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Limited English Proficiency Shouldn’t Mean Limited Health Care

Wednesday, September 23, 2009

  • By: CHANIN BALLANCE
  • Organization: The Health Care Blog

It’s impossible to know exactly what shape healthcare will take for Americans as Congress and President Obama struggle with reform measures in the coming months. But one thing is certain: Those who have limited English proficiency will continue to have more health care services they can understand.

Though the U.S. has prohibited discrimination, including language access for limited English proficient persons, since the passage of the Civil Rights Act of 1964, the reality in the healthcare industry is very different. Whether insured or not, those who don’t speak or read English “very well” tend to have care that’s not as good as those who do. The Agency for Healthcare Research and Quality (AHRQ) reported that in 2005 only 54 percent of Latinos experiencing an injury or illness had timely access to healthcare, compared to 65 percent of whites. And if uninsured, Latinos got care in only 27 percent of cases.
It should be pointed out that “treatment” extends clear through medication, and here also, there’s room for improvement as many pharmacies fail to provide prescription information in a language other than English. A recent study by the Albert Einstein College of Medicine in New York of all 161 pharmacies in the Bronx, N.Y. (a borough with a large Spanish-speaking population) revealed that 31 percent could not provide prescription labels in Spanish. And one pharmacy used translation software that couldn’t translate common prescription terms like “dropperful.”

Miscommunications in healthcare can have dire results. A child given a tablespoonful of medication when a dropperful was prescribed could wind up poisoned or worse. And then there’s the simply spoken miscommunications that can be deadly, such as the 13-year-old Phoenix girl whose ruptured appendix was initially mistaken for gastritis because no one could question her Spanish-speaking parents. Her death in 1984 sparked a lawsuit resulting in a $71 million malpractice award against the hospital and physicians involved.

Such horror stories simply don’t have to happen if health care professionals take care to make themselves understood — in everything they do, from spoken to written patient materials and prescriptions.

The Civil Rights Act of 1964 pointed out that language barriers are a form of discrimination. But it wasn’t until August 2000 when President Clinton signed executive order 13166 to remind federal agencies to “examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so LEP persons can have meaningful access to them.”

The state of California followed the federal mandate with Senate Bill 853. Officially signed in 2003, insurance companies had until January 1, 2009 to comply with Senate Bill. 853. The law requires health, dental and specialty insurers licensed in California to have services, information and materials available to LEP members in a language they can understand. Other states are considering similar legislation.

Healthcare organizations that are making real strides in translating materials for non-English speakers are not only fulfilling the laws, they’re fulfilling their mission to improve health. It’s been shown that if people get healthcare information in own language, the care gets better, whether it’s understanding health insurance policies to taking medicine.

Chanin Ballance brings a wealth of expertise in language translation services and multicultural communications to viaLanguage. She co-founded viaLanguage in 2000 and served as the Chief Operating Officer prior to her appointment as Chief Executive Officer in 2003. Previously, Chanin co-founded The Language Company, a language and cross-cultural training school and translation service provider.

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