Examining the Impact of Language Barriers, Ethnicity on Asthma Outcomes

How ethnic and language barriers in respiratory care affect Hispanic patients were presented at the American Academy of Allergy, Asthma & Immunology conference, with results showing the need for improved asthma care.

How language barriers affect Spanish-speaking patients in the United States

What is the impact of language on asthma outcomes when a patient’s first language is not English? Researchers at the University of Texas Medical Branch and Oklahoma State University Center for Health Sciences reported updated clinical outcomes of Hispanic Spanish speakers in the United States.¹

Data for the cross-sectional analysis of Hispanic patients aged 18 years and older with asthma came from a survey in 2018 and 2019. Primary language was determined by the language in which the survey was conducted, and researchers adjusted for age, sex, income, education, and health insurance status to determine the odds ratio (OR) and adjusted odds ratio (AOR), respectively.

Most of the participants were female and low income, with a mean age of 44 years.

Of a total of 1847 patients, Hispanic Spanish speakers were more likely to have an emergency asthma-related visit in the past 12 months (OR, 1.78; 95% CI, 1.02-3.1), sleep disturbances (OR, 2.07; 95% CI, 1.11-3.87), and to have missed work due to their symptoms (AOR, 1.89; 95% CI, 1.1-3.24), compared with White patients.

Although there was no difference between the 2 groups when it came to the likelihood of having been prescribed asthma medications or having an asthma action plan, researchers said the results still call for improved interpreter services.

Asthma mortality by place of death

It is already known that asthma places a heavier mortality burden on non-Hispanic Black individuals and residents of Puerto Rico compared with White individuals. Researchers from the University of Puerto Rico analyzed National Center for Health Statistics data that sought to examine the differences in place of death stratified by hospital or non-hospital settings.² Adjusted logistic regression models for hospital asthma deaths were conducted to determine links between races/ethnicities and place of death.

Results showed that Black, Puerto Rican, and older-aged individuals have a higher risk of dying from asthma comorbidities across hospital and non-hospital settings. A total of 27,458 asthma-related deaths were reported from 2011 to 2018, in which 51.9% were in hospitals.

Puerto Rican individuals had the highest age-standardized asthma death rates at non-hospital settings (ASR, 9.99; 95% CI, 9.05-11.00), while Black individuals had the highest age-standardized asthma death rates at hospitals (ASR ,12.70; 95% CI, 12.36-13.06).

Additionally, Puerto Rican females (aged 65 or more) showed 37% higher odds of hospital asthma death (adjusted odds ratio, 51.37; 95% CI, 0.97-1.93) than non-Hispanic White individuals.

Non-Hispanic White individuals had the lowest rates of death from asthma both in and out of the hospital.

The findings illustrate the need for “access to high-quality acute asthma care,” the researchers said.

References

1. Greiner B, Cronin K, Salazar L, et al. Asthma related disparities in emergency department usage and clinical outcomes among Spanish speakers. Abstract presented at: American Academy of Allergy, Asthma & Immunology; February 25, 2023. San Antonio, Texas. Session 235.

2. Serrano-Santiago S, Gonzalez-Sepulveda L, Telon-Sosa B, et al. Disparities in asthma place of death among races and ethnicities in the United States and Puerto Rico. Abstract presented at: American Academy of Allergy, Asthma & Immunology; February 25, 2023. San Antonio, Texas. Session 221.