Disparities of Hispanics in Healthcare
By Adam Dryfhout
Canisius College
Mentor: Dr. Richard Reitsma
Introduction
Conclusion
Conclusion
Conclusion
Latino populations wrestle with many disparities day in and day out in all aspects of life. In a country where the Latino community is increasing immensely, our society is becoming more and more multilingual and multicultural. The predominant language of the United States is English, but approximately one-fifth of U.S. citizens are Spanish speakers. The United States has the second largest Spanish-speaking population in the world, second to Mexico. The language barrier is as prevalent as ever in the United States, especially in areas with high densities of Spanish-speakers such as across the southern border or large cities. The language barrier is most evident in the context of business, especially medicine. To combat this growing language barrier, there are laws protecting those who cannot speak English in the United States. For example, patients that are treated in hospitals/clinics have rights to access to a translator if there is a language barrier; however, the consequences of using a translator or the lack thereof are largely unknown. It is hypothesized that treatment of a patient without using a common language decreases the quality of treatment in addition to the cultural competency between populations. This study will evaluate the use of translators in medical settings, specifically targeting Spanish-speaking populations, and the effects that language barriers have on patients that seek treatment. Language barriers are evident in healthcare, but the relationship and consequences between the patient and physician are not well studied in literature.
Data and Discussion
Testimonials from Medical Professionals
Conclusion and Future Recommendations
Sources
Adherence to a medication regimen has been demonstrated to be less likely in a situation when a patient does not understand the instructions from a patient’s physician. Clear communication of medication instructions is a critical component to adherence. The inability to communicate with a patient may result in a lack of adherence, which could decrease potential positive patient outcomes. Potential negative side effects could also have a probability of effecting the medicinal adherence as well. This study concludes that even a basic explanation of side effects and/or a regimen for prescriptions is likely to increase compliance with therapy.
According to the 2000 US Census, there are more than 46 million people in the United States who do not speak English as their first language. Furthermore, 21 million of these people speak English less than “very well”. This was a 42% increase from the prior Census. For these residents, there are very few medical services that are able to provide bilingual healthcare providers in practice. As a result, the majority of providers rely on other patients, medical staff, and untrained translators to converse with their patients despite the laws that are in place requiring linguistic access. Title VI of the Civil Rights Act of 1964 requires that persons with limited English proficiency (LEP) have access to linguistic tools to aid them in health services. Unfortunately, these laws are not frequently enforced due to the cost and the feasibility of providing this service depending on the size or patient mix of the health care entities. Consequently, many people in the healthcare field are questioning how the medical field should approach language barriers, or if it is even possible to approach the issue at all.
adhere to directions from their medical professionals compared to patients who have proficient English skills. Lastly, LEP patients are less satisfied with the treatment they do receive. Medical professionals also report they are less satisfied with their patient interaction when they face a language barrier (Homberger, Itakura, and Wilson 1997).
Language barriers strongly affect LEP patients in their access to health care, adherence and understanding of the care they are receiving, quality of care, and the patient-provider satisfaction. Not all studies account for possible confounding variables. More research needs to be conducted in order to explore these relationships to determine if the language barrier is truly the culprit of these disparities.
Multiple articles demonstrate that LEP patients are less likely to receive the medical care they need. These studies found that, compared with English speakers, people who do not speak English as their primary language are less likely to become insured, receive preventative care, or have a primary care physician. This may be a result of a lack of income to become insured or cultural differences within the Latino community. This population is less likely to schedule follow up visits and
Francesca Velardi, University of Buffalo School of Dental Medicine 2020
Alex Breeser, Internal Medicine Resident
Dorian Ramirez, Kirsten G. Engel, Tricia S. Tang. “Language Interpreter Utilization in the Emergency Department Setting: A Clinical Review”
Elizabeth jacobs, Alice Hm Chen, Leah Karliner, Niels Agger-Gupta, Sunita Mutha. “The Need for More Research on Language Barriers in Health Care: A proposed Research Agenda”
Fletcher SW, Fletcher RH, Thomas DC, et al. Patients' understanding of prescribed drugs. J Community Health 1979; 4:183B189.
Hanchak N, Patel M, Berlin J, Strom B. Patient misunderstanding of dosing instructions. J Gen Intern Med 1996; 11:325B328.
The Joint Commission. “Root Causes of Sentinel Events”. Available at: http://www.jointcommission.org/NR/rdonlyres/FA465646-5F5F-4543-AC8F-E8AF6571E372/o/root_cause_se.jpg.
As the Latino population in the United States grows rapidly, the language barrier is becoming increasingly prevalent. The United States institutes the use of translator telephones so that way doctors can communicate with their patients. While this does help, a lot is lost in translation and this medium removes a lot of the humanistic aspects of medicine that are the cornerstone of good medical practice. By not being able to communicate properly with one’s patient, a provider has a harder time comforting them and forming a relationship. As a result, LEP patients are less likely to feel safe or comfortable while receiving medical care and to seek medical care when they do actually need it. Lastly, this skepticism and lack of comprehension of treatment leaves this LEP population more vulnerable to adverse reactions than non-LEP populations.
Bilingual providers are in extreme demand. Translators can be utilized (though not always readily accessible), but there are many issues when it comes to maintaining a personal relationship with patients. While it is not feasible to have every provider learn the Spanish language in order to resolve this issue, it is important that providers recognize that these issues are important considerations to incorporate into their own evidence-based practice. Language intervention workshops have proven to reduce the effects of a language barrier. It is essential that an emphasis is put on multilingual education in healthcare so that providers are able to bridge this gap and accommodate their patients.
This research helped me solidify my passion for helping bridge the gap between Spanish-speaking patients and medical professionals. By continuing my education in the medical field while studying Spanish, I will be able to administer more personable care to an entire population that many professionals are not able to give. I will be applying for a Fulbright Grant for 2020-2021 in order to investigate more about the language barrier and see how it relates to cultural differences. Hopefully by learning more about the Spanish culture in terms of healthcare first hand, I will be able to apply my knowledge to my evidence-based practice when I become a medical professional.