Linguistic disparities in health care access and health status among older adults
Linguistic disparities in health care access and health status among older adults
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DOI：
10.1111/j.1525-1497.2006.00491.x
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发表时间：
2006-07-01
影响因子：
5.7
通讯作者：
Cunningham, William E.
中科院分区：
文献类型：
--
作者：
Ponce, Ninez A.;Hays, Ron D.;Cunningham, William E.
背景：英语水平对于解释老年人健康和医疗保健获取方面的差异可能很重要。 主题：2001 年加州健康访谈调查中 55 岁及以上成年人的人口代表性样本 (N = 18,659)。 方法：我们研究了英语水平有限 (LEP)、精通英语但在家说另一种语言 (EP) 的老年人的医疗保健获取和健康状况是否存在差异。只说英语 (EO)。我们进行了加权双变量和多变量调查 Logit 分析，以检验语言能力在获得护理的 2 个方面（没有常用护理来源、延迟获得护理）和 2 个健康状况指标（自评总体健康和情绪健康）的作用。 结果：在我们的 4 项获得护理和健康状况指标中的 3 项中，英语水平有限的成年人的情况明显比 EO 老年人差（风险高 1.68 至 2.49 倍）。除了护理延迟外，英语水平有限的老年人获得护理的机会和健康状况均明显较差于 EP 老年人。与讲 EO 的人相比，精通英语的成年人报告情绪健康状况较差的风险增加了 52%。 结论：向患者提供语言援助服务和对提供者进行文化能力培训是医疗保健系统减少语言障碍、改善获得护理的机会并最终改善这些弱势群体健康状况的两种手段。
BACKGROUND: English proficiency may be important in explaining disparities in health and health care access among older adults.SUBJECTS: Population-based representative sample (N = 18,659) of adults age 55 and older from the 2001 California Health Interview Survey.METHODS: We examined whether health care access and health status vary among older adults who have limited English proficiency (LEP), who are proficient in English but also speak another language at home (EP), and who speak English only (EO). Weighted bivariate and multi-variate survey logit analyses were conducted to examine the role of language ability on 2 aspects of access to care (not having a usual source of care, delays in getting care) and 2 indicators of health status (self-rated general health and emotional health).RESULTS: Limited-English proficient adults were significantly worse off (1.68 to 2.49 times higher risk) than EO older adults in 3 of our 4 measures of access to care and health status. Limited-English proficient older adults had significantly worse access to care and health status than EP older adults except delays in care. English proficient adults had 52% increased risk of reporting poorer emotional health compared with EO speakers.CONCLUSIONS: Provision of language assistance services to patients and training of providers in cultural competence are 2 means by which health care systems could reduce linguistic barriers, improve access to care, and ultimately improve health status for these vulnerable populations.