Abstract
We analyzed the interrelationships of economic stressors, mental health problems, substance use, and intimate partner violence (IPV) among a sample of Hispanic emergency department patients and probed if Spanish language preference, which may represent low acculturation and/or immigrant status, had a protective effect, in accordance with the Hispanic health paradox. Study participants (n = 520; 50% female; 71% Spanish speakers) provided cross-sectional survey data. Gender-stratified logistic regression models were estimated for mental health problems (PTSD, anxiety, depression), substance use (risky drinking, cannabis, illicit drug use), and IPV. Results showed that economic stressors were linked with mental health problems among men and women. Among men, PTSD was associated with greater odds of cannabis and illicit drug use. Men who used cannabis and illicit drugs were more likely to report IPV. Male Spanish speakers had lower odds of anxiety and cannabis use than English speakers. Female Spanish speakers had lower odds of substance use and IPV than English speakers. The protective effect of Spanish language preference on some mental health, substance use, and IPV outcomes was more pronounced among women. Future research should identify the mechanisms that underlie the protective effect of Spanish language preference and explore factors that contribute to the observed gender differences.
Highlights
Hispanics constitute the largest ethnic minority group within the U.S, with 60.6 million individuals, representing 18.5% of the U.S population [1]
Male Spanish speakers had lower odds of anxiety compared to English speakers (AOR = 0.42; 95% CI 0.20, 0.90; p < 0.05)
None of the economic stressors were significantly associated with depression, nor were Spanish speakers less likely to have mental health problems than English speakers
Summary
Hispanics constitute the largest ethnic minority group within the U.S, with 60.6 million individuals, representing 18.5% of the U.S population [1]. The term Hispanic typically refers to individuals who have migrated to the U.S from Central and South American countries and Spain, or their ancestors if they have lived in the U.S for generations, and who identify as Hispanic and share a language, religion, and other cultural characteristics [2]. Mexicans account for the largest subgroup of Hispanics; other significant subpopulations include Cuban, Puerto Rican, Central American and Caribbean, and South American people [2]. Compared to non-Hispanic whites/Caucasians, Hispanics have poorer indicators of socioeconomic status (SES). The poverty rate in 2019 for Hispanics was 15.7%, more than double the rate for non-Hispanic whites/Caucasians (7.3%) [3]. During the second quarter of 2020 (the outset of the COVID-19 pandemic), unemployment rates among
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