Introduction
A clear channel of communication between the healthcare providers and patients is important, for the provision of appropriate and quality healthcare. Approximately 46 million individuals in the United States take English as their second language, and this is a challenge for them when they are seeking for healthcare services. Another 21 million Americans speak English as their first language, but they are not fluent. Accordingly, language barriers play a significant role in the provision of health care services (Jacobs, Shepard, Suava & Stone 1). This paper will look into the significant problems that language barriers present to the healthcare system.
The increase in the number of the immigrant population in the United States has affected the healthcare system greatly. For example in 2005, the non-Hispanic white in the United States stood at 68 million, in 2005. This represents 33 percent of the 296.4 Americans in the United States. High rates of immigration into the United States led to the drastic increase in the population, in effect having an impact on the country’s healthcare system. Sadly, the health care facilities in the United States have not enhanced their capacity to handle the burgeoning population in need of healthcare services. In order for the medical care systems to render appropriate and quality health care services, there is a need to guarantee equivalent access to all people living in the community (Via Language par.1).
Inhabitants of the Hispanic origin have greatly contributed to the high increase in the population, in the United States. Between the year 2004 and 2005, individuals of Hispanic origin living in the United States represented about 49 percent of the country’s population growth of about 2.8 million. On the other hand, there was a rapid rise in the Asian population estimated at three percent between the year 2004 and 2005. In addition, the African-American population experienced tremendous rise of about 496,000 between the same years (Via Language par.3).
To attend to the three groups of patients mentioned above effectively, along with their relatives, the health care sector in the United States is in the process of implementing a plan that endeavors to highlight the healthcare problems facing these groups. For instance, people with limited English proficient (LEP) and immigrants’ population do not have adequate access to medical insurance. Whether the above groups lack knowledge and skills on the United States medical care systems or are due to the conditions of immigrants, offering translated medical care resources or materials to them, can be very significant to improve their health, survival and welfare in their new country of adoption. Transformation and explanation services mostly receive lessons to enable them confine medical care resources to the various cultures and levels of medical knowledge. Knowledge of the various cultures and the translators’ proficient experience can be priceless to many health facilities (Via Language par.5-6).
Language barriers in the health care systems can lead to patients developing negative perceptions about health care providers and more so, the health care services rendered to them. In addition, individuals with LEP face challenges while seeking medical/health care services. Moreover, language barriers can lead to a dissatisfaction of patient outcomes and health care actions and this might raise the probability that someone might not wish to go back to the same health facility for future health services. Therefore, the best method to overcome these challenges is for the health care facilities to employ professional interpreters for improved health care services and reduced health care costs. In addition, this will also guarantee equal health care accessibility to all community including the patients with LEP (Jacobs, Agger, Chem, and Piotrowski & Hardt 7-8).
Poor communication
Most of the employees experience either language barrier challenges or literacy problems, and this affects their capability to comprehend oral or written guidelines/instructions, clinical forms and prescriptions. As a result, this greatly influences their health status. According to the American Medical Association (AMA), approximately 90 million individuals in America face a hard time understanding and responding to clinical or health information. Therefore, the AMA finalize that as a result the health care system cost rises up to 73 billion dollars annually because of unnecessary hospitalizations, visits by health care providers and lack of the patients to conform to the medication plans and preventive attempts. Besides poor health and greater rates of usage, people having low health literacy rates mostly experience challenges in accessing medical care settings, understanding medical/clinical brands, understanding engagement slips and treatment, comprehending authority forms, health education information and treatment guidelines. As the health care setting costs are enormous, healthcare providers (Swedersky par.1) have not yet noticed effects of these challenges.
Similarly, employees with language and literacy problems perform their duties less effectively and are at high risk of sustaining workplace injuries. In addition, they are not in a position to read safety manuals, instructions and warnings for operating machinery, and are likely to cause destruction to the machines or equipment. Several studies have verified that language and literacy problems have great effect on health behaviors, individuals’ health and the capability of the health care personnel to maximize medication or results (Swedersky par.2).
