Intra-Ethnic Disparities in Respiratory Health Problems Among Hispanic Residents Impacted by a Flood

Abstract

Objectives. The primary objective of this article is to assess the respiratory health impacts of a flood disaster on Hispanic people residing in the United States, with a focus on intra-ethnic disparities related to age, sex, socioeconomic status, mold exposure, family conflict, English-language proficiency, and a lack of US citizenship. Methods. Data were collected in 2010 after a flood disaster (2006) in El Paso County (Texas), which has a Hispanic majority population. A mail-out population-based survey was used retrospectively to assess respiratory health impacts for 363 people residing in 176 self-identified Hispanic households impacted by the flood; logistic regression was utilized to assess intra-ethnic health disparities in flood impacts. Results. About 41% of individuals experienced one or more post-flood respiratory health problem. Lower income (OR = 0.532,p = .002), mold exposure (OR = 2.267, p < .001), increased family conflict (OR = 1.452, p = .025), English-language proficiency (OR = 4.023, p < .001) and a lack of US citizenship (OR = 13.111, p = .013) were significantly associated with higher odds of respiratory health problems in the regression model. Conclusion. Statistical findings provide evidence of intra-ethnic disparities in post-flood respiratory health status. Specifically within this Hispanic sample, individuals with lower household incomes, whose homes were covered by larger surface areas of mold, and whose families were characterized by increased tension experienced higher odds of post-flood respiratory health problems. Interestingly, greater English-language proficiency and lacking US citizenship were also risk factors. Given that this is one of the first studies of intra-Hispanic disparities in health following a US-based disaster, the findings underscore the importance of considering diversity within the US Hispanic population when studying environmental and post-disaster respiratory health.

• disaster
• respiratory health
• language acculturation
• El Paso (TX)
• Hispanic health disparities

Notes

These characteristics are closely connected to Hispanic ethnicity in El Paso County. In 2006, Hispanics made up 99% of the county's total Spanish-speaking population that spoke English not well or at all (115,356/116,270), and 95% of the total non-US citizen population (114,363/120,812) (29).

All data from the survey were self-reported by heads-of-households.

An expert translated the survey from English into Spanish; then the survey was reviewed bymultiple bilingual English-Spanish graduate students, and revised to ensure clarity and comparability.

The mold exposure variable was based on Riggs and colleagues' study of mold growth in flood-damaged homes following Hurricane Katrina (35). Similar measures requiring respondents to recall the extent of the physical damages of disasters have been used in prior disaster health impacts research [see 1, 16, 36, 37].

The family conflict variable is based on self-reported measures that have been long employed in survey-based disaster health impacts studies (2, 19, 22)

We used SPSS version 19 (“IBM SPSS Statistics 19” with the “IBM SPSS Missing Values” add-on module) for our analysis.