The Silence that Kills: How Language Barriers Break Down the Relationship Between Patient and Provider
Written by Michelle Bui
Some people say that a hospital’s emergency department is a good representation of America: people of all backgrounds and races are welcome, and they will be treated regardless of who they are. When a patient is rushed in on a gurney with critical gunshot wounds, a heart attack, or a high grade fever, the primary concern is that person’s survival, not whether he or she is an immigrant or a criminal.
But there is another parallel between the melting pot that is America and the emergency department: people who speak a different language are often at a disadvantage. This actually applies to the whole of the medical field. Although the U.S. Department of Health and Human Services (HHS) requires that interpreters and other resources are made available to non-English speaking patients, sometimes medical professionals fail to provide such accommodations .
It was estimated in 2013 that 61.6 million Americans spoke a language other than English, and about half of them were considered limited English proficient (LEP) . This simply means that they do not consider themselves fluent speakers. While this may pose small struggles for them in daily life, it puts them in life-threatening situations in a medical setting.
There have been several reports in the past couple years about individuals who had difficulties with their providers due to language barriers. In 2012, the California Health Interview Survey found that 40% of respondents, which included 51,048 participants representative of California’s diverse population, reported having low health literacy. Healthy literacy is defined as being able to follow doctor’s written instructions and understand directions on prescription bottles. Of those who reported low health literacy, 44.9% reported having poor health status. While this may simply be a correlation, the fact that patients do not understand their own treatment instructions is in itself concerning .
In addition, a study was published this past month documenting the effects of language barriers on Latino breast cancer patients in LA county. While the study states that the patients were given ample information from their providers, it also notes that many had to bring in family members to help them understand their treatment. In many cases, the women also asked few questions and let their doctors make final decisions on their treatment .
But even having trustworthy family members and physicians at hand can lead to chaos. In 2006, the HHS published a case report about parents who had given their anemic baby over 12 times the recommended dosage of medicine. They had misinterpreted the directions of their doctor and pharmacist, and didn’t find out the proper dosage until they spoke to an interpreter in the emergency room .
At the end of the day, language is an important and necessary connection between patients and providers. Without proper communication, quality of care decreases and general trust between the two parties is broken. If America truly is a melting pot, then it cannot allow cultural differences to put its people’s lives at risk.
1. Flores, Glenn. “Language Barrier.” Patient Safety Network. Agency for Healthcare Research and Quality. April 2006. Web. 8 April 2017.
2. “Guidance to Federal Financial Assistance Recipients Regarding Title VI and the Prohibition Against National Origin Discrimination Affecting Limited English Proficient Persons - Summary.” hhs.gov. U.S. Department of Health and Human Services. Web. 8 April 2017.
3. “Research shows how language barriers, cultural differences disadvantage Latina breast cancer patients.” News Medical. AZoNetwork, 12 April 2017. Web. 22 April 2017.
4. Sentell, Tetine and Kathryn L. Braun. “Low Health Literacy, Limited English Proficiency, and Health Status in Asians, Latinos, and Other Racial/Ethnic Groups in California.” Taylor and Francis Online. Journal of Health Communications, 3 October 2012. Web. 22 April 2017.
5. Zong, Jie and Jeanne Batalova. “The Limited English Proficient Population in the United States.” migrationpolicy.org. Migration Policy Institute, 8 July 2015. Web. 22 April 2017.