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Addressing Language Barriers in Healthcare

Maura Deering, J.D.
Updated September 29, 2023
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    With 1 in 5 American households speaking languages other than English, breaking down languages in healthcare has become more important than ever.
    Bilingual patient talking to doctor and nurseCredit: Getty Images

    Imagine being in a country far from home. You wake up one morning with severe stomach cramps. You find your way to a walk-in clinic, but no one speaks your language – nor can you understand theirs.

    This scenario happens daily for many people in the United States who experience language barriers in healthcare facilities. Discover ways to address inequities in healthcare due to language barriers.

    The Impact on Patient Care

    According to a systematic review published in the Oman Journal, language barriers can adversely impact patient care and lead to bias, misinformation, confusion, and physical harm in the following ways:

    • Difficulty with medications: Studies have found that among patients who did not speak the local language, nearly 35% experienced confusion about how to use their medication, and almost 16% suffered a bad reaction to the medication due to not understanding the proper usage.
    • Access to healthcare: According to research, more than 65% of patients who did not speak the local language experienced barriers to healthcare, including 20% who did not seek healthcare services because of fear of misunderstanding healthcare providers.
    • Adverse health events: Language barriers led to detectable physical harm in just over 49% of patients and moderate temporary harm in nearly 47% of patients, as reported by one study.

    Advantages of Bilingual Healthcare Professionals

    Research from Nursing Management has shown that bilingual healthcare professionals and effective interpreter services increase patient health and satisfaction. Bilingual healthcare professionals and interpreters help improve healthcare outcomes by facilitating communication and bridging cultural gaps between patients and providers.

    The study author recommends that healthcare organizations help bilingual staff members become trained and certified as medical interpreters. Another recommendation is to prioritize hiring staff who speak the languages of the patient population. Both of these strategies can maximize understanding of diagnoses and instructions for care.

    Strategies to Address Language Barriers in Healthcare

    In 1 out of 5 U.S. households, the occupants mainly speak a language other than English, according to the U.S. Census Bureau. Strategies for overcoming language barriers in healthcare, facilitating communication, and improving healthcare outcomes include:

    Language Access Programs

    These programs provide in-person interpreters at the medical facility and telephone or technology-based interpreter services. Whether hired by the organization or contracted, interpreters are trained in different languages and healthcare terms. They also adhere to a code of ethics that requires patient confidentiality.

    Healthcare organizations can also offer written materials in several languages to serve their patients.

    Multicultural Training

    In addition to interpreters who receive multicultural training, healthcare staff can undergo similar training. Multicultural training teaches skills like observing patients’ body language, using culturally specific phrasing, and understanding cultural norms around healthcare.

    The U.S. Department of Health & Human Services offers e-learning in culturally competent nursing care and a self-directed training course in culturally competent care for physicians, physician assistants, and nurse practitioners.

    Patient Advocates

    Patient advocates provide services that help eliminate barriers to healthcare, including serving as the voice of patients who speak limited or no English. Nonprofit organizations, such as the Patient Advocate Foundation, offer case management services in a variety of different languages, free of charge, to patients with chronic conditions and debilitating diseases.

    Bilingual Medical Documentation

    Stronger communication leads to better health outcomes. Bilingual medical documentation, such as electronic health records accessible to non-English speakers, can help break down language barriers in healthcare.

    For example, an American Medical Informatics Association patient survey of Spanish speakers found that 72% of respondents believed that stronger relationships between patients and healthcare providers would develop with communication via bilingual English-Spanish online patient portals.

    Collaboration with Community Organizations

    Community organizations typically offer educational resources to overcome language barriers in healthcare and create culturally competent practices. The American Hospital Association, for example, offers information on health equity transformation and cultural competency for hospitals and healthcare systems. Recommendations include linguistically competent care development and strengthening community partnerships.

    Translation Laws & Regulations in U.S. Healthcare

    Federal law requires healthcare providers who receive federal funding to offer interpretation services to patients with limited English proficiency.

    Interpretation services must be free of charge to patients, regardless of whether or not the healthcare organization receives reimbursement from the government. Medicaid and the State Children’s Health Insurance Programs can apply for federal matching funds for language services.

    All U.S. states have enacted language access laws as of 2019. Every state has at least three linguistically appropriate healthcare provisions, and California has more than 250 provisions addressing language barriers.

    The Future of Language in Healthcare

    Physicians, nurses, and other medical staff can become culturally and linguistically competent to help overcome language barriers to healthcare.

    Equal access for all patients is possible when organizations use interpreters and patient advocates, prioritize bilingual staffing, provide bilingual patient records, and undergo multicultural training.

    Page Last Reviewed September 7, 2023