May 2017
Language Barrier in Health Care
It’s bad enough being sick, but being sick in a place where you do not speak the language is even worse. How can you communicate what your symptoms are with the one person who can help? How do you understand the instructions that will alleviate those symptoms and make you feel better?
According to the U.S. Census Bureau, over 60 million people in the U.S. speak a language other than English. Almost 24 million live here in Texas1. The CDC states that people with limited English experience “disproportionately high rates of infectious disease and infant mortality2.”
Language barriers are associated with less health education. For example, Hispanics who do not speak English at home, are less likely to receive all recommended healthcare services, such as preventive care. Follow-up and adherence to medication regiments is significantly lower than English speakers3. When medical providers are unable to communicate effectively, it can lead to more invasive and costly diagnostic procedures, and the overprescribing of medications.
Miscommunication can lead to serious, sometimes fatal, errors in diagnosis and treatment. Healthcare professionals who misinterpreted symptoms led to misdiagnosis, mistreatment or even tragic outcomes. According to the New England Journal of Medicine4, an interpreter told the mother of a 7-year-old girl with otitis media to put oral amoxicillin in her ears. In another case, a Spanish-speaking mother told a physician that her 2-year-old had “hit herself,” but was unable to communicate that she “hurt herself” when she fell off her tricycle. Misinterpreting the words, the physician understood the fracture to be the result of abuse and called the Department of Social Services (DSS). DSS also failed to take a trained medical interpreter. Thus, the mother was forced to sign over the custody of her two children. Another healthcare provider misinterpreted “dizziness” as paralysis4.
Because of the increasing population of Spanish speakers in Texas, state law requires after-hour messaging and/or answering services to offer Spanish language services. Blue Cross and Blue Shield of Texas monitors this language component during our quarterly audits.
Thank you for doing your part in helping to close the gap in our state’s disparity amongst our patient population.
1 United States Census Bureau, 2013 Report,
www.census.gov
2 Office of Minority Health, “Eliminating Racial and Ethnic Disparities.” http://www.cdc.gov, April 25, 2007.
3 Ngo-Metzgler et al. J Gen Intern Med 2007.22 (Suppl 2):283-8, 324-30.
4 Glenn Flores, M. D., NEJM, “Language Barriers to Health Care in the United States,” (July 20, 2006).