Limited English Speaking Ability Research Articles

Epidemiology of COVID-19 vs. influenza: Differential failure of COVID-19 mitigation among Hispanics, Cook County Health, Illinois.

During the early phases of the COVID-19 pandemic in the U.S., African-American or Hispanic communities were disproportionately impacted. To better understand the epidemiology and relative effects of COVID-19 among hospitalized Hispanic patients, we compared individual and census-tract level characteristics of patients diagnosed with COVID-19 to those diagnosed with influenza, another viral infection with respiratory transmission. We evaluated temporal changes in epidemiology related to a shelter-in-place mandate. We evaluated patients hospitalized at Cook County Health, the safety-net health system for the Chicago metropolitan area. Among self-identified hospitalized Hispanic patients, we compared those with influenza (2019-2020 season) to COVID-19 infection during March 16, 2020-May 11, 2020. We used multivariable analysis to identify differences in individual and census-tract level characteristics between the two groups. Relative to non-Hispanic blacks and whites, COVID-19 rapidly increased among Hispanics during promotion of social-distancing policies. Whereas non-Hispanic blacks were more likely to be hospitalized for influenza, Hispanic patients predominated among COVID-19 infections (40% relative increase compared to influenza). In the comparative analysis of influenza and COVID-19, Hispanic patients with COVID-19 were more likely to reside in census tracts with higher proportions of residents with the following characteristics: Hispanic; no high school diploma; non-US citizen; limited English speaking ability; employed in manufacturing or construction; and overcrowding. By multivariable analysis, Hispanic patients hospitalized with COVID-19 compared to those with influenza were more likely to be male (adjusted OR = 1.8; 95% CI 1.1 to 2.9), obese (aOR = 2.5; 95% CI 1.5 to 4.2), or reside in a census tract with ≥40% of residents without a high-school diploma (aOR = 2.5; 95% CI 1.3 to 4.8). The rapid and disproportionate increase in COVID-19 hospitalizations among Hispanics after the shelter-in-place mandate indicates that public health strategies were inadequate in protecting this population-in particular, for those residing in neighborhoods with lower levels of educational attainment.

Econometric search of undocumented workers in the USA

This study seeks to find where undocumented workers reside in the USA. By postulating that the US destination of an undocumented worker is affected by socio-economic factors, an equation is estimated using the standard panel-data methods. A static panel-data estimation (fixed-effects and random effects) does not reveal a meaningful relation between undocumented workers and other factors. The Arellano-Bond estimation, in which the previous level of undocumented workers are used as a proxy for a network, provides statistically significant relations at the 0.05 level; the number of undocumented workers in a state is determined by the state's socio-economic factors such as economic conditions (e.g., unemployment rate and household income) and social factors necessary to form a network (e.g., foreign-born population, Hispanic population, urban population, the number of households having limited English-speaking ability and the previous level of undocumented workers). Among these factors, the previous level of undocumented workers has the largest impact on the current level of undocumented workers.

Heatwave-health vulnerability in Adelaide: Analysis of mortality and morbidity outcomes

Background: Heatwaves are of increasing concern due to its impacts on population health (mortality/morbidity). As heatwave-impacts varies between populations and locations, evidence concerning the places and people vulnerable at a local level is critical for effective policy, planning, and interventions, especially in a warming climate. This study part of a larger national research aimed to investigate heatwave-associated mortality and morbidity (using general practitioner-GP visits) in Adelaide and identify the drivers of heatwave-vulnerability. Methods: Data on mortality (2007-2017), GP visits (2011-2016), heatwaves (Excess Heat Factor-EHF), and vulnerability factors (socio-demographic, health-risk, and environmental) were obtained from the Australian Bureau of Statistics, Bureau of Meteorology, and Geoscience Australia. Heatwave effects on mortality and morbidity outcomes at the Statistical Area Level 2 (SA2) geography (representing suburbs) were estimated using a case-crossover design. Results are reported as relative risks (RRs) in heatwaves periods compared with non-heatwave periods. Effect modification by individual- and area-level factors were also assessed. Results: Mortality increased during heatwaves (RR 1.08; 95%CI: 1.04-1.12) but varied spatially. Higher RRs were found in areas with a greater proportion of renters, inaccessibilities (access to vehicle/internet), less vegetation, newer houses, and prevalence of respiratory and psychological diseases. Risks were elevated among individuals with limited English-speaking ability, diabetes, asthma/chronic obstructive pulmonary diseases and those using antidepressants, anxiolytics and sedative medications. Preliminary analysis of GP visits with EHF reveals a significant decrease in GP visits (RR 0.98; 95%CI:0.98-0.99) during low-intensity heatwaves, which increased during severe/extreme heatwaves (RR 1.14; 95%CI: 1.13-1.15). Analysis of the individual- and area-level drivers of heatwave-related GP visits is ongoing. Conclusions: Our results, leveraging a substantive person and area-level dataset, show that heatwaves increase mortality and place a greater burden on primary care services (GPs) in Adelaide. Attention to the spectrum of identified heatwave-vulnerability drivers is key for developing effective and efficient prevention strategies.

