Why is language access important in health care?
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, it had increased to 8.6%. 47 million people speak a language other than English at home. More than 11 million households are linguistically isolated — nobody in the family speaks English. LEP populations grew the most in states that had been linguistically homogeneous: North Carolina, Georgia, Nevada. The need for language access in health care has never been greater, nor more widespread.
Language access promotes access to care.
Immigrant and refugee communities repeatedly identify language as one of the principle barriers to accessing quality health care. When they 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.
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.
Providing clear communication across language barriers from the first encounter saves money and promotes efficiency.
Access to interpreters creates clear communication. This supports correct diagnosis, appropriate use of diagnostic exams, and increased use of primary care. It also supports appropriate rates of clinic throughput, leading to greater systems efficiency. This can create lesser cost.
Providers can’t do their jobs if they can’t communicate clearly.
Communication is the heart of health care. The single most important—and the cheapest—diagnostic test that healthcare providers perform is the medical interview. But how can providers get a good history if they can’t communicate easily with their patients? How can the share a diagnosis, explain a treatment regimen, or follow up on results?
When language barriers are not addressed, providers can’t do their jobs, patients can’t get the care they need and deserve, health care systems get backed up and care is more expensive.
So 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.