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In America in general, but especially in a small time with limited resources, non-english speaking people are underserved. "Non-English-speaking patients receive fewer preventive services and have less access to care than English-speaking patients" (Taira 1995). From personal experience as a healthcare worker I can say that I feel very uncomfortable when caring for a non-english speaking patient, because communication is key, and a language barrier makes that difficult, and while I always do my best to see to it that they have the same care as anyone else, Im only as useful as the resources I have available.

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a study revealed "49% had trouble understanding a medical situation, 34.7% were confused about how to use medication, 41.8% had trouble understanding a label on medication, 15.8% had a bad reaction to medication due to a problem understanding their healthcare provider’s instructions, 66.7% faced a barrier when accessing healthcare, and 20% did not seek healthcare services if these were not readily available for fear of not understanding their healthcare provider." (Med 2020). With this information we can conclude that there is area for improvement if nearly half of this population have trouble understanding medical situations.

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Nurses can be advocates for non-english speaking patients by ensuring that all possible avenues are explored to give these patients equal treatment. As an inpatient nurse in an acute care setting, I would be sure to use the available resources such as interpreter, printed instructions in languages they can understand, and assigning a nurse that speaks that language if available.

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1. https://onlinepublichealth.gwu.edu/resources/limited-english-proficiency-health-care-how-to-support/

This is a website that has resources such as stroke resources, immigrant, refugee and migrant resources, immigration law, and a health and medical information library all at the touch of a button.

2. https://go.jeenie.com/

This is an online medical interpriter certified medical providers there to assist with seamless workflow of healthcare. They serve 300+ languages and are available 24/7!

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After the COVID-19 pandemic hit the United States, disparities in health care access became even more apparent. Data from a Boston hospital showed that non-English-speaking COVID-19 patients were experiencing higher fatality rates from the disease. Then, when vaccines for the virus became available to the public, individuals with limited English proficiency did not have accessible information about how to get vaccinated.

These disparities are not new; non-English-speaking communities have long experienced barriers to accessing health care services. Having access to credible information, being able to navigate misinformation and understanding the requirements for health care facilities to provide language services are just a few examples of the challenges non-English speakers face. In response to these issues, public health professionals, community organizations and dedicated individuals have focused on improving access to public health information.

Barriers to Health Care for Non-English Speakers

According to the U.S. Census Bureau, 67.3 million U.S. residents spoke a language other than English at home in 2018. Despite the prevalence of people with limited English proficiency, health care systems are not always prepared to best serve this population. As a result, language and cultural barriers contribute to health disparities experienced by immigrants and non-English-speaking communities.

According to Elizabeth Andrade, Dr.P.H., MPH, assistant professor at the George Washington University Milken Institute School of Public Health, there are multiple factors that contribute to these disparities.

One issue is health literacy and the lack of accessible resources for non-English speakers. When there is a gap in information, people may turn to alternative sources to reconcile their uncertainty, Andrade said.

"This is one place where misinformation is born. When you're communicating with a language minority population, it's important to keep in mind it's never just about language," Andrade said.

A patient's level of health literacy and access to credible information affects their ability both to make decisions about their health (e.g., "Should I get vaccinated?"), as well as the ability to seek health services when they do make a decision (e.g., "Where are vaccines available?" or "How do I make an appointment?").

Another barrier that may keep individuals with limited English proficiency from seeking health services is their lack of trust in health care systems and major health organizations.

Community organizations and clinics have helped to bridge this gap by forming relationships with the populations they serve.

How to Reach Non-English Speakers

To improve access to health services for non-English speakers, it's important to minimize the spread of misinformation while bringing awareness to helpful public health resources. Andrade said that these efforts need to be rooted in establishing trust.

Tips for Getting Involved: Supporting Non-English Speakers

How Multilingual Family Members Can Support Loved Ones

Cómo Los Miembros De familias Plurilingües Pueden Apoyar A Sus Seres Queridos

Resources for Supporting Non-English Speakers

General Health Resources

COVID-19 Resources
Citation for this content: MPH@GW, the George Washington University online Master of Public Health program

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Limited English Proficiency and Health Care: How to Support Non-English Speakers

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Patients with limited English proficiency are more likely to have worse clinical outcomes. Public health can address language and cultural barriers.

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As previously discussed, a percentage of non-english speaking people don't seek medical treatment for fear of not understanding the medical information. With that being said, and area of need for this population starts prior to the need for medical treatment. As a community, we should be proactive instead of reactive. Post flyers with available resources, in different languages, in the areas that are more populated with non-english speaking people. Social media is also a great way to get information out, as this day in time, nearly everyone has some sort of social media account.

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AMA J Ethics. 2017;19(3):263-271. doi: 10.1001/journalofethics.2017.19.3.medu1-1703.

Abowen. (2022, November 30). Limited English proficiency and health care: How to support Non-English speakers. GW. https://onlinepublichealth.gwu.edu/resources/limited-english-proficiency-health-care-how-to-support/

Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of language barriers for Healthcare: A systematic review. Oman Medical Journal, 35(2). https://doi.org/10.5001/omj.2020.40

Medical interpreters. Jeenie. (n.d.). https://go.jeenie.com/ssu-medical-interpreting-2p?utm_device=c&utm_source=google&utm_medium=cpc&utm_campaign=Jeenie_Non-Brand_Medical&utm_term=interpreter+medical&utm_content=nb&hsa_acc=1844165748&hsa_cam=19350631843&hsa_grp=144255451386&hsa_ad=692260337405&hsa_src=g&hsa_tgt=kwd-304502193775&hsa_kw=interpreter+medical&hsa_mt=p&hsa_net=adwords&hsa_ver=3&gad_source=1&gclid=Cj0KCQjwpP63BhDYARIsAOQkATZaQCDcESxZ_pQaE_UlWuR9K-g-i4qWHfCuUNO_Acd3AWTSQcS-8JsaAiTvEALw_wcB

Taira, D. A. (1999). Improving the health and health care of non-english-speaking patients. Journal of General Internal Medicine, 14(5), 322–323. https://doi.org/10.1046/j.1525-1497.1999.00345.x