D'Agostino Emily M, Ramirez Garcia Jorge I, Bakken Suzanne R, Wruck Lisa, Nilles Ester Kim, Stefano Troy A, Martin Haley R, Hungler Annette, Lee Rebecca E, Perreira Krista M, Baum Marianna K, Brown David
Department of Orthopaedic Surgery, Occupational Therapy Doctorate Division, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Prev Med Rep. 2023 Aug 2;35:102359. doi: 10.1016/j.pmedr.2023.102359. eCollection 2023 Oct.
The Hispanic, Latino, or Spanish (hereafter, "Hispanic") populations in the U.S. bear a disproportionate burden of COVID-19-related outcomes, including disease incidence and mortality. Developing culturally appropriate national public health services for Hispanic persons remains a challenge. This study examined the association of heritage and language preference with COVID-19 testing (tested vs. not tested) and vaccination (vaccinated vs. not vaccinated) outcomes among Hispanic participants from 18 Rapid Acceleration of Diagnostics-Underserved Populations (RADx-UP) projects (n = 3308; mean age = 44.1 years [SD = 14.9], 60% women; 83% spoke other than English at home). Generalized estimating equation models adjusted for age, gender, education level, income, insurance coverage, geographic region, comorbidities, and prior infection. Relative to Mexican heritage, individuals identifying as Puerto Rican or Dominican were more likely to test for COVID-19, and South American heritage was associated with higher testing and vaccination rates. Speaking Spanish or another language at home was associated with increased testing compared with speaking English at home for individuals who preferred not to report their heritage, and increased vaccination for those with Mexican, Cuban, or Central American heritage. This study highlights heterogeneity in testing and vaccination behaviors among Hispanic populations based on heritage and language preference, underscoring the diversity within the U.S. Hispanic community. In contrast to other studies on linguistic acculturation and health care utilization, our study found that a language other than English spoken at home was associated with greater vaccine uptake. That is, enculturation - the retention of Spanish language and presumably of Hispanic cultural norms - was linked with being vaccinated.
美国的西班牙裔、拉丁裔或说西班牙语的人群（以下简称“西班牙裔”）在与新冠病毒病相关的结果方面承担着不成比例的负担，包括疾病发病率和死亡率。为西班牙裔人群制定适合其文化的国家公共卫生服务仍然是一项挑战。本研究调查了来自18个快速加速诊断-服务不足人群（RADx-UP）项目的西班牙裔参与者（n = 3308；平均年龄 = 44.1岁[标准差 = 14.9]，60%为女性；83%在家说英语以外的语言）的祖籍和语言偏好与新冠病毒检测（检测与未检测）及疫苗接种（接种与未接种）结果之间的关联。广义估计方程模型对年龄、性别、教育水平、收入、保险覆盖范围、地理区域、合并症和既往感染进行了调整。相对于墨西哥祖籍，自认为是波多黎各或多米尼加裔的个体更有可能进行新冠病毒检测，而南美祖籍与更高的检测率和疫苗接种率相关。对于那些不愿报告其祖籍的个体，在家说西班牙语或其他语言与在家说英语相比，检测率增加，对于有墨西哥、古巴或中美洲祖籍的个体，疫苗接种率增加。本研究强调了基于祖籍和语言偏好的西班牙裔人群在检测和疫苗接种行为方面的异质性，凸显了美国西班牙裔社区内部的多样性。与其他关于语言文化适应和医疗保健利用的研究不同，我们的研究发现在家说英语以外的语言与更高的疫苗接种率相关。也就是说，文化传承——西班牙语的保留以及大概西班牙文化规范的保留——与接种疫苗有关。
