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

Abstract

Purpose: 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. Methods: 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. Results: 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. Conclusion: 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.

The synergistic health impacts of exposure to multiple stressors in Tulare County, California

“…The US Census Bureau defines linguistic isolation as households that lack at least one person, aged 14 or older, who is proficient in English [23]. Zhang et al found significant associations between linguistic isolation and higher mortality among older Mexican American [24]. This association is consistent with previous studies linking language barriers with poor health services and unequal access to healthcare [25].…”

Linguistic isolation correlates with length of stay and mortality for pediatric oncology patients in California

“…Programs and initiatives that decrease linguistic isolation and mitigate the potential harms include enhanced access to interpreter services, coupled with initiatives to improve health literacy and outreach programs. These programs have been shown to improve healthcare access and outcomes for vulnerable populations 31,32 . While the use of medical interpreters has shown promise in mitigating disparities and has been federally mandated, according to the Title VI of the Civil Rights Act and Executive Order 13166 issued in 2000, 33 it is crucial to address potential barriers, such as access, 34,35 and reimbursement from third‐party payers 36 .…”

“…26,29,30 Pediatric oncology outcomes have steadily improved over time thanks to a protocolized approach and ongoing clinical research. 31 Hospitals should continue efforts aimed at improving healthcare access for non-Englishspeaking families to address the concerns related to linguistic isolation. Programs and initiatives that decrease linguistic isolation and mitigate the potential harms include enhanced access to interpreter services, coupled with initiatives to improve health literacy and outreach programs.…”

“…These programs have been shown to improve healthcare access and outcomes for vulnerable populations. 31,32 While the use of medical interpreters has shown promise in mitigating disparities and has been federally mandated, according to the Title VI of the Civil Rights Act and Executive Order 13166 issued in 2000, 33 it is crucial to address potential barriers, such as access, 34,35 and reimbursement from third-party payers. 36 Additionally, culturally sensitive approaches are essential, as cultural beliefs and perceptions about cancer may influence communication and understanding of prognosis.…”

Toward Language Justice in Environmental Health Sciences in the United States: A Case for Spanish as a Language of Science

“…7 In many parts of the United States, marginalized communities have experienced disproportionately high exposure to numerous environmental hazards. 8 – 12 Residing in neighborhoods with a high proportion of linguistically isolated households has been associated with higher mortality 13 and more depressive symptoms. 14 Despite the widespread use of Spanish in frontline communities and scientific institutions in the United States, there has been limited investment in Spanish-language science communication in the environmental health sciences.…”