Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Prev Med. 2022 Jun;159:107042. doi: 10.1016/j.ypmed.2022.107042. Epub 2022 Apr 7.
Language barriers have been associated with worse access to healthcare and poorer health outcomes. To assess differences in access to care and utilization of healthcare services between Hispanic adults and non-Hispanic white adults (NHW), we used the Medical Expenditure Panel Survey (2013-2016) to compare Hispanic adults who expressed limited comfort speaking in English (LCE) with Hispanic adults who were comfortable speaking in English (CE) and NHW adults. Hispanic adults with CE were less likely than NHW adults to have a usual source of care, use preventive services, including cervical cancer screening, and healthcare services. However, after adjustment breast and cervical cancer screening exceeded that of NHW adults. Hispanic adults with LCE fared substantially worse than their Hispanic counterparts with CE in having a usual source of care, use of preventive services, breast and colorectal cancer screening, and healthcare services. After adjustment, use of all cancer screening tests were similar. Eliminating disparities for Hispanic adults will require a multi-pronged approach to address access to healthcare and other social determinants of health, including poverty, employment discrimination, and educational inequities. The public health community can help improve health literacy, address barriers to care, and provide appropriate language assistance at point of care using culturally-competent means to promote greater utilization of preventive services, including demand for and delivery of cancer screenings.
语言障碍与较差的医疗保健获取和较差的健康结果有关。为了评估西班牙裔成年人和非西班牙裔白人成年人（NHW）之间在获得医疗保健服务方面的差异和利用，我们使用医疗支出面板调查（2013-2016 年）来比较表示英语表达能力有限的西班牙裔成年人（LCE）与能够熟练使用英语的西班牙裔成年人（CE）和 NHW 成年人。能够熟练使用英语的西班牙裔成年人比 NHW 成年人更不可能有常规医疗来源，使用预防服务，包括宫颈癌筛查和医疗保健服务。然而，在调整后，乳腺癌和宫颈癌筛查的比例超过了 NHW 成年人。与能够熟练使用英语的西班牙裔成年人相比，英语表达能力有限的西班牙裔成年人在拥有常规医疗来源、使用预防服务、乳腺癌和结直肠癌筛查以及医疗保健服务方面的情况要差得多。调整后，所有癌症筛查测试的使用情况相似。要消除西班牙裔成年人的差异，需要采取多管齐下的方法来解决医疗保健获取和其他健康决定因素的问题，包括贫困、就业歧视和教育不平等。公共卫生界可以通过使用文化能力手段来提高健康素养、解决护理障碍，并在护理点提供适当的语言援助，以促进更多地利用预防服务，包括对癌症筛查的需求和提供。