Racialized Structural Vulnerability: Neighborhood Racial Composition, Concentrated Disadvantage, and Fine Particulate Matter in California.

This study contributes to previous research by advancing a “racialized structural vulnerability” framework and presenting a new empirical analysis of the relationship between neighborhood Asian, Black, and Latinx composition; extrinsic and intrinsic vulnerability; and PM2.5 exposures in California with secondary data from 2004–2014. Principal component analyses revealed that tract Latinx composition was highly correlated with extrinsic vulnerability (economic disadvantage and limited English-speaking ability), and that tract Black composition was highly correlated with intrinsic vulnerability (elevated prevalence of asthma-related emergency department visits and low birth weight). Spatial lag regression models tested hypotheses regarding the association between Asian, Black, and Latinx population vulnerability factors and the 2009–2011 annual average PM2.5 percentile rankings, net of emissions and spatial covariates. Results indicated that the percent Latinx population, followed by the regional clustering of PM2.5, and the percent of non-Latinx Black and non-Latinx Asian population were the strongest positive multivariable correlates of PM2.5 percentile rankings, net of other factors. Additional analyses suggested that despite shifting demographic and spatial correlates of 2012–2014 PM2.5 exposures, the tracts’ Black and Latinx composition and location in the San Joaquin Valley remain important vulnerability factors with implications for future research and policy.

Retooling CalEnviroScreen: Cumulative Pollution Burden and Race-Based Environmental Health Vulnerabilities in California.

The California Community Environmental Health Screening Tool (CalEnviroScreen) advances research and policy pertaining to environmental health vulnerability. However, CalEnviroScreen departs from its historical foundations and comparable screening tools by no longer considering racial status as an indicator of environmental health vulnerability and predictor of cumulative pollution burden. This study used conceptual frameworks and analytical techniques from environmental health and inequality literature to address the limitations of CalEnviroScreen, especially its inattention to race-based environmental health vulnerabilities. It developed an adjusted measure of cumulative pollution burden from the CalEnviroScreen 2.0 data that facilitates multivariate analyses of the effect of neighborhood racial composition on cumulative pollution burden, net of other indicators of population vulnerability, traffic density, industrial zoning, and local and regional clustering of pollution burden. Principal component analyses produced three new measures of population vulnerability, including Latina/o cumulative disadvantage that represents the spatial concentration of Latinas/os, economic disadvantage, limited English-speaking ability, and health vulnerability. Spatial error regression analyses demonstrated that concentrations of Latinas/os, followed by Latina/o cumulative disadvantage, are the strongest demographic determinants of adjusted cumulative pollution burden. Findings have implications for research and policy pertaining to cumulative impacts and race-based environmental health vulnerabilities within and beyond California.

Supporting an ethnic minority woman's choice for pain relief in labour: A reflection

Despite professional expectations for midwives to provide care to women that is founded in equality and recognises diversity ( Nursing and Midwifery Council, 2015 ), women from ethnic minority populations consistently suggest that they are not heard ( Briscoe and Lavender, 2009 ; Tobin et al, 2014 ). This article reflects on a situation where a Portuguese woman with limited English-speaking ability was denied access to epidural anaesthesia as the midwife felt that the woman could not give valid consent to the procedure without the presence of an interpreter. The midwife's role in this situation is reflected on, and implications for midwifery practice identified.

