Objective: Although disparities in vaccination have been well documented, limited research has examined how specific Social Determinants of Health (SDOH) are associated with COVID-19 vaccination outcomes among Latino subgroups. The aims of the study are to investigate 1) the relative effects of distinct SDOH on reasons for and against vaccination among Latino adults and 2) how these effects may vary by language spoken at home.
Methods: A meta-analysis was conducted utilizing person- and study-level data from 13,406 Latino participants in the United States across 12 study samples from 2020 to 2023. Analyses evaluated SDOH effects on (a) reasons for and (b) against vaccination, as well as (c) the ratio of the two. Three SDOH were entered in a single model to compare their relative effect sizes: education, economic insecurity, and healthcare insecurity.
Results: Education and economic insecurity had the largest effect sizes compared to healthcare insecurity, which was not associated with outcomes. Greater economic insecurity was associated with more reasons against relative to reasons for vaccination. Spanish spoken at home moderated the effect of education levels, increasing both reasons for and against vaccination for highly educated participants, relative to non-Spanish speaking participants.
Conclusions: Findings inform future efforts aimed at reducing health disparities. The overall pattern of results suggests tailored interventions aimed at supporting COVID-19 vaccine attitudes in Latino communities should provide supports early and in accessible formats, particularly for communities with low educational levels and who use Spanish at home.
Keywords: Attitude; COVID-19; Health disparities; Hispanic or Latino; Social determinants of health; Vaccines.
Copyright © 2025. Published by Elsevier Inc.