Keep Essential Care: Language Access

By: Mara Youdelman

COVID19 is having an unprecedented impact on the lives of billions of people. But a robust and effective COVID19 response must not be a vehicle for denying access to essential health care services.

NHeLP is fighting to protect access to the range of critical services that people — especially low-income and historically vulnerable communities — need in order to live their lives. Yes, even in a pandemic. Especially in a pandemic.

Coronavirus is a lonely disease — isolation, quarantine, shelter-in-place. And if someone needs to go to the hospital, no family or friends can visit. But what if the sick person is limited English proficient (LEP)? Do they get the help they need to communicate with health care providers about their symptoms, consent to treatment, and understand their prognosis and outcomes? What about their family members – do they get information in a language they can understand?

Unfortunately, it seems more often than not, the answer may be no. We’ve already seen stories of the higher death rates from Coronavirus for African Americans and other people of color. Many of the same factors apply to LEP individuals because they often are people of color – structural racism; lack of insurance and access to health care; higher rates of underlying conditions; lack of paid sick leave; inability to work-at-home; being on the front lines working in hospitality, on farms and factories, in childcare, etc. Then add communication barriers as the cherry on top.

Health care providers required by law to provide language services

Longstanding civil rights laws require that hospitals and other health care providers provide language services – including interpreters and translated materials – to help their LEP patients communicate with them. Both Title VI of the Civil Rights Law of 1964 and Section 1557 of the Affordable Care Act prohibit discrimination against LEP patients. But even before Coronavirus, getting interpreters or translated materials for many LEP patients was uneven. Now with Coronavirus, it seems to be getting even worse. As the title of one article puts it, Hospitals Have Left Many COVID-19 Patients Who Don’t Speak English Alone, Confused and Without Proper Care.

Health interpreters

It’s a twofold issue – on the one hand, interpreters are an integral part of the patient care team and must be available to ensure effective communication. On the other, if there’s not enough Personal Protective Equipment (PPE) to go around, how can interpreters do their job and not be exposed to Coronavirus? As noted by the Certification Commission for Healthcare Interpreters, we must ensure either that PPE is available or that interpreters are able to participate in patients’ care via remote interpreting.

Translated materials delayed behind English materials

We also can’t leave LEP individuals behind as we share information on how to protect ourselves from transmission. Yet, translated materials are often not developed at the same time as English materials. Thankfully, the Covid-19 Health Literacy Project has already translated essential Covid-19 information about prevention and possible treatment options, among other issues, in over 35 languages. But we should not have to rely on volunteers to do this. Our federal and state agencies should be providing this information directly themselves, for no other reason than that we’re all in this together. Over 8% of the population is LEP. If a segment of the community does not understand social distancing, shelter-in-place or to wear masks, all of us continue to be at risk.

Problems in ensuring language access aren’t new. Unfortunately, they’re just one more problem – like health disparities – that has been ignored for far too long and is now compounded in the midst of a pandemic.