Experiences of Korean-American Women with High Risk Hereditary Breast Cancer

Purpose: This micro-ethnographic study aimed to understand coping experiences of Korean-American (K-A) women after diagnosis with breast cancer due to a hereditary gene mutation. Methods: Participatory observation and in-depth interviews were performed at one breast cancer screening center in Southern California, in 2005 with eleven first generation K-A immigrant women. All transcribed interviews and field notes were analyzed using ethnographic methodology. Results: K-A women’s experience varied based on acculturation risk factors including: limited English speaking ability; disrupted family relationships, individualistic family values, or intergenerational communication barriers; lack of Korean speaking nurses; and Korean physicians’ who lacked knowledge about hereditary breast cancer risk. These risk factors led to isolation, loneliness, lack of emotional and social support. In comparison to Korean homeland women in a similar medical situation, these K-A immigrants felt disconnected from the healthcare system, family support and social resources which increased their struggling and impeded coping during their survivorship journey. These women were not able to access self-support groups, nor the valuable resources of nurse navigator programs. Conclusion: Professional oncology associations for nurses and physicians have a moral obligation to support and promote knowledge of hereditary cancer risk and self-help groups for non-native speaking immigrants.

Intimate Partner Violence Perpetration, Immigration Status, and Disparities in a Community Health Center-Based Sample of Men

We examined disparities in male perpetration of intimate partner violence (IPV) based on immigration status. From 2005 to 2006, 1,668 men aged 18-35 who were recruited from community health centers anonymously completed an automated, computer-assisted self-interview. Men self-reported their immigrant status (e.g., native-born, <6 years in the U.S. [recent immigrants], or > or = 6 years in the U.S. [non-recent immigrants]) and IPV perpetration. We calculated differences in IPV perpetration based on immigrant status. Among immigrant men, we further examined differences in IPV perpetration based on English-speaking ability. Recent immigrants were less likely to report IPV perpetration than native-born men in the overall sample (adjusted odds ratio [AOR] = 0.60, 95% confidence interval [CI] 0.36, 1.00). However, we observed no differences in IPV perpetration between non-recent immigrants and native-born men (AOR=0.88, 95% CI 0.63, 1.23). Among immigrant men, those who were non-recent immigrants and reported limited English-speaking ability were at the highest risk for IPV perpetration, compared with recent immigrants with high English-speaking ability (AOR=7.48, 95% CI 1.92, 29.08). Although immigrant men were at a lower risk as a group for IPV perpetration as compared with non-immigrants, this lower likelihood of IPV perpetration was only evident among recent immigrants. Among immigrant men, those who arrived in the U.S. more than six years ago and reported speaking English relatively poorly appeared to be at greatest risk for using violence against partners. Future research should examine the effects of fear of legal sanctions, discrimination, and changes in gender roles to clarify the present findings.

The complexities of measuring access to parks and physical activity sites in New York City: a quantitative and qualitative approach

BackgroundProximity to parks and physical activity sites has been linked to an increase in active behaviors, and positive impacts on health outcomes such as lower rates of cardiovascular disease, diabetes, and obesity. Since populations with a low socio-economic status as well as racial and ethnic minorities tend to experience worse health outcomes in the USA, access to parks and physical activity sites may be an environmental justice issue. Geographic Information systems were used to conduct quantitative and qualitative analyses of park accessibility in New York City, which included kernel density estimation, ordinary least squares (global) regression, geographically weighted (local) regression, and longitudinal case studies, consisting of field work and archival research. Accessibility was measured by both density of park acreage and density of physical activity sites. Independent variables included percent non-Hispanic black, percent Hispanic, percent below poverty, percent of adults without high school diploma, percent with limited English-speaking ability, and population density.ResultsThe ordinary least squares linear regression found weak relationships in both the park acreage density and the physical activity site density models (Ra2 = .11 and .23, respectively; AIC = 7162 and 3529, respectively). Geographically weighted regression, however, suggested spatial non-stationarity in both models, indicating disparities in accessibility that vary over space with respect to magnitude and directionality of the relationships (AIC = 2014 and -1241, respectively). The qualitative analysis supported the findings of the local regression, confirming that although there is a geographically inequitable distribution of park space and physical activity sites, it is not globally predicted by race, ethnicity, or socio-economic status.ConclusionThe combination of quantitative and qualitative analyses demonstrated the complexity of the issues around racial and ethnic disparities in park access. They revealed trends that may not have been otherwise detectable, such as the spatially inconsistent relationship between physical activity site density and socio-demographics. In order to establish a more stable global model, a number of additional factors, variables, and methods might be used to quantify park accessibility, such as network analysis of proximity, perception of accessibility and usability, and additional park quality characteristics. Accurate measurement of park accessibility can therefore be important in showing the links between opportunities for active behavior and beneficial health outcomes.