To recognize and deal with an individual with literacy and language problems the use of diverse approaches becomes necessary. While the appearance and word pronunciation of the patient may recognize him or her as an unfamiliar or foreigner, these are not the actual determinants of communication challenges or language barriers to the provision of healthcare services. In addition, it is hard at times to recognize an individual challenged in communicating in a certain language, such as English. This is because such people frequently obscure their predicament and may look unapproachable, overly uneasy and irritated. Probably one of the best approaches utilized by the health care providers is being non-restraining while communicating to the patients that there is no problem for them to request for help while filling any forms or understanding certain guidelines. It is important for health care providers to develop and improve their capability to identify patients facing problems in language and literacy and establish measures that they can utilize in order to have clear and appropriate communication with the patients (Swedersky par.4).
Effects of language barriers
The lack of understandable and suitable spoken and written language is the main challenge to health care system aiming at disease prevention, curative and disease rehabilitation. In addition, it contributes to mis-utilization of medical care, increasing medical care cost and patient non-cooperation. Without quality and suitable language services, non-English proficient and limited English proficient population face inadequate medical care. In addition, they frequently depend on non-profit health care personnel and utilizing underground or substitute sources of health care (Tang, Lanza, M-Rodriquez & Chang par.1).
For the last several years, immigrants from other countries especially from Europe, Asia and Latin America have migrated to the United States. The resulting rise in linguistic, ethnic and cultural diversity has resulted in a growing and wide requirement or need for the accessibility of language services in the medical care systems. In the recent years, matters concerning language barriers have gained importance because of serial of centralized policies. People living in the United States continue to increase rapidly and their diversity persists to increase drastically during the 21st century. Such diversity has led to doctors and other health care personnel to network more often with individuals or patients of different ethnic relationships where life experiences, health beliefs, cultures and languages are different. Medical care settings in the United States greatly focus in rendering health services to English speakers. The main reason for this is due to the fact the most general barriers in any medical care system is English and it is a risk factor that lead to unpleasant results. Therefore, communication between patients and health care personnel are positively associated with improved and quality healthcare results like patient satisfaction, medication regime and preventive testing (Aboul-Enein & Ahmed par.1).
Healthcare facilities explanations
At Kaiser Permanente (KP), there is a great chance and a duty to develop the quality of healthcare services rendered to individuals hence improving the quality of life. For individuals where English is not their preferred or primary language, KP’s capability to offer health care that is patient-centered but its services face language barrier challenges, if they cannot communicate effectively with the patients in their languages. For example, caring for learned consent, accessing the clinical benefits and treatment information are some of the challenges. In addition, KP has to deal with the challenge of ensuring patients with NEP/LEP receive complete and appropriate data to accompany pre-operative guidelines. Therefore, the accessibility of skilled interpreters and understandable translated materials is crucial to obtain predominant equivalent accessibility to health information and suitable medication and treatment that result to quality care and patient safety (Tang, Lanza, M Rodriquez & Chang par.1).
Most of the patients who cannot speak English proficiently need a translator and getting such a person is another challenge to them. This places them at a high risk of underprivileged and at times dangerous medical conditions. From the year 1990 to 2000, the number of individuals living in United States who were experiencing limited English aptitude rose from seven million to 21 million. Although the number was skyrocketing in such a drastic manner there was no interpreters available to cater for approximately 46 percent of the patients in the accident and emergency department as reported by the United States census figures. Only 23 percent of the teaching hospitals provide health care providers with training programs based on the methods of working with an interpreter. However, failure of a medical care systems to have interpreters lead to poor health care quality, higher risk of admission since in the hospitals, greater risk of under-diagnosing or mis-diagnosing of the patient, greater risk of drug complications and lower chances of patient follow-up (Weise par.2-3).
In the United States, people facing limited English proficiency (LEP) looking for medical care encounter with two main problems which are inadequate information of the multifaceted U.S. medical care system and language barrier. Comprehending written data is significant so that the patients and health care providers can communicate effectively. However, most fundamental medical material such as thoughts and words like the difficult medical language and terminologies that are particular to the health care system, challenge many people including those who are proficient in English. Literacy in health, language and culture has great impact on the degree to patients understand the information or written material. The best solution for such challenges is to have translated materials that are non-English though they pose challenges to the health care providers (Hablamos Juntos 1).
