title: Primary language and receipt of recommended health care among Hispanics in the United States.
abstract: BACKGROUND
  Disparities in health care services between Hispanics and whites in the United States are well documented.
  
  
  OBJECTIVE
  The objective of the study was to determine whether language spoken at home identifies Hispanics at risk for not receiving recommended health care services.
  
  
  METHODS
  The design of the study was cross-sectional, nationally representative survey of households.
  
  
  METHODS
  The patients were non-Hispanic white and Hispanic adults participating in the 2003 Medical Expenditure Panel Survey.
  
  
  METHODS
  We compared receipt of ten recommended health care services by ethnicity and primary language adjusting for demographic and socioeconomic characteristics, health status, and access to care.
  
  
  RESULTS
  The sample included 12,706 whites and 5,500 Hispanics. In bivariate comparisons, 57.0% of whites received all eligible health care services compared to 53.6% for Hispanics who spoke English at home, 44.9% for Hispanics who did not speak English at home but who were comfortable speaking English, and 35.0% for Hispanics who did not speak English at home and were uncomfortable speaking English (p < .001). In multivariate logistic models, compared to non-Hispanic whites, Hispanics who did not speak English at home were less likely to receive all eligible health care services, whether they were comfortable speaking English (risk ratio [RR] 0.88, 95% confidence interval [CI] 0.74-0.97) or not (RR 0.84, 95% CI 0.68-0.95).
  
  
  CONCLUSIONS
  Speaking a language other than English at home identified Hispanics at risk for not receiving recommended health care services, whether they were comfortable in speaking English or not. Identifying the mechanism for disparities by language usage may lead to interventions to reduce ethnic disparities.
authors.affiliation: Department of Neurology, VA Greater Los Angeles, Los Angeles, CA, USA. eric.cheng@va.gov
authors.forename: Eric M
authors.initials: EM
authors.lastname: Cheng
authors.forename: Alex
authors.initials: A
authors.lastname: Chen
authors.forename: William
authors.initials: W
authors.lastname: Cunningham
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control; D005260:Female; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data; D007802:Language; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000175:diagnosis; D011314:Preventive Health Services / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data