Language access enables access to care
- Immigrant and refugee communities repeatedly identify language as one of the principle barriers to accessing quality health care.
- When people cannot access routine care, they are more likely to have poor health outcomes, to have children with chronic health problems, and to enter the Emergency Department with serious and costly complications.
Patient populations are changing
- Between 1990 and 2000, the number of people in the U.S. with limited English proficiency (LEP) rose from 14 million to 21.3 million – from 6.1% to 8.1% of the population.
- By 2008, this had increased to 8.6%.
- In the U.S., 47 million people speak a language other than English at home.
- In more than 11 million U.S. households, nobody in the family speaks English — they are linguistically isolated.
- LEP populations have grown the most in states that have been predominantly English-speaking: North Carolina, Georgia, and Nevada.
- Due to changing demographics, the need for language access in health care has never been greater, nor more widespread.
Language access is the law—and required for Joint Commission accreditation
- The Americans with Disabilities Act (ADA) requires interpreters for patients who are deaf or hard of hearing.
- Title VI of the 1964 Civil Rights Act prohibits discrimination on the basis of race, color or country of national origin. The Supreme Court, in Lau vs. Nichols (1974), ruled that language is an aspect of country of national origin. So, if your facility receives any kind of federal funding and is therefore bound by the 1964 Civil Rights Act, you must provide language access to your services.
- Section 1557 of the Affordable Care Act prohibits discrimination on the basis of race; ethnicity; country of national origin; disability; sexual orientation; gender identity, including transgender individuals; sex stereotyping; and sexual characteristics including intersex traits. The rules implanting Section 1557 clearly require the provision of qualified interpreters for patients speaking limited English.
- Many civil liability suits have been lost because of language barriers.
- New Joint Commission accreditation standards in 2011 are even clearer about the requirement to provide language access to care.
Communication is at the heart of health care—providers can’t do their jobs well if they can’t communicate clearly
- The single most important—and cheapest—diagnostic test that healthcare providers perform is the medical interview, which is rendered impossible if their patients can’t understand them because they don’t speak the same language.
- If providers can’t communicate easily with their patients, they can’t get a good history.
- Without the means to cross a language barrier, providers can’t share a diagnosis, explain a treatment regimen, or follow up on results.
Access to interpreters creates clear communication
- Qualified interpreters enable better understanding of patient input, which supports correct diagnosis, appropriate use of diagnostic exams, and increased use of primary care.
- Skilled interpreting improves rates of clinic throughput, leading to greater systems efficiency and cost savings.
- Providing clear communication across language barriers from the first encounter saves lives, promotes efficiency, and reduces costs.
The bottom line is…
…when language barriers are overcome by access to qualified interpreters, providers better understand what they need to do, and fewer mistakes are made in patient care, which improves outcomes and reduces risks to patients’ health. This in turn improves throughput, achieves compliance with regulations, decreases liability, and increases revenues.
Whether you are a patient with limited English proficiency, a healthcare administrator, a healthcare provider, a community advocate, an interpreter, or just someone waiting to be seen in a busy clinic or emergency room, language access is important to you.