Linguistic Acculturation and Skin Cancer–Related Behaviors Among Hispanics in the Southern and Western United States

Abstract

Objective To examine the association between linguistic acculturation (assessed using the Language Use and Linguistic Preference subscales from the Bidimensional Acculturation Scale for Hispanics) and skin cancer-related behaviors among U.S. Hispanic adults. We hypothesized that, compared to Hispanics denoted as Spanish acculturated, English acculturated Hispanics would report less frequent shade seeking and use of sun protective clothing and higher rates of sunscreen use, sunbathing, and indoor tanning. Design Online survey study conducted in September, 2011. Setting Survey of Hispanic adults residing in five southern and western U.S. states. Participants A population-based sample of 788 Hispanic adults drawn from a nationally representative web panel. Main Outcome Measures Self-reported sunscreen use, shade seeking, use of sun protective clothing, sunbathing, and indoor tanning. Results Multivariable regression analyses were conducted to examine predictors of the skin cancer-related behaviors. As hypothesized, English acculturated Hispanics had lower rates of shade seeking and use of sun protective clothing and reported higher rates of sunbathing and indoor tanning than Spanish acculturated Hispanics. English acculturated Hispanics and bicultural Hispanics (i.e., those with high Spanish and high English acculturation) reported comparably high rates of sunbathing and indoor tanning. Results suggested that bicultural Hispanics seek shade and wear sun protective clothing less often than Spanish acculturated Hispanics but more often than English acculturated Hispanics. Acculturation was not associated with sunscreen use. Conclusions Hispanic adults do not routinely engage in behaviors that reduce their risk of skin cancer. Bicultural and English acculturated Hispanics are particularly in need of skin cancer prevention interventions.

Prevalence and Clinical Characteristics of Nonmelanoma Skin Cancers Among Hispanic and Asian Patients Compared With White Patients in the United States

“…As SCC-IS/Bowen is a superficial form of SCC tumors, this finding may indicate that early diagnoses of skin cancer in Hispanics and Asians are becoming more frequent, possibly because of increasing awareness of skin cancer and education on skin cancer prevention techniques. 12,25 Thus, the clinical and prognostic characteristics of this particular subtype should be an important consideration in the treatment and management of SCC.…”

“…As new generations of children from minority groups are raised in the United States, a larger proportion of these populations become assimilated to American culture and consequently, adopt the risky sun exposure behaviors traditionally seen more commonly in whites. 12 In a study of sun protection behavior in Hispanics living in the Southern and Western United States, Coups and colleagues 12 compared the habits of individuals who primarily spoke English and those who spoke only Spanish. Those who mainly used English, and thus considered more assimilated, were less likely to seek shade and wear protective clothing.…”

“…Furthermore, they were more likely to engage in risky behaviors such as sunbathing and indoor tanning. 12 In a survey of Asian-Americans living in northern California, Gorell and colleagues 13 found that individuals raised in Asia were more likely to desire lighter skin, whereas more "westernized" second-generation Asians believed that tanned skin is attractive, spent significantly more time in the sun and had greater tanning bed use. From these studies, it seems likely that adoption of sun exposure attitudes commonly seen in the American society may contribute to increasing skin cancer rates in these minorities.…”

Psychosocial correlates of sun protection behaviors among U.S. Hispanic adults

“…Many Hispanics do not engage in these behaviors on a routine basis (Coups et al, 2012; Coups et al, 2013a; Weiss et al, 2012). For example, in a recent study of 788 Hispanic adults residing in the southern and western United States, routine engagement (i.e., “most of the time” or “always” when outside on a sunny day) in sun protection behaviors was as follows: using sunscreen, 30.9%; shade seeking, 53.2%; and wearing sun protective clothing, 24.4% (Coups et al, 2013a). Data from several studies indicate that a number of sociodemographic factors are associated with Hispanic individuals’ engagement in sun protection behaviors (Andreeva et al, 2009; Coups et al, 2012; Coups et al, 2013a).…”

“…For example, in a recent study of 788 Hispanic adults residing in the southern and western United States, routine engagement (i.e., “most of the time” or “always” when outside on a sunny day) in sun protection behaviors was as follows: using sunscreen, 30.9%; shade seeking, 53.2%; and wearing sun protective clothing, 24.4% (Coups et al, 2013a). Data from several studies indicate that a number of sociodemographic factors are associated with Hispanic individuals’ engagement in sun protection behaviors (Andreeva et al, 2009; Coups et al, 2012; Coups et al, 2013a). For example, Hispanic women are more likely than Hispanic men to use sunscreen and stay in the shade, but women are less likely to use sun protective clothing than men.…”