Language Diversity Important to Healthcare

Understanding cultures, not just languages, is key to treating a diverse patient population
By Veronica Torres Martin 

An increasingly diverse population of Americans is coming through the doors of our hospitals every day, speaking different languages, reflecting different cultures and having very different experiences and expectations around medical treatment. It’s not enough for hospitals to interpret the languages of their patients. They need to interpret their cultures. 

Simply put, people hurt differently in different languages and cultures. The way a patient from one Latin American country views and responds to medical treatment may be very different from the way a patient from a neighboring nation experiences it, much less someone from another country halfway around the world. A community could have the finest hospital and the most qualified doctors in the world, but if the patient can’t understand the language spoken – or if the treatment ignores or offends a patient’s cultural sensibilities – all of that clinical excellence may be wasted.

Establishing trust and treating a patient medically means understanding them culturally, knowing who they are, where they’re from and what’s most important to them when it comes to healthcare.

Language is part of the equation. A trip to the Emergency Department or a hospital stay can be a worrisome ordeal for anyone. But if you’re among the more than 25 million Americans who, according to the Census Bureau, speak English “less than very well,” the experience can be even more intimidating. One in five U.S. residents — more than 61 million people — speak a language other than English at home.Another million or so use American Sign Language (ASL) to communicate, making it the fourth-most-used language.

Hospitals provide translation services because it’s the right thing to do. It’s also the law. Title VI of the Civil Rights Act requires hospitals and health clinics to provide the service to patients with limited English proficiency. Services generally are offered in three forms: In-person interpreting, with an on-site interpreter guiding the