{"doi":"10.1016/j.focus.2025.100326","title":"Social Determinants of Health Associated With SARS-CoV-2 Testing and Vaccine Attitudes in a Cross-Sectional Study of Latinx Individuals in Oregon","abstract":"Introduction Latinx communities have reported higher barriers to SARS-CoV-2 testing and vaccination and experienced disproportionate COVID-19 burden, especially compared with non-Latinx Whites. Social determinants of health models explain health inequities; however, it is unknown how each social determinant of health is associated with SARS-CoV-2 testing and vaccination attitudes among Latinx Americans. This study determined the relative importance of social determinants of health indicators on testing and vaccine attitudes among Latinxs and whether English proficiency and parental nativity moderate associations. Methods Cross-sectional survey data were collected between January and December 2022. Multilevel structural equation path modeling addressed the nonindependence of respondents nested within 52 SARS-CoV-2 testing sites across Oregon, U.S. Equality constraints were used to test for differences in the magnitudes of the associations. Results Latinx respondents ( n =1,247) predominantly spoke Spanish at home (94%) and had no U.S.-born parents (92%). Pandemic vulnerability (β=0.95, p <0.001), economic insecurity (β=0.17, p <0.001), and discrimination (β=0.16, p <0.001) were associated with testing hesitancy; education was associated with vaccine hesitancy (β=0.15, p <0.001); and education (β=0.13, p <0.001) and discrimination (β=0.08, p <0.01) were associated with vaccine safety acceptance. Social determinants of health associations were statistically equal in magnitude. English proficiency moderated the associations from discrimination (β=0.07, p <0.01) and economic insecurity (β= −0.09, p <0.05) to vaccine hesitancy. Parental nativity moderated the associations from economic insecurity to testing hesitancy (β= −0.21, p <0.001) and lack of healthcare access to vaccine hesitancy (β=0.37, p <0.01). Conclusions Findings from this study identified distinct social determinants of health paths to testing and vaccine attitudes among Latinxs as well as by English proficiency and parental nativity. These results inform culturally responsive disease prevention for Latinx subgroups.","journal":"AJPM Focus","year":2025,"id":543172,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9509,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":422081,"name":"Stephanie De Anda","orcid":"0000-0003-3791-9494","position":1,"is_corresponding":false},{"id":886847,"name":"Sven Halvorson","orcid":"0000-0001-7375-6843","position":2,"is_corresponding":false},{"id":275845,"name":"Leslie D. Leve","orcid":"0000-0003-3061-4524","position":3,"is_corresponding":false},{"id":886846,"name":"Anne Marie Mauricio","orcid":"0000-0002-0818-3249","position":4,"is_corresponding":false},{"id":886845,"name":"Ellen Hawley McWhirter","orcid":"0000-0002-9670-3629","position":5,"is_corresponding":false},{"id":886848,"name":"Jorge Garcia","orcid":"0000-0002-0374-5468","position":6,"is_corresponding":false},{"id":427844,"name":"David S. DeGarmo","orcid":"0000-0001-8449-3057","position":7,"is_corresponding":false},{"id":388603,"name":"Elizabeth L. Budd","orcid":"0000-0003-4854-3795","position":0,"is_corresponding":true}],"reference_count":78,"raw_metadata":null,"created_at":"2026-07-19T02:53:04.088079Z","pmid":"40231115","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}