Limited English Proficiency Is a Barrier to Receipt of Advice about Physical Activity and Diet among Hispanics with Chronic Diseases in the United States

Abstract

The prevalence of obesity, diabetes, and cardiovascular disease is reaching epidemic proportions among Hispanics in the United States. Health care providers play an important role in motivating patients to make healthful lifestyle changes to reduce the burden of such conditions. Data from the US 2000 National Health Interview Survey was analyzed to determine differences in report of physician-provided physical activity and/or dietary advice by level of English proficiency among obese Hispanics or those who reported having diabetes or cardiovascular disease and who contacted a physician during the past year (n=1,186). Only one third of the sample reported receiving advice to increase their physical activity or to improve their dietary habits; one fifth reported receipt of advice about both. English-proficient Hispanics were about 50% more likely to report receiving advice on physical activity (adjusted odd ratio [AOR]=1.5; 95% confidence interval [CI]: 1.1 to 2.1), diet (AOR=1.5; 95% CI: 1.1 to 2.2) or both (AOR=1.6; 95% CI: 1.1 to 2.3), as compared with limited English-proficient Hispanics, after controlling for health insurance coverage and number of visits to a physician during the last year. Sex, age, region of residence, level of education, annual family income, and smoking status were not significantly associated with receiving physical activity and/or dietary advice. In order to address racial health disparities, and lower the burden of chronic illness, culturally sensitive strategies must be implemented to enhance delivery of effective health-promotion messages by physicians, particularly among at-risk communities.

Gender Differences in Diabetes Self-Management: A Mixed-Methods Analysis of a Mobile Health Intervention for Inner-City Latino Patients

“…3 Many obstacles contribute to this disparity, including socioeconomic status, access to care, and language barriers. [4][5][6][7][8][9] To reach Latinos and other underserved groups, innovative interventions must be designed; mobile health may be just that solution.…”

Effectiveness of Salsa, Sabor y Salud Program and the Impact of a Salsa, Sabor y Salud Maintenance Program on Outcome Measures

“…Chronic diseases in the USA occur at disproportionately higher rates in the Hispanic population (Lopez-Quintero, Berry, & Neumark, 2009). There are numerous Hispanic immigrants who come to the USA with healthy diets and levels of high physical activity, but there is evidence that through acculturation there is a negative impact on their nutrition and exercise (Ayala, Baquero, & Klinger, 2008).…”

“…There are numerous Hispanic immigrants who come to the USA with healthy diets and levels of high physical activity, but there is evidence that through acculturation there is a negative impact on their nutrition and exercise (Ayala, Baquero, & Klinger, 2008). Health care providers have had difficulty conveying the importance of nutrition and physical activity to the Hispanic population (Lopez-Quintero et al, 2009). Researchers have found that if the health information is presented to Hispanic participants in a culturally sensitive manner they will have a higher success rate in their health programs, such as diabetes education programs (Brown, Kouzekanani, Garcia, & Hanis, 2002;Gilmer, Philis-Tsimikas, & Walker, 2005;Gordon, 2004).…”

Factors Correlated to Protective and Risk Dietary Patterns in Immigrant Latino Mothers in Non-metropolitan Rural Communities

“…This approach aligns with the resilience perspective in which English language proficiency is considered an asset. Previous studies document greater access to nutritional advice and resources for English-proficient immigrants compared to non-proficient whereas Spanish preference has been previously correlated with reduced access and use of preventive healthcare services, including nutritional advice [35,36]. Contrary to the second hypothesis, the risk factor household food insecurity was negatively associated with harmful dietary patterns.…”