Effect of language on heart attack and stroke awareness among U.S. Hispanics.
BACKGROUND
Hispanics with acute heart attack or stroke have longer delay times to hospital arrival, and are thus less likely to benefit from time-dependent reperfusion therapies. Delay time is influenced largely by recognition of warning symptoms and activation of the 911 system. Previous studies suggest poor symptom recognition among racial/ethnic minorities, but very little is known about heart attack and stroke knowledge among Hispanics, or the influence of English language proficiency on cardiovascular emergency awareness.


METHODS
Cross-sectional analysis (conducted in 2005) of data from the 2003 Behavioral Risk Factor Surveillance System population survey was limited to states with Spanish-language interviews. Principal study outcomes were the correct identification of five heart attack and five stroke warning symptoms, and intention to call 911 for a suspected event. Subjects included 698 English-speaking Hispanics, 527 Spanish-speaking Hispanics, and 24,201 non-Hispanics.


RESULTS
Spanish-speaking Hispanics are far less likely to know all heart attack symptoms (7%) than English-speaking Hispanics (23%), non-Hispanic blacks (28%), and non-Hispanic whites (39%) (p<0.001); and far less likely to know all stroke symptoms (18%) than English-speaking Hispanics (31%), non-Hispanic blacks (41%), and non-Hispanic whites (50%) (p<0.001). Intention to call 911 did not differ significantly among groups. Spanish-speaking Hispanics remain significantly less likely than all other groups to correctly identify symptoms after adjustment for sociodemographic characteristics, healthcare access, and cardiovascular risk factors (p<0.05).


CONCLUSIONS
Lack of English proficiency is strongly associated with lack of heart attack and stroke knowledge among Hispanics. This highlights the need for educational intervention about cardiovascular emergencies targeted to Spanish-speaking communities.
University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. annettedubard@hotmail.com
C Annette
CA
DuBard
Joanne
J
Garrett
Ziya
Z
Gizlice
D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D004522:Educational Status; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006630:Hispanic or Latino / Q000193:education / Q000523:psychology*; D006801:Humans; D007802:Language; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology; D012959:Socioeconomic Factors; D020521:Stroke / Q000175:diagnosis / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology