Dr. Pérez-Stable: Bridging Health Gaps through Language Access

As an academic researcher and a primary care clinician, I have spent more than 30 years searching for ways to improve the health of racial and ethnic minorities and underserved populations. Our research efforts have had some noteworthy successes over the years, including advancing patient-centered care and developing a more diverse research workforce. But it turns out that attaining success can be simpler—and more personal. I have learned that clinicians themselves can have an immediate impact on improving the health of these populations through one simple tool: better communication across language and cultural barriers.

Health literacy refers to a person’s ability to understand the basic health information they need to make appropriate health decisions. Health care and health-related information in the United States are most frequently delivered in English, which means that patients with limited English proficiency (LEP) have poorer health literacy than their English-speaking counterparts, influencing multiple health outcomes. LEP is an increasingly significant challenge in the United States. In 2013, more than 60 million U.S. residents (almost 1 in 5) spoke a language other than English at home. The largest share of that group spoke Spanish, followed by shares speaking Indo-European languages (such as French, German, and Russian), Chinese (including Mandarin, Cantonese, and other dialects), Vietnamese, Tagalog, and Arabic.

This linguistic and cultural richness presents a unique challenge for LEP patients and their clinicians. We know that poor health literacy can be dangerous: Patients among racial or ethnic minorities are more likely to read a pill bottle incorrectly or to misunderstand medical advice. People with poor health literacy are 1.5 to 3 times more likely to face adverse medical outcomes. But by improving communication through a few steps, including using professional interpreters, clinicians can prevent misunderstandings and help their patients lead healthier, safer lives.

Errors in medical interpretation are common for patients with LEP, especially when the interpreter is a family member or other untrained individual. But those error rates could be cut in half if trained professional medical interpreters were used, whether in person or by video conference or even by phone. Health systems and practices around the country need to train and deploy these professionals for LEP patients.

NIMHD is committed to supporting research and communications efforts to improve cultural competency and clinician–patient communications. This portal is meant to be a resource for NIMHD stakeholders who work with LEP populations, to help improve access to health information produced by NIH and other federal agencies. Together, we can find solutions to language and cultural barriers and improve the health of all U.S. residents.

Learn more about Dr. Pérez -Stable’s work on this topic here.