SPEAKING OF SALUD DISPARITIES IN THE HEALTH INFORMATION ENVIRONMENT AND EFFECTS ON LATINO HEALTH A. Susana Ramírez, PhD, MPH

2 Health information is everywhere

Unequal Information Access & Ability  Information environment disparities  Information seekers  Health literacy  Clinician-patient communication challenges

Information Deserts

Mapping Health Information Environment in Merced County 14 Newspapers 570 health related articles in 6 months 1 in 18 published stories 1 Bilingual Spanish/English

Top 6 Health Topics in Merced Co News CodeIllustrative Headlines Access to Care/Policy “New deadline looms for Valley Medi-Cal – Rush is to sign up by April 15” Nutrition & Diet “Legislature should put warning on sugary soda” Infectious Disease “West Nile virus detected in Stanislaus County” Preventive Health “Stay hydrated when working out in heat” Cancer “Baseball must snuff out the use of tobacco” Physical Activity “Assets boosts studies, exercise”

Discussion  Paucity of health information  Quality and substance issues  Intervention implications

Despite unequal information environments Latinos disproportionately trust and rely on media for health information People look for health information from the media

What do linguistic minorities want to know about health?

Seeking a Cita con el Dóctor  Radio call-in show  Host: Dr. Elmer Huerta  Research Questions  What health concerns do callers have?  Do health concerns vary by caller type?  Methods  Content Analysis  N=1283 calls

What do callers want to know?

Women and men had (mostly) the same health concerns.

Who are the proxy callers? (N=281) Callers Female70% Age, mean41 Subjects Female49% Relationship of caller to subject Child39% Parent/Older Adult11% Spouse/Sibling/Contemporary19%

Do callers on behalf of others have different concerns? χ 2 (9,N=1537)<0.0001, p<0.001

Discussion  Partnerships: Ethnic media + health communicators  Talk radio: Potentially valuable health promotion channel  Unique: Wide reach + personal  Low cost  Trustworthy

The moderating role of acculturation (it’s not just Spanish translation!) Communicating Health to U.S. Latinos

What does culturally-appropriate health communication mean in the context of acculturatively-diverse Latino population?

Testing the effectiveness of ethnically-tailored English-language messages 19 Funded by a pilot grant from the NCI Center for Excellence in Cancer Communication Research (CECCR) at the Annenberg School for Communication at the University of Pennsylvania (P20-CA ). Sample - Latina and non-Hispanic White women aged Recruited from online panel maintained by Survey Sampling, International - English only: Latinas are highly-acculturated Randomization and Stimuli NHWLatinaTotalPSA Experiment 1: Breast Cancer General-Market Targeted Experiment 2: Pap Test General-Market Targeted Total

Ethnically-tailored message more effective than general-market message for target audience 20 Ramírez, A.S. (2013). J Health Communication. p<0.05 n.s. …and they are equally effective for the comparison group n.s.

Discussion 21  Ethnicity-based message tailoring can be persuasive among highly-acculturated Latinas  Campaign implications  Reach: General-market channel (English-language)  Message: Targeted by ethnicity  Caveats:  Messages must be good (not just ethnically-tailored)  Why?

Information inequality…  Affects  Access to information  Ability to use information  Considered a social determinant of health  Research needed to use communication strategically with diverse Latino populations

Erendira Estrada Ariana Ruiz Listeners and callers to Cita Con El Dóctor Hellman Family Fund Acknowledgements Contact: Susana Ramirez, PhD, MPH