Language barriers may be causing the growing number of people in the United States who do not speak English fluently to receive lower levels of health care than those who do speak English, a new analysis of a Canadian survey suggests.
Steven Woloshin, MD, of the Department of Veterans Affairs Medical Center, White River Junction, VT, and colleagues note that, among those surveyed, Canadian women whose main spoken language was not English were less likely to receive important preventive health services, such as mammograms and pap tests, even when they had equal access to health care and insurance coverage.
Writing in the August 1997 Journal of General Internal Medicine, the researchers stated, "The effect of language persisted after adjusting for variables reflecting socioeconomic factors, contact with the health care system, and culture, suggesting that observed differences across language groups may be attributable to a communication barrier."
They analyzed the responses of 22,448 Canadian women surveyed in the 1990 Ontario Health Survey, 10 percent of whom spoke a language other than English at home and were thus considered non-native speakers.
As ethnic minorities grow and the number of people with limited English continues to expand in both Canada and the U.S., researchers urge improving communication with such patients to increase their participation in preventive health programs.
While many confounding factors lead to reduced levels of care among non-native English speakers, they suggest that communication barriers may be more rapidly remedied than others. However, the authors caution that some solutions, such as using professional interpreters, may be too costly, while others, such as using untrained interpreters, may be ineffective.
The Journal of General Internal Medicine, a monthly peer-reviewed journal of the Society of General Internal Medicine, publishes original articles on research and education in primary care. Dr. Steven Woloshin can be reached by contacting Betty Petrie at (802) 295-9363, ext. 5190, or Gail Evilsizer at (802) 296-5178.
Contact: : Margo Glen Alderton, managing editor