Hi, my name is Kamalika Das and the title of my presentation is “Victims to broken solutions: the Hispanic community in North Carolina, language barriers, and healthcare”. I have volunteered in a hospital setting for 3 years and I have seen the language barrier continue to become a greater problem in North Carolina, which has intrigued me to research the history and current efforts towards bridging this gap.
Hablas español? This is a phrase we often hear in our daily lives, but more commonly when we find ourselves in healthcare settings. Language barriers have existed for decades, as influxes in immigration have made it more evident and troublesome especially for the Hispanic community. Language is the foundation to understanding, knowledge and communication, and when this foundation is inevitably deprived from those in the Hispanic community, everything we take for granted in our daily lives is jeopardized. Language barriers are especially harmful in healthcare settings, where communication is integral for one’s well-being. Over the years, grants and organizations have pushed to fund efforts in bridging this gap. Interpretation services, translators, brochures in different languages and more have been introduced to healthcare facilities but unfortunately prove to be faulty. It would be a responsible action for healthcare facilities to take a step back now to analyze these problems faced by underserved communities in North Carolina and to recognize that these solutions have well proved to be ineffective and change needs to be immediate.
The Hispanic community faces more than just a language barrier when it comes to healthcare. Despite having employment, more than half of the Hispanic community in the workforce lack insurance or any type of healthcare coverage (Herrick & Gizlice, 2004, p. 1). Important cultural differences exist in Spanish-speaking countries, specifically the culture of healers and natural remedies are trusted, making a hospital or private practice a less likely place to seek help (NC IMO Latino Task Force, 2003, p. 120).
With the Hispanic community tripling in size over the years, North Carolina and other states are facing a crisis as they refuse to recognize that current measures for language barriers are neither effective or widespread across the state (Herrick & Gizlice, 2004, p. 2). According to the UNC Popular Government, Hispanic residents have noticed longer waiting times, and when receiving care, family members and unqualified members such as custodians and receptionists, are used to translate for appointments (Perkins, 1999,p. 39). Similarly English-speaking Hispanics are left to translate for multiple patients, as a child once did in the Emergency Room (Perkins, 1999,p. 39). Despite unprofessional efforts like these to bridge the language barrier, healthcare professionals often make wrong diagnoses, have a weak idea of medical history and as a result, patients have to suffer through unnecessarily increased testing and subsequently expensive hospital bills (Pabon & Wisotzkey, 2013, p. 19).
In a survey done by nurses as they interacted with Hispanic patients, they described the inefficiency of translation and interpretation services. Using hand gestures and family members being the interpreters in their occasional interactions became the most frequently used forms of communication (Pabon & Wisotzkey, 2013, p. 20). Interpreters and written resources are the least utilized and also the most expensive, especially for smaller healthcare facilities (Pabon & Wisotzkey, 2013, p. 20). The nurses reflected that most of their interactions and care procedures were only protocol and not as catered and specialized to the patient, as would be expected from a threshold hospital standpoint. Based on personal experience, unqualified members continue to interpret for members of the Hispanic community in hospitals, as a common sentiment of alienation and embarrassment surrounding the topic of receiving help from an interpreter prevents the use of these resources.
(Pabon & Wisotzkey, 2013)
In an interview that I conducted with the manager of Interpreter Services at UNC Hospitals, she mentions the overconfidence held by some healthcare professionals who know Spanish, but not enough to properly do their jobs, consequently avoiding to ask for help from interpreters. Additionally, the team has been understaffed due to the pandemic and is not able to meet for their check-ins regularly after each shift. iPads and technology have been implemented to try to help, but the best interaction proves to be between an interpreter and a patient. Though interpretation services has proved to be ineffective from past studies, an important factor to this conclusion may be influenced by the lack of healthcare professionals asking for the help of this resource or an overall lack of medical interpreters.
Just as all patients are promised to have the best quality of healthcare and reap the benefits of knowledge given to them by their trusted healthcare professionals, the Hispanic community has been deprived of those benefits and trust in the system for decades. Whatever the solution may be, it will be the most effective if the solution is decided upon with the presence and advice of members of the local Hispanic community. It is only fair for those who need help to be the ones helping with a solution for themselves. Often asking for help creates a sense of alienation which indicates that the healthcare system should work on bridging the gap and incorporating it into the structure of its facilities. Medical and professional schools should start providing students with language classes to have a basic understanding with their patients to foster a healthy relationship with the Hispanic community in order for them to start to believe and trust in the efforts made by the healthcare community. Thank you.
Works Cited:
Herrick H., Gizlice Z. (2004). Spanish-speaking Hispanics in North Carolina: Health status, access to health care, and quality of life, North Carolina Department of Health and Human Services (143), Retrieved from https://schs.dph.ncdhhs.gov/schs/pdf/schs143.pdf
Language barriers contribute to health care disparities for Latinos in the United States of America. (2002). Rev Panam Salud Publica/ Pan Am J Public Health. 11(56-58). https://scielosp.org/pdf/rpsp/2002.v11n1/56-58/en
Latino Health Task Force.(2003). The challenge of health promotion & health literacy in North Carolina’s Latino population. https://nciom.org/wp-content/uploads/2017/08/C8.pdf
Pabon S., Wisotzkey S.(2013). Hablas Inglés? Language barriers in healthcare. Nursing Management, 44(8),19 -21, 24. Retrieved from https://journals.lww.com/nursingmanagement/FullText/2013/08000/_Hablas_Ingl_s__Language_barriers_in_healthcare.4.aspx
Perkins J. (1999). Overcoming language barriers to health care, Popular Government, Fall, Retrieved from https://www.sog.unc.edu/sites/www.sog.unc.edu/files/articles/f99-3844.pdf
Featured Image Source:
Das, Kamalika. (2021) [Google Translate used for a question] [Digital Photograph].