September 18, 2023

Overcoming Language Barriers in Health Care

A Spanish-speaking woman tells a medical resident that her 2-year-old “hit herself” when she fell off her tricycle; due to language barriers, the resident misinterpreted two words, understood the fracture to have resulted from abuse, and contacted the Department of Social Services.

Stories like this, taken from the New England Journal of Medicine, clearly illustrate the importance of overcoming language barriers in health care.

According to the U.S. Census Bureau, nearly 14% of Polk County, Iowa (Des Moines metro) households speak a language other than English at home. A closer look at the Census Tracts finds the percentage of households where residents speak English less than “very well” rises to as high as 25% in some areas of the county.

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Overcoming language barriers in health care is not just the nice thing to do; it can be a matter of life and death. According to an article by Cheri Wilson in the International Journal of Health Policy Management, when compared to English-proficient patients, limited English proficiency (LEP) patients have:

• Longer hospital stays when professional interpreters were not used at admissions and/or discharge.
• Greater risk of surgical infections, falls and pressure ulcers.
• Greater risk of surgical delays due to difficulty understanding instructions, including how to prepare for a procedure.
• Greater chance of readmissions for certain chronic conditions due to difficulty understanding how to manage their conditions and take their medications, as well as which symptoms should prompt a return to care or when to follow up.

EveryStep employs 13 locally based interpreters fluent in 23 languages. But correctly making language connections is only part of what these interpreters do, according to EveryStep Interpretation business development specialist Sammantha Ruiz-Yager. “Aside from bridging the language gap, they are their face-to-face cultural connection, making it easier for families to open up more and ask questions that they might otherwise feel would not be answered.”

“During interpretation sessions, our interpreters provide cultural brokering with the providers, and that is extremely beneficial because the providers can build rapport with the clients,” says Ruiz-Yager. “We don’t want to offend our clients by doing something improper in the home (e.g., kiss a baby’s forehead, not take shoes off at the front door, having a male interpreter in a home without the husband present). In addition, the interpreter brings a sense of comfort into the home if the client sees that another guest in the home is from their own country. Since we are entering their residence, we want to make sure that we are providing the best possible care to their family.”

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Despite studies that show improved outcomes when LEP patients are paired with interpreters, misconceptions remain about the use of interpreters to overcome language barriers in health care. “I think the biggest misconception is that interpreters are a nuisance, and they get in the way of the communication with the clients,” says Ruiz-Yager. “If you are using a professional interpreter who is qualified to interpret in your work setting, the conversation should be so flawless that you forget that the interpreter is even there. Also, when working with interpreters, it is not just about the language barrier, but also about learning about your client’s culture and beliefs. When working in a clinical setting for example, some cultures use traditional medicinal healings that are uncommon in western medicine. Sometimes, those alternative or traditional medicine can create complications when mixed with prescribed medication (e.g., herbal remedies). If the provider had not used an interpreter and just ‘winged it’ they could have potentially created a more serious situation in which death could have occurred.

EveryStep’s highly trained interpreters bridge the gap around linguistics. Providing interpretation in the professional fields of social work, healthcare and education, EveryStep focuses on offering interpretation and translation services to the growing refugee immigration population with a goal of setting the bar for the interpretation and translation profession.

All EveryStep interpreters must pass a language proficiency test in English and their native language prior to being offered a position. Once they are part of the organization, the staff complete Mandatory Reporter of Child and Adult Abuse training and are offered continuous training in the health care and human service field.

Offering a comprehensive slate of nonprofit health care and human services, EveryStep helps individuals and families overcome times of crisis and build the foundation for a healthier future. Your donation to EveryStep is a powerful act, demonstrating that you believe in a community where people show up for one another. Providing interpreters to overcome language barriers in health care is one-way EveryStep fills the gaps some refugees and immigrants in our community encounter.

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