Maryland Environmental Public Health Tracking Outreach With Spanish-Speaking Persons Living in Baltimore City or County

Context: 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. Design: Behavioral Risk Factor Surveillance System (BRFSS) survey questions were administered orally in Spanish to Spanish-speaking study participants. Setting: Volunteers were tested at a non-for-profit social service and referral agency in Baltimore. Participants: To control for acculturation, only Spanish-speaking persons who had lived in the United States for less than 10 years were selected. Main Outcome Measures: 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.