title: Maryland environmental public health tracking outreach with Spanish-speaking persons living in Baltimore city or county.
abstract: BACKGROUND
  The 2000 Pew reports became the impetus for the National Environmental Public Health Tracking (EPHT) Program, but there was no mention that Spanish-speaking persons are at increased risk of exposure to environmental hazards.
  
  
  OBJECTIVE
  To undertake successful EPHT outreach on Spanish-speaking persons (Hispanics), it is necessary to better understand their environmental health profile and barriers to health care access.
  
  
  METHODS
  Behavioral Risk Factor Surveillance System (BRFSS) survey questions were administered orally in Spanish to Spanish-speaking study participants.
  
  
  METHODS
  Volunteers were tested at a non-for-profit social service and referral agency in Baltimore.
  
  
  METHODS
  To control for acculturation, only Spanish-speaking persons who had lived in the United States for less than 10 years were selected.
  
  
  METHODS
  Responses to 40 BRFSS survey questions asked during the assessment and completion of 3 intervention activities.
  
  
  RESULTS
  This study provides new information about Spanish-speaking persons, most of whom (85.3%) would not have been included in the landline administration of the BRFSS survey. Although 29.9% of the participants reported indoor pesticide use and another 9.2% reported outdoor pesticide use, lifetime (3.5%) and current (1.2%) asthma prevalence was significantly lower than asthma prevalence reported by Maryland Hispanics and all Maryland residents. There were significantly lower cholesterol screening (21.5%) and a significantly higher prevalence of diabetes (12.5%) in Spanish-speaking participants than in Maryland Hispanics and all Maryland residents. Among study participants, only 7.8% had health insurance and 39.9% reported that they could not see a doctor. Of the 3 outreach efforts completed, the most promising one involved asking Spanish-English-speaking health care professionals to distribute Spanish comic books about pesticides exposures and health outcomes in community settings where Spanish-only speakers and children were found.
  
  
  CONCLUSIONS
  The effectiveness of passive and community-based EPHT interventions directed toward Spanish-only speakers has to be evaluated.
authors.affiliation: Environmental Health Bureau, Maryland Department of Health and Mental Hygiene, Baltimore (Drs Braggio and Mitchell); and Spanish-speaking Health Leaders of Maryland, Baltimore (Drs Braggio and Fierro-Luperini).
authors.forename: John T
authors.initials: JT
authors.lastname: Braggio
authors.forename: Clifford S
authors.initials: CS
authors.lastname: Mitchell
authors.forename: Sonia
authors.initials: S
authors.lastname: Fierro-Luperini
mesh_terms: D015142:Baltimore; D040343:Behavioral Risk Factor Surveillance System; D003144:Communication Barriers; D003159:Community-Institutional Relations / Q000639:trends*; D004782:Environmental Health / Q000379:methods*; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D011634:Public Health / Q000379:methods* / Q000592:standards