Interpretation access, digital tech to bridge gap on language-based inequity in US health care
By Marivir R. Montebon
New York - Yes, Virginia, there is a language-based inequity in the health care system of the US. A study made by Stanford Medicine in California noted that language barriers often occur when healthcare providers and patients do not share a native language and that patients and families with limited English proficiency (LEP) face exacerbated health disparities.
Stanford population researcher and medical doctor Latha Palaniappan said that patients with language-discordant healthcare providers reported receiving less health education, worse interpersonal care, and lower patient satisfaction. Palaniappan reported that both patients and providers reported less than satisfactory access to adequate interpretation services.
Dr. Latha Palaniappan
Palaniappan is an internist, and clinical and population researcher. She is the faculty co-Director of the Stanford Biobank designed to accelerate translatable scientific discoveries. She co-founded the Center for Asian American, Native Hawaiian and Pacific Islander Health Research and Education (CARE) at Stanford in 2018.
Palaniappan made her presentation during the nation-wide media forum initiated by the Ethnic Media Services (EMS) on July 21, 2023.
The Palaniappan study noted that America has become a multi-lingual country with a population of 25.5 million (of the 67.2 million population who speak a language other than English at home) speaking English less proficiently. These households are identified as predominantly Chinese, Korean, and Vietnamese followed by Polish, Russian, and other Slavic cultures.
Meanwhile, another speaker during the EMS media forum, Dr. Ingrid J. Hall of the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, pointed out that 84% of non-Hispanic whites recorded that they had a usual source of care such as having a regular doctor.
Dr. Ingrid Hall
Hispanics who are comfortable speaking English, when we asked them if they had a usual source of care, only 78% of Hispanics who speak English well said they have a regular doctor.
For Hispanics with limited comfort speaking English or those who don't speak English very well, only 69% of them report having a usual source of care.
Hill noted a “downward gradient from non-Hispanic whites at 84% who speak English well to 78% for Hispanics who are comfortable with English and speak English well and down to 69% for those Hispanics who report that they have trouble with English.
The same pattern is seen in the availment of preventive services such as routine checkup, blood pressure, cholesterol, annual flu shot, and dental care in the last two years and health care utilization such as emergency room visits.
“Hispanics who don't speak English well report receiving fewer of these services at a lower percentage. So, we can start to see the familiarity with English and how that impacts people's access to preventive services and use of health care services,” concluded Hall.
Hall is an epidemiologist in the Division of Cancer Prevention and Control’s Epidemiology and Applied Research Branch. Her current research focus is in minority health, particularly finding culturally relevant ways to publicize the need for participation in cancer screening and early detection by minority populations.
The EMS forum moderated by Sunita Sohrabi
Palaniappan’s Stanford-funded research identified solutions to the language-based inequity in health care. It noted to translate materials into patient’s preferred language; integrate HIPAA-compliant translation tools in tandem with interpretation services to improve healthcare delivery, patient safety, and decrease costs.
Under Section 1557 of the ACA, healthcare providers are required by law to provide qualified interpreting services free of charge.
The research also recommended to “account for cultural nuances and ensure team is on same page when communicating to patients and preparing treatment plans.”
It also emphasized the need for “employing bilingual staff, leveraging multimedia methods,
translated consent forms, and implementing trainings can help address system and individual level barriers to research.”
Dr. Elena Rios
Dr. Elena Rios, president of the National Hispanic Medical Association, commended the efforts some legislators on the issue on language accessibility. NHMA represents 50,000 Hispanic physicians in the US.
Rios cited New York congresswoman Grace Meng for introducing the mental health workforce and language access for health centers and Monterey Park congresswoman Judy Chu to increase resources for language training for nonprofits.
Meng’s legislation is geared for community health centers to be able to have better mental health services and increased support for training of the healthcare workforce in language access. #
