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Interpreter Use and Healthcare Experiences Among Spanish-Speaking Patients

Sabrina Lee, Oakland University William Beaumont School of Medicine, Department of Foundational Medical Studies

Adina Schneeweis PhD (mentor), Department of Communication, Journalism, and Public Relations, College of Arts and Sciences

Introduction

  • Hispanic population in the U.S. grew by 23% between 2010 and 2020, with over 41 million Spanish-speakers nationwide¹
  • Spanish is the most common non-English language spoken in U.S. homes (62% in 2019)²
  • Community health clinics, like the Gary Burnstein Clinic in Pontiac, MI, serve uninsured, low-income Hispanic patients (Pontiac: 24% Hispanic population)³
  • Language barriers challenge Spanish-speaking, foreign-born Hispanic patients in healthcare
  • Lack of interpreters can worsen health outcomes, decrease trust, and lead to avoidance of care
  • Study aim: examine how medical care with interpreter present affects patient trust, satisfaction, and understanding
  • Findings highlight the role of interpreters in promoting equitable, patient-centered care for underserved Spanish-speaking communities

Aims and Objectives

  • Assess how interpreter use impacts healthcare experiences, understanding, and trust among Spanish-speaking Hispanic patients.
  • Demonstrate that care delivered in patients’ primary language improves communication, engagement, satisfaction, and health outcomes in these communities.

Methods

Study Design & Setting

Qualitative study

Semi-structured interviews

Conducted at Gary Burnstein Community in Pontiac, MI

Participants

13 Hispanic adults (ages 18–54), Spanish primary language

Recruited via snowball sampling

Data Collection

Brief demographic survey (English proficiency, interpreter use, satisfaction).

In-person interviews, 10–15 min, audio-recorded, transcribed, translated by bilingual author.

Outcome Measures

Patient satisfaction, trust, understanding of medical information, and perceived quality of care with vs. without interpreters

Data Analysis

Thematic analysis of 4 major themes

Results

Theme 1: Communication & Understanding

  • Essential for sharing symptoms, asking questions, understanding diagnoses and treatment plans
  • Interpreter present: deeper, more meaningful communication
  • Language barriers persisted in long-term residents (>15 yrs)
  • Barriers led to frustration, confusion, loss of autonomy
  • Without interpreters: communication superficial, incomplete
  • In-person interpreters preferred over phone/device

Theme 2: Trust & Relationship-Building

  • Fostered trust in providers and the healthcare system
  • Trust grew if patients felt heard, respected, emotionally secure
  • Feelings of security (seguridad)
  • Greater confidence in clinicians and care decisions
  • Confidentiality and comfort with sensitive topics
  • Barriers led to nervousness, insecurity, weak connection

Theme 3: Patient Experiences & Perceived Quality of Care

  • Greater comfort, confidence, engagement in appointments
  • Interpreter access eased logistical and financial burdens
  • High-quality, patient-centered care

Theme 4: Community-Level Experiences

  • Impacts broader Spanish-speaking community
  • Reliance on children or relatives as interpreters
  • Interpreter absence: frustration, helplessness, care avoidance
  • Reduces structural barriers, promotes health equity
  • Highlights systemic need

Conclusions

  • Interpreter services are essential for equitable, patient-centered care for Spanish-speaking patients.
  • Lack or insufficiency of interpreters impacts communication, weakens trust, and lowers care quality.
  • Language barriers create economic and logistical challenges, often requiring reliance on family or friends for translation.
  • On-site, culturally competent interpreters improve patient satisfaction, engagement, and the patient–provider relationship, supporting health equity at both individual and community levels.
  • This study confirms previous findings that effective interpreter services enhance communication, trust, and healthcare outcomes for limited-English-proficiency patients.
  • It adds insight into the broader community-level impact of language access, showing how reliable interpreter services reduce disparities and promote equitable access to care.

References

  1. Passel JS. U.S. Hispanic population continued its geographic spread in the 2010s. Pew Research Center. February 3, 2022. https://www.pewresearch.org/short-reads/2022/02/03/u-s-hispanic-population-continued-its-geographic-spread-in-the-2010s/
  2. Hernandez SD. Nearly 68 million people spoke a language other than English at home in 2019. Census.gov. December 13, 2022. https://www.census.gov/library/stories/2022/12/languages-we-speak-in-united-states.html
  3. U.S. Census Bureau. QuickFacts: Pontiac city, Michigan — Hispanic or Latino, percent. https://www.census.gov/quickfacts/fact/table/pontiaccitymichigan/RHI725224
  4. Espinoza J, Derrington S. How should clinicians respond to language barriers that exacerbate health inequity? J Ethics | AMA. 2021;23(2):E1-E9. https://journalofethics.ama-assn.org/article/how-should-clinicians-respond-language-barriers-exacerbate-health-inequity/2021-02
  5. Staff AC. Michigan’s population topped 10 million in 2020. Census.gov. January 30, 2023. Accessed June 13, 2023. https://www.census.gov/library/stories/state-by-state/michigan-population-change-between-census-decade.html
  6. O’Brien M, Shea J. Disparities in patient satisfaction among Hispanics: the role of language preference. J Immigr Minor Health. 2011;13:408–412. doi:10.1007/s10903-009-9275-2

Acknowledgements

Acknowledgements: Gary Burnstein Community Health Clinic, study participants, OUWB mentor and staff. Funding/ support: OUWB

Figure illustrating primary interview themes. Created by Sabrina Lee (concept and design) with AI assistance, 2026.