Study Highlights Language Barriers Faced in Healthcare

Teresa Watanabe, Los Angeles Times, March 21, 2008

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The three Southern California immigrants reflect the widespread problem—and the potentially devastating consequences—of language barriers in healthcare. The problem’s massive scope was illuminated Thursday, when the Asian Pacific American Legal Center in Los Angeles released a new study documenting the language barriers faced by nearly one in three Los Angeles County residents, or 2.5 million people.

The data, based on the 2000 census, show that most of residents in five of the county’s eight service planning areas—which are used to plan and deliver health and social services—speak a language other than English at home. The top languages spoken are Spanish, Chinese, Tagalog, Korean, Armenian, Vietnamese, Persian, Japanese and Russian.

The largest number of limited-English speakers are in the San Gabriel Valley, totaling 482,310, including roughly 200,000 Mexicans and 100,000 Chinese. In the metro Los Angeles area, which includes downtown and other core areas of the city, the primary language spoken by 70% of residents is not English and 43% reported speaking limited English, the county’s highest rate.

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Miya Iwataki, director of diversity programs for the county Department of Health Services, said the language needs in the county’s four public hospitals were “overwhelming.” In 2006, 49% of the system’s 3.9 million patient visits involved people with limited English skills who primarily spoke one of 98 languages. Spanish speakers accounted for 1.9 million visits, followed by 17,000 visits by Korean speakers.

But Iwataki said county language services have improved in the last year. This year, nine full-time healthcare interpreters will be hired for the first time for the hospitals.

In addition, the county expanded its video medical interpretation system to all four hospitals this year. The system, which was introduced at Rancho Los Amigos Rehabilitation Center in Downey last year, uses video-conferencing technology to connect doctors and patients with an interpreter network that offers assistance in Armenian, Russian, Korean, Spanish, Mandarin and Cantonese.

County hospitals also use a phone-in interpreter system. But that system is flawed, according to Wingshan Lo of the Asian Pacific center. Lo said she tested the system last year and was hooked up to a language assistance center whose staffer did not understand the Cantonese she was speaking.

In addition, immigrant advocates said many hospital staff are not aware that healthcare providers who receive federal funding are legally required to offer language assistance, regardless of the patients’ immigration status. PALS for Health, a Los Angeles nonprofit organization that provides language assistance, gets several complaints every month about healthcare providers who tell patients they need to find their own interpreters, according to Marchela Iahdjian of the organization.

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