Language Use and Adherence to Multiple Cancer Preventive Health Behaviors Among Hispanics

Hispanics have lower cancer mortality rates than non-Hispanic Whites and Blacks, despite demographic profiles previously associated
with higher cancer mortality. Differences in adherence to multiple cancer-preventive behaviors by acculturation may offer
one explanation for this “Hispanic paradox,” but the relationship is not well understood. We examined this relationship using
the 2000 National Health Interview Survey, which provides cross-sectional data on a nationally representative sample of US
Hispanics. Multinomial logistic regression models estimated relationships between language use (a measure of acculturation)
and patterns of adherence, by gender, to multiple cancer-preventive health behaviors using adherence scores. Hispanics had
greater odds of adherence to multiple behaviors compared to Non-Hispanics (OR = 2.76 [2.27, 3.36]). Hispanics with greater
English language use had lower odds of adherence (OR = 0.45 [0.29, 0.69]). Women were more adherent than men (P < 0.01) and their language use was associated with patterns of behavioral adherence more so than among men. Differences by
gender and language use were identified in patterns of adherence to behavioral recommendations among the Hispanic population.
Greater English language use was negatively associated with tobacco, alcohol, fruit and vegetable recommendation adherence
but not with exercise. Study findings support evidence behaviors occur in combination and contributes to understanding of
the role of language use in patterns of behavioral adherence.