Assessing the Prevalence of Depression Among English- and Spanish-Speaking Patients at a Free Medical Clinic

The goal of this study was to assess the rate of positive depression screens in a randomly selected group of 111 patients at St. Luke's Free Medical Clinic in Spartanburg, South Carolina, while also looking for differences in positive depression screeners between English- and Spanish-speaking patients. Our hypothesis is that at the free clinic, there is an overall low positive screening rate for depression in Spanish-speaking patients due to stigma, lack of interpreters, and the English language Patient-Health Questionnaire-2 (PHQ-2).

All patients seen at St. Luke's fill out a PHQ-2, which screens for depression. Patients self-report this information. To conduct the research study, a random number generator was used to pick five dates from 2023 when patients were seen at the clinic. Patients were given a numerical code as deidentifiers, and the data were recorded in a password-protected computer. The deidentified data recorded included patient year of birth, biological sex, race, preferred language, need for an interpreter, depression screen date, depression screening result, and follow-up plan if positive for depression screening. Given the categorical nature of the outcomes, tests of association will be conducted with chi-square tests using a type I error rate of 0.05. All statistics and significance tests were performed using Statistical Analysis System 9.4 (SAS Inc., Cary, NC).

Of the 111 patients, 20 individuals screened positive for depression (18.02%), while 90 screened negative (81.98%). Of the 20 individuals who screened positive, 10 (50.00%) had a documented follow-up plan. Using chi-square tests of association, those who screened positive for depression had a statistically significant association with English as their preferred language (13.03% positive given preferred language is English, 6.97% positive given preferred language is Spanish, p = 0.0175). Additionally, there was a statistically significant association between a positive depression screening and not needing an interpreter (13.761% positive given an interpreter was not needed, 6.2385% given an interpreter was needed, p = 0.0236).

Through our data collection and analyses, we observed a statistically significant difference in rates of positive depression screenings between English- and Spanish-speaking patients. This supports our hypothesis in theorizing that language barriers create inequities in access to healthcare and resources.