NCPA - National Center for Policy Analysis


July 20, 2006

One of the biggest barriers to high-quality health care for millions of U.S. residents has nothing to do with medicine: It has to do with language.

According to Glenn Flores, director of the Center for the Advancement of Underserved Children, there are 50 million people in the United States, 19 percent of the population, who speak a language other than English at home and 22 million who have limited English proficiency and the number is growing.

  • Between 1990 and 2000, the number of Americans speaking a language other than English at home grew by 15.1 million (a 47 percent increase) and the number with limited English proficiency grew by 7.3 million (a 53 percent increase).
  • Patients who face language barriers have difficulty accessing care, receive fewer preventive services, and are less likely to follow medication directions; for example, asthmatic children with language barriers are more likely to end up intubated in intensive care.

"Patients who do not have the opportunity to have a culturally and linguistically competent physician often don't get as good care," confirmed Robert Schwartz, chairman of family medicine and community health at the University of Miami Miller School of Medicine.  "It's a critical issue to be able to speak to a patient."

Schwartz's department serves a predominantly Hispanic part of Miami.  And in Miami, according to the journal article, 75 percent of residents speak a language other than English at home.

The language issues are most pronounced in the emergency room and in psychiatric settings.  One study found that no interpreter was used in 46 percent of emergency-room cases involving patients with limited English proficiency.

Psychiatric patients who have language barriers are more likely to receive a diagnosis of severe psychopathology, and are also more likely to leave the hospital against doctors' orders.

Source: HealthDay News, "Language a Widening Barrier to Health Care," Forbes, July 19, 2006.


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