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

Language and cultural barriers contribute to health disparities experienced by immigrants and non English speakers in the U.S.

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.

There are multiple ways to get involved in helping to make health care more accessible to non English speakers.

Tips for Getting Involved: Supporting Non-English Speakers

  • See who is already doing the work. It is often easier and more effective to contribute to existing efforts than to independently start your own initiative.  
  • Connect with community-based organizations. In addition to having established trust in a community, local organizations often will already offer language services. “They’ll also be able to determine what the information needs are,” Andrade said. However, it is important to consider an organization’s capacity—in cases where demand is high, community-based organizations may refer you to other resources. 
  • Plug into digital organizing. Sharing credible information in different languages on social media is another way to contribute without leaving your desk chair. For example, Andrade is helping to lead an effort called Brigada Digital de Salud to create social media content in Spanish that can be shared via community partners.
When it comes to health care, there are ways for multilingual family members to help support loved ones with limited English proficiency.

How Multilingual Family Members Can Support Loved Ones

  • Know your rights. Understanding what services and safety nets exist can empower you and your loved ones to ask questions and get the support you need. Organizations like the National Immigration Law Center offer information on health care rights and other legal issues. 
  • Consider a federally funded health center. Providing access to a trained medical interpreter is required, and these facilities are more likely to have additional language resources, Andrade said. The Health Resources and Services Administration (HRSA) offers a directory of federally funded health centers in the United States.
  • Set boundaries with interpreting. While a family member who is fluent in English may be able to assist their loved one in communicating in certain circumstances, it’s important to ask for a trained medical interpreter when visiting a health care facility. “You don’t want…to be put in the place of having to interpret terms or health topics that can sometimes be complex or hard to understand,” Andrade said.  
  • Align expectations before a health visit. If your family member is new to interacting with a medical interpreter, it can be helpful to explain that it may feel different than having a regular one-on-one conversation. Acknowledging this difference may help them adjust to speaking through an interpreter to communicate with their health care provider.

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

  • Conozca sus derechos. Comprender los servicios y nichos de seguridad existentes puede ayudarlo a usted y a sus seres queridos a formular preguntas y obtener el apoyo que necesita. Organizaciones como el Centro Nacional de Leyes de Inmigración ofrecen información sobre los derechos de atención médica y otros asuntos legales.
  • Tome en consideración un centro de salud financiado con fondos federales. Es necesario proporcionar acceso a un intérprete médico formado, y es más probable que estas instalaciones tengan recursos lingüísticos adicionales, dijo Andrade. La Administración de Recursos y Servicios de Salud (HRSA) ofrece un directorio de centros de salud financiados con fondos federales en los Estados Unidos.
  • Establezca límites con la interpretación. Si bien un miembro de la familia que domina el inglés puede ayudar a su ser querido a comunicarse en determinadas circunstancias, es importante solicitar un intérprete médico formado cuando visite un centro de atención médica. “No desearías… verte en la situación de tener que interpretar conceptos o temas de salud que a veces pueden ser complejos o difíciles de entender”, dijo Andrade.
  • Prevea las expectativas antes de una visita médica. Si su familiar es nuevo en la interacción con un intérprete médico, puede ser útil explicarle que puede ser diferente a tener una conversación individual normal. Reconocer esta diferencia puede ayudarlos a adaptarse a hablar a través de un intérprete para comunicarse con su proveedor de atención médica.

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