Effect of Awareness of Language Law on Language Access in the Health Care Setting

doi:10.1111/j.1525-1497.2006.00492.x

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Wiley InterScience

Journal of General Internal Medicine

Volume 21 Issue 7, Pages 683 - 688

Published Online: 1 Jun 2006

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Effect of Awareness of Language Law on Language Access in the Health Care Setting

Vanessa Grubbs, MD, MPH ¹ , Alice Hm Chen, MD, MPH ¹ , Andrew B. Bindman, MD ^1,2 , Eric Vittinghoff, PhD ² , Alicia Fernandez, MD ¹

¹ Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, CA, USA; ² Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

Address correspondence and requests for reprints to Dr. Grubbs: San Francisco General Hospital, Building 10, Ward 13, 1001 Potrero Ave, San Francisco, CA 94110 (e-mail: vgrubbs@medsfgh.ucsf.edu).

None of the authors have any conflicts of interest to declare.

This paper has been presented as a poster at the Society for General Internal Medicine Conference (May 2005) and the National Research Service Award Trainees Conference (June 2005).

KEYWORDS

limited English proficient • interpreter • health policy • language barrier

ABSTRACT

BACKGROUND: Federal law obligates health care providers receiving federal funding to ensure language access to limited English-proficient (LEP) individuals who cannot communicate with their provider.

OBJECTIVE: To determine whether LEP individual awareness of this law improved language access through interpreter utilization.

DESIGN, SETTING, AND PARTICIPANTS: In June 2003, a telephone survey of 1,200 Californians was conducted in 11 non-English languages.

MEASUREMENTS: The survey included items on English proficiency, awareness of language law, health care utilization, and communication methods. Language access was defined as having a provider who speaks the individual's language (language-concordant) or utilizing an interpreter.

RESULTS: There were 1,000 LEP participants, of whom 371 (37%) were aware of the language law. Four hundred and ninety-one (49%) of LEP participants had a language-concordant provider. Of the remaining 509 LEP participants without a language-concordant provider, 111 (22%) reported interpreter utilization in the health care setting. After controlling for age, gender, education, income, insurance status, years in the United States, health care utilization, and level of English proficiency, awareness of law was not associated with interpreter utilization (odds ratio [OR] 0.66; 95% confidence interval [CI] 0.38, 1.17; P=.16), but was associated with having a language-concordant provider (OR 1.64; 95% CI 1.19, 2.26; P=.003).

CONCLUSION: Awareness of language law is not sufficient to resolve language barriers for LEP individuals. Provider and organization level barriers to language access must be addressed.

Manuscript received September 8, 2005
Initial editorial decision November 11, 2005
Final acceptance February 2, 2006

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1525-1497.2006.00492.x About DOI