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.
Highlights
Inadequate or poor English language proficiency is one of the social determinants of health in the United States that hinders residents from establishing and maintaining positive health outcomes and leads to health inequities.[1]
Our results showed that living in a neighborhood with more than 30% of linguistically isolated households predicted higher mortality, 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
A marginally significant hazard ratio (HR) was observed for living in a neighborhood with more than 30% of linguistically isolated households predicting a higher risk of death (HR = 1.14, 95% confidence interval [CI]: 0.98–1.32; Table 1)
Summary
Inadequate or poor English language proficiency is one of the social determinants of health in the United States that hinders residents from establishing and maintaining positive health outcomes and leads to health inequities.[1] It has been documented that limited-English proficient older adults had significantly worse outcomes in health status and access to health care than older adults who speak English only.[2]. (c) limited English of other adult household members.[3] It is known that limited English proficiency and increased language isolation are associated with adverse health outcomes.[4] For example, language isolation is found to be associated with an increased risk of depressive symptoms.[5] Language barrier is linked with an increased risk of delaying care, and forgoing preventive services such as pap tests, and resulting in overall worse health status.[2,6]
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