Medical care organizations state several explanations as the cause for poor response to problems concerned with literacy and language. For instance, some of the organizations state that the main factor behind translating materials is high cost that is required to publish the materials. In addition, the organizations argue that various dialects make it hard for them to offer each society or culture with the appropriate data. The best solution to language barriers for the health care facilities is not complaints or excuses but rather, to employ bilingual clinical or medical expertise. In addition, the health care organizations can ask for health educational resources or materials from the industries in different languages and can go an extra mile and ask for an assistance of telephone companies, which are in a position to provide translation services. Similarly, they can educate or teach their employees by offering bilingual training classes or courses (Diversity Rx par.2).
Overcoming language and literacy problems
Coming up with useful and practical materials written in Spanish is the main goal for the demonstration sites of Hablamos Juntos. In the field of medical care settings, the most often translated materials are those formed to assist medical care facilities in fulfilling their core objectives like conforming to the official needs, rendering specific guidelines to the patients or working out the tasks of the administrative. However, some of the translated materials established by the Gab Analysis resulted to poor quality having no samples proposed for duplication. Eventually, it emerged that medical care facilities have wide mis-understanding on the process of translation and ineffective techniques to assess the translated text. These challenges faced by the medical care organizations make it hard for them to generate appropriate non-English health text. However, medical care facilities or organizations can develop and improve their performance by coming up with systems or processes that can identify and generate text that are translated and by make decisions by creating awareness about the translated version or non-English text (Hablamos Juntos 2).
Appropriate communication between the health care providers and their patients is important so that patient can obtain high quality and safe health services. Written information or materials are the most form of communication depended on to facilitate interaction between the patients and the physicians. However, there are hindrances with the written materials since they take the position between the patients who are the readers and health care providers who are the writers and hence, they have no chance to interact and clarify matters concerning the intention and meaning of the written information. On the other hand, the translated text has additional roles that include expressing data across health literacy, language and culture diversity. Moreover, translation expertise argue that the culture and language intermix has several challenges and at sometimes it may be impossible. This is because the meaning of the text formed socially and the same amalgamation of words in two various languages might not give similar meaning as the primary meaning. In addition, exhaustive reworking and rethinking of information or words might be required in order to form translations, which can maintain the original or primary meaning. Unfortunately, the original or primary meaning might not at all times exceed differences in language and culture, hence the original content of the materials also requires close assessment for it to be applicable to non-English individuals (Diversity Rx par.1).
Though medical care systems are encouraged to come up with translated materials, very few health care facilities support have been made to guarantee the efficient implementation of this idea. In addition, there are ineffective funding procedures and policies to help transform the challenges of the healthcare system due to language barriers. For example, approximately all the health care organizations that the demonstration sites of Hablamos Juntos worked with, had systems that lacked tools for the identification and prioritizing of non-English text growth and development. In addition, processes for reviewing and commissioning innovative translations for quality and safe health care were absent. To make it worse, there were no specified makers of decision for the procedure (Hablamos Juntos 3).
Conclusion
Language barriers in any medical care setting are issues that contribute to poor medical care services and severe injuries or accidents (Flores 231). There has been a drastic increase in the total number of individuals with limited English proficiency (LEP) in the United States over the last ten years. As a result, it leads to an important rise in need for communication challenges from a medical care perspective. These individuals face many health problems since they are not in a position to access information required for preventive purpose. Moreover, they cannot communicate their problems or medical conditions properly and as a result, they are under-diagnosed or mis-diagnosed by the physicians. To make it worse, the health care providers offer patients with LEP follow up guidelines, which they are not in a position to comprehend and this result to poor recovery period. There is the possibility of precluding some of the reported mismanagement cases to the health care system in the United States due to language barriers when suitable and applicable translated materials are used (Jacobs, Agger, Chem, and Piotrowski & Hardt 7).
In conclusion, language barriers lead to inappropriate explanation of medical conditions hence inadequate treatments or mis-diagnosing leading to reduced satisfaction of the patient with the health care. Therefore, in order for the patient to receive safe and quality health care service, there is need for clear communication between the patients and their health care providers. In cases where the patient cannot speak English proficiently, it is crucial for the health care facilities to employ professional interpreters if they are to render quality health care services (Jacobs, Lauderdale and and Meltzer 274). Moreover, to cater for the patient with LEP, translated materials can be availed. However, most of the organizations have misconceptions about employment of professional interpreters and therefore, only a few facilities have employed such individuals and others have not employed any at all. Some of these organizations have cited the large financial commitment as one of the challenges to employing professional interpreters. Hence, patients with LEP are not able to receive the required quality health care services.
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