FALL 2020 • VOL 14 ISSUE 1
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Breaking Down the Language Barrier Writer: Maya Kovacevic • Editor: Isaac Murdokuvich
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oing to the hospital is almost always a stressful process—navigating through the labyrinthine hallways, filling out infinite nit-picky forms, processing the medical jargon from test results. And for many Americans, this is all done in their native language—English. But for many others, English is not their most comfortable language. It’s bulky, unfamiliar, haphazard. None of which are helpful in understanding the critical information given by the physician. So when the doctor and patient speak different languages, their relationship weakens. Not only are they unable to communicate about the patient’s health but also the feeling of trust and comfort also disintegrates. More plainly speaking, the language barrier denies non-English-proficient patients quality healthcare in the United States. In every facet of daily living, the as-
In every facet of daily living, the assumption is that the general public can read, speak and understand English—and the healthcare system is no exception. sumption is that the general public can read, speak and understand English— and the healthcare system is no exception [6]. Some options are available within larger organizations to foster interlanguage communication, such as translation and interpretation services. However, the demographics of Americans who speak non-English
languages at home is rapidly increasing. The Center for Immigration Studies found that “as a share of the population, 21.9 percent of U.S. residents speak a foreign language at home.” They further report that “of those who speak a foreign language at home, 25.6 million (38 percent) told the Census Bureau that they speak English less than very well.” As the percentage of these foreign-language speakers continues to grow and the number of those who are not proficient in English, the demand for translation and interpretation services rises [10]. In addition to the increasing demand, a study by the Joint Commission in 2015 found that limited English proficient (LEP) patients “are at a higher risk for adverse events than Englishspeaking patients. Language barriers significantly impact safe and effective health care… The study found that 49.1 percent of LEP patients experienced physical harm versus 29.5 percent of English-speaking patients.” [2] As the LEP demographic grows, ending this trend is critical to bridge the divide in quality healthcare based on English language proficiency. Yet this split in care is already rampant throughout the American healthcare system, and in March 2020, when the COVID-19 pandemic reached the continental US, its amplified effects were devastating. The New York Times reported that by April, “At Cambridge Health Alliance in Massachusetts, nearly half of the 126,000 patients in its primary care system have limited English proficiency. The Alliance has 100 staff interpreters who usually work in its emergency rooms and community clinics.” This disproportionate ratio between LEP patients and the resources
available to them has shifted the burden onto interpreters, who have had to cope with both an overwhelming number of cases and the shift to remote work. The New York Times elaborates, “Communicating through [an] interpreter doubles or triples the length of a medical exchange, adding new confusion and anxiety to situations that are already stressful for patients and their families [3]. And the conditions of COVID-19 care—the novelty of the virus and its possible effects, the desire of hospital workers to limit the duration of their exposure to patients and prohibit non-patient visitors (who often can serve as interpreters for the patients)— create numerous obstacles to effective interpretation.” [7] Without proper language services, non-English-proficient patients suffer from confusion about their situation and their physical health ailments. Outside of the hospital, the language barrier has been hindering COVID-19 public health efforts. Contact trac-
Without proper language services, non-English-proficient patients suffer from confusion about their situation and their physical health ailments.
ing, an essential practice for curbing the spread among immigrant communities, has proven to be extremely difficult to maintain due to mistrust in the government and the lack of
