Community-engaged needs assessment of Deaf American Sign Language users in Florida, 2018


Objectives: Deaf American Sign Language (ASL) users comprise a linguistic and cultural minority group that is understudied and underserved in health education and health care research. We examined differences in health behaviors, concerns, and access to health care among Deaf ASL-users and hearing English-speakers living in Florida. Methods: We applied community-engaged research methods to develop and administer the first linguistically accessible and contextually tailored community health needs assessment to Deaf ASL-users living in Florida. Deaf ASL-users (n = 92) were recruited during a 3-month period in summer 2018 and compared with a subset of data on hearing English-speakers from the 2018 Florida Behavioral Risk Factor Surveillance System (n = 12 589). We explored prevalence and adjusted odds of health behavior, including substance use and health care use. Results: Mental health was the top health concern among Deaf participants; 15.5% of participants screened as likely having a depressive disorder. Deaf people were 1.8 times more likely than hearing people to engage in binge drinking during the past month. In addition, 37.2% of participants reported being denied an interpreter in a medical facility in the past 12 months. Conclusion: This study highlights the need to work with Deaf ASL-users to develop context-specific health education and health promotion activities tailored to their linguistic and cultural needs and ensure that they receive accessible health care and health education.

Public Health Reports

What is this paper about?

This paper reports the results of a survey of Deaf people in Florida. The survey was administered in 2018. In total, 92 Deaf people who use American Sign Language to communicate completed the survey.

How does this paper improve public health?

There is a lack of research on the health of Deaf people in the United States. Most of the existing research is funded by large grants. We identify three major priorities for improving the health of Deaf people in Florida: focus on access to mental health services and improving mental health, stress, and anxiety reduction; reduce the occurence of drinking a lot of alcohol in one period of time; and, improving access to ASL interpreters in medical facilities.

How was the community involved?

Members of the Florida Deaf community helped make decisions about this project. We had a team of Deaf community members, Deaf researchers, and non-Deaf researchers. Deaf community members helped us decide survey questions, translate the survey, recruit participants, and write manuscripts. They are included as authors on the paper. In addition, we acknowledge the support of organizations including the Florida Association of the Deaf, regional Deaf-led organizations, and the Florida Disability and Health Program.


  • The Florida Behavioral Risk Factor Surveillance System data used in this report were collected by the Florida Department of Health (FDOH). The views expressed in the paper do not necessarily reflect those of the FDOH.

  • Is this paper peer reviewed? This paper is published in Public Health Reports. This journal uses a peer review process where the authors do not know the identities of the reviewers.

  • Who paid for this project? This project was paid for with personal funds by the primary author, Tyler G. James.

  • Are there any conflicts of interest? There are no conflicts of interest.