The ongoing COVID-19 pandemic has certainly shed light on the language gap in the United States’ healthcare system — all too often, individuals with limited English proficiency are left behind and suffer from worse health outcomes than those who speak English with high proficiency. While the pandemic has clearly exacerbated these issues — from poor accessibility of public health communications to hospitals lacking medical interpreters — they’ve been around for a long time.
A recent Scientific American op-ed written by two doctors at the Brigham and Women’s Hospital in Massachusetts further explored these issues, emphasizing the dire need for better language access services in U.S. hospitals.
“Language discordance — the situation when providers and patients speak different languages — is all too common throughout the United States,” write doctors Benjamin Alazar and Gezzer Ortega. “Limited English proficiency impacts the patient-physician-system interaction by undermining communication, trust, and health literacy. This miscommunication leads to suboptimal care, decreased understanding of diseases and treatments, difficulties in shared decision-making and lower satisfaction with care.”
Alazar and Ortega note that medical interpreters are extremely critical to address the language barriers that arise in healthcare situations, however many hospitals do not hire an adequate number of medical interpreters. This is in large part due to the fact that — although the law requires hospitals to provide medical interpreters for patients who do not speak English fluently — insurance companies generally do not cover the costs of interpreting services, and thus hospitals must pay themselves. As a result of the high costs hospitals must take on in employing interpreters, only about 75% of hospitals in high-need areas (and just 65% in low-need areas) offer adequate interpreting services, according to a 2016 study published in Health Affairs.
Alazar and Ortega also argue that the increased usage of telehealth services during the COVID-19 pandemic could potentially be a good move toward improving language access in hospitals. Still, studies conducted throughout the pandemic show that individuals with limited English proficiency are at higher risk of COVID-19 incidence and mortality.
“Improving access to timely medical interpretation is a moral imperative in a society looking for a more just system in and out of healthcare,” the doctors write.