、慢性病数量、是否吸烟、是否饮酒以及其他邻里层面的背景因素后,居住在语言隔离家庭比例超过30%的社区预示着更高的死亡率(风险比:1.25;95%置信区间:1.04 - 1.50)。居住在语言隔离家庭比例高的社区预示着墨西哥裔美国老年人的死亡率更高。解决语言隔离社区的社会资本短缺问题是解决美国健康差距问题的一种方式。

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