The Health Care Language Gap: Limited Language Accessible Health Care for Refugees

Kabul refugee children welcome winter clothes, ResoluteSupportMedia, 2013, Modified

By Zuwena Plata

Published November 24, 2015

From September 26 to October 6, 2015, Brandon Stanton, the photographer behind the popular blog and Facebook page, “Humans of New York,” posted photos of Syrian refugees with captions that told a small part of each individual’s story. The photos, which have garnered hundreds of thousands or more “likes,” left viewers to reflect on their lives and the lives of those affected by the Syrian Civil War.

One of the main concerns of these and other refugees is accessing health care after leaving their home country. Often after resettlement in the United States, refugees have few or no resources to help them adjust to their new environment and seek needed medical care. As a result, many refugees who do not speak English must navigate foreign healthcare systems on their own. In high-income countries like the United States, the healthcare system is complicated and even Americans struggle to navigate it.

One of the biggest challenges to seeking and receiving health care is the lack of effective communication between these patients and healthcare professionals. This is usually due to language and/or cultural barriers. Often, healthcare providers and administrative staff do not speak the same language as the refugee, making it difficult or even impossible to determine the exact cause of the patient’s visit and provide appropriate care. This is despite a legal responsibility to provide language access resources across all federal programs and activities. Individual states have a wide breadth of laws pertaining to language access in healthcare settings and still many providers are unaware of their legal obligations to their non-English speaking patients. Where medical professionals are able to communicate with the patient, it is frequently through a telecom interpreter service or through an in-person interpreter.

To complicate matters more, although some healthcare providers recognize the importance of language access, the quality of interpretation varies from location to location and from one visit to the next. Language access can be as simple as having pamphlets or paperwork in different languages for patients on topics such as abortion consent, breast cancer and HIV/AIDS, or as integrative as having an in-person interpreter as a permanent fixture in a hospital’s emergency department. Unfortunately, in cases where there are written documents, if the patient is illiterate or visually impaired, the information is ineffective.

Developing channels for effective communication is one step toward better care for refugee patients but it is far from the last step. The challenges that refugees face are unique. Existing legislation needs to be enforced to ensure that this already vulnerable population is not neglected after they have escaped crisis. Given the popularity of Stanton’s photos, it seems clear that the issue of refugee health has found its way into the minds of many and has the potential to serve as a launching point for a discussion surrounding the ways in which the healthcare language gap can be remedied for present and future refugees.

References

Perkins J , Youdelman M. Summary of State Law Requirements: Addressing Language Needs in Health Care. National Health Law Program. 2008.

Institute of Medicine (US) and National Academy of Engineering (US) Roundtable on Value & Science-Driven Health Care. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary. Washington (DC): National Academies Press (US); 2011. 3, Healthcare System Complexities, Impediments, and Failures.