HealthEd Academy Report: Speaking Multiculturally in Health Care

An often repeated saying in health care goes that patients lose about 80% of the information they heard during a doctor’s appointment by the time they reach the parking lot. It emphasizes that patients aren’t able to put followup care instructions into practice when they either forget or don’t comprehend what was said during a visit. Whatever the actual percentage might be, a guaranteed way to ensure that patients take home 0% of that information is to talk to them in a language they don’t understand.

Twenty percent of the United States population reported that they speak a language other than English at home, according to the U.S. Census Bureau. Many health care workers see limited English proficient patients every day, and within Accountable Care Organizations (ACOs) and Patient-Centered Medical Homes (PCMHs) it will be up to these workers to make sure that patients have the best health outcomes, no matter how high the language barriers are.

Today HealthEd Academy released the results of a survey that looked at the way non-MD health care professionals interact with their patients from multicultural backgrounds. The report examined responses from a survey of 192 health care extenders, which included nurses, social workers, pharmacists, patient educators, and more. One in five of those surveyed were part of an ACO or PCMH.

The respondents reported working with a huge array of languages. They were asked to name the most common languages spoken by their patient populations, and four out of 10 checked “other,” despite being able to choose from 10 languages identified by the Census Bureau as the most commonly spoken. Among the languages respondents wrote in were Arabic, Yiddish, several Indian/Pakistani languages, and sign language.

“An alarming finding is there is such a large potential for miscommunication between health care extenders and patients, and that can have all sorts of health and safety ramifications,” said Katherine Margolis, PhD, one of the lead analysts of the survey and director of health behavior strategy and research at HealthEd Academy. And health care workers certainly don’t have all of the patient education materials they need in each of the languages they need them in. Margolis said that materials are typically developed in English first, then in Spanish, but it usually ends there.

Another interesting but not entirely surprising finding from the report was a statistic about the respondents themselves. More than 80% are Caucasian. HealthEd Academy said this reflects the current racial profile of health care extenders in the U.S., citing other national surveys like ones that found that 83% of registered nurses are white, and so are 82% of registered dietitians.

Half of HealthEd’s survey respondents reported that they are making an effort to recruit staff that better reflect the populations they serve. “I think it will be interesting to see how the demographics shift in time because I think it’s only a matter of time before they do. The U.S. Census has reported that over 50% of people under the age of one are from a minority group,” Margolis said.

Some of HealthEd Academy’s other findings from this report include that:

  • Health care extenders usually forgo technology and primarily deliver education materials in print or in person
  • Health care extenders involve minority community members less often than they involve health care providers when designing patient education materials
  • Patient education is provided at many community locations, but it’s rarely provided at pharmacies

The report is full of examples of what health care professionals are doing to better care for their patients from minority populations. For example, in addition to using interpreters, many said that they are currently working on translating patient education materials into other languages. HealthEd Academy pointed to existing resource Healthy Roads Media for help with this. Healthy Roads is a grant-supported organization, which creates materials in all different languages in written, audio and mobile formats. The report highlights other tools health care extenders can use to serve all of their subpopulations and concludes that providing this kind of tailored care is complex, but it’s critical.

2 replies »

  1. It’s very sad that the average person going to the doctor only remembers about 20% of what they are told. Being told in a different language than your first language would make it very, very difficult to comprehend. We really need PHRs to become the norm.