Enhancing Communication in Dental Clinics with Linguistically Different Patients

The United States is becoming substantially more diverse in its citizenry, with numerous racial and ethnic cultural groups and immigrants living and working in this country. In addition, there has been an increase in the number of languages other than English spoken in homes, as well as an increase in the number of individuals with limited English-speaking abilities. Given the emerging racial, ethnic, and cultural trends in U.S. society, it is important that dental students as future practitioners have knowledge of interpreter services, working with professionally trained interpreters, and the legal responsibilities and requirements of interpretation. The purposes of this study were to 1) describe the role of interpreters in dental health care settings; 2) identify challenges they face; and 3) propose approaches and strategies to improve communication between dental students as future practitioners and non-English-speaking patients. Data were collected through a series of individual in-depth, face-to-face interviews using a semi-structured open-question format and email communications with three key informants who were purposefully selected to participate in this study based on their comprehensive knowledge and experience as interpreters. The qualitative analysis revealed themes or stories related to the following areas of this study: 1) the role of professional interpreters in dental and other health care settings; 2) challenges faced by interpreters and providers working with patients with limited English-speaking ability; and 3) strategies and approaches used to improve communication and address challenges. By understanding the unique interpreting needs of non- or limited English-speaking patients, dental students have an opportunity to broaden their cultural competency skills. Dental schools have an obligation to ensure that students, faculty, and staff know and understand the legal rights of patients and health care providers to communicate effectively when using an interpreter, although having a professionally trained interpreter working in a facility does not end the cultural learning processes needed in a multicultural society.

アメリカのバイリンガル教育法における言語観

The first federal legislation for bilingual education in the United States was the Bilingual Education Act of 1968, which was passed by Congress under Title VII of the Elementary and Secondary Education Act. The 1968 Bilingual Education Act represented the first national acknowledgment of special educational needs of children of limited English proficiency. This Act was reauthorized in 1974, 1978, 1984, 1988 and 1994.This paper traces the historical development of language policy of the Bilingual Education Act. Teaching English and teaching the native language for minority language children have been the main theme of this Act. But the estimate and the meaning of teaching these two languages have changed from the 1968 Act to the 1994 Act.The Bilingual Educatin Act of 1968 provided funds for bilingual education programs, but it didn't specify ‘bilingual’ education.The 1974 amendments defined a ‘program of bilingual education’. The definition provided that ‘there is instruction given in, and study of, English and, to the extent necessary to allow a child to progress effectively through the educational system, the native language of the children of limited English-speaking ability’. It also authorized ‘the voluntary enrollment to a limited degree’ of English-speaking children in bilingual education programs.The 1978 amendments clarified the definition of eligible children. The term ‘limited-English-proficient’ supplanted ‘limited-English-speaking’ in recognition of the importance of reading, writing, understanding and cognitive skills in addition to speaking. It also clarified the 1974 provision authorizing the voluntary enrollment ‘to a limited degree’ of English-speaking children by specifying that up to 40 percent of the students could be native-English speakers.Although federal bilingual education policy had proceeded along with the civil rights enforcement during 1970s, the Reagan Administration quickly moved to change federal education policy and to cut funding for the Bilingual Education Act.Both the 1984 amendments and the 1988 amendments clarified that the goal of all Bilingual Education Act programs was enabling LEP (limited English proficient) students ‘to achieve competence in the English language-and to meet grade-promotion and graduation standards’. Not only bilingual programs but also monolingual English programs for LEP students were authorized for grants. The three major instructional programs were TBE (transitional bilingual education), DBE (developmental bilingual education) and SAIP(special alternative instructional programs), that is, monolingual English programs.The 1994 amendments also authorized to fund both bilingual programs and monolingual English programs. The 25 percent allowance for SAIP, defined as those that do ‘not use the student's native language for instructional purposes’, has been retained. In awarding grants, it gave priority to applicants seeking to develop ‘bilingualproficiency both in English and another language for all participating students’. In addition, it is authorized to fund programs designed to conserve endangered Native American languages.Richard Ruiz, who specializes in the study of language policy, has proposed three ‘basic orientations’ toward language and its role in American society. That is language-as-problem, language-as-right and language-as-resource. Language policy of the Bilingual Educatuin Act can be considerded in the framework of these orientations. Language-as-problem seeks solutions to complications created by diversity. Language-as-right stresses principles of equality, self-determination and entitlement. Language-as-resource regards linguistic skills as a form of human capital to be conserved and developed in pursuit of national goals.

Health Practices of Korean Elderly People: National Health Promotion Priorities and Minority Community Needs

The official health promotion goals for the year 2000 in the United States include an emphasis on behavioral and contextual changes to increase the healthy lifespan of Americans. The goals also encompass reducing disparities in health status among different groups, and many of the specific goals address issues pertinent to older people. Limited data on the health status and health behaviors of older Asians and Pacific Islanders contributed to the absence of any goals for this group of elderly people. This article uses 1993 to 1994 data on 213 Korean and 201 non-Hispanic white people age 65 and over who lived in Los Angeles County to compare, by ethnicity and gender, health behaviors that may influence the health of older people. The older Koreans practiced a somewhat higher number of healthy behaviors overall, but smoking cessation for older Korean men and increased exercise for older Korean women were specific areas needing attention. Limited English-speaking ability and educational levels of the older Koreans make it imperative that health promotion activities for older Koreans use community-based organizations that can reach the older Koreans in an effective manner.

Vocational/VESL teacher collaboration: some substantive issues

In an increasing number of programs in the United States, in both secondary and postsecondary settings, vocational ESL (VESL) teachers address technical content-related language learning needs of their students of limited English speaking ability by forming working relationships with their vocational counterparts. In a study supported by the National Center for Research in Vocational Education, the author and her research team addressed questions related to the establishment of these relationships, and their impact on vocational instruction. The questions were investigated by means of teacher interviews and video- or audiotaped classroom observations. Most of the data were collected at six highly recommended vocational programs in the United States; the rest were collected at other sites prior or subsequent to the main study. Underlying the establishment of collaborative relationships that produce instructional improvement are issues pertaining to philosophical and professional orientation, attitudes, authority in the school, and integration of knowledge. The study's main unexpected finding was that the most effective vocational instruction came about not as a result of vocational/VESL teacher collaboration, but from the vocational teachers' participation in language-oriented staff development. Researchers observed teachers who had undergone staff development both by making sure students understood them, and by creating opportunities for the vocational students to speak with their teachers and peers in meaningful and sustained conversations. With such colleagues as these, VESL teachers might enter into truly productive working relationships. These, in turn, should foster greater language and conceptual growth for students of limited English-speaking ability. Such relationships can come about, however, only if a vision of good vocational education and good language instruction is shared. This paper highlights conceptual issues surrounding the formation of this vision.

Television Use by Melbourne's Greek Community

With multicultural television available, persons migrating from non-English-speaking countries have the opportunity to view programs which reflect their background. This study examines patterns of television use by Greek immigrants living in Melbourne. Average viewing recorded was 22 hours a week. The results also show that these people commonly watch the same top rating programs as other Australians, but also seek out Greek-language programming. This viewing is heavier among those with limited English-speaking ability, but is not restricted to them, suggesting that cultural maintenance is an important function for most immigrants.

Language Development in Normal and Language Handicapped Spanish-Speaking Children

The objective of this study was to compare and contrast language development in normal and language handicapped school-aged children who speak Spanish as a first language and who have been classified as being of limited English speaking ability The focus of this report will be on the differences and similarities found in the children's first language, Spanish. This investigation was conducted in three phases. First a battery of instruments, including measures of syntax and articulation, was administered to a group of 50 monolingual Spanish speakers aged 3 to 8 in Oaxaca, Mexico, to establish base-line data for the handicapped study In the second phase, a group of 22 language-delayed Spanish speakers was identified in the United States and administered the same instruments and procedures. In the third phase, comparisons were made to a control group of normal children in the United States, comparable in terms of age, sex, ethnicity, socioeconomic status, exposure to English, and language history All instruments in the second and third phases were also administered in English. Handicapped children performed significantly worse than comparable controls in the production of syntactic features though not in comprehension. Handicapped children also exhibited a significantly higher number of articulation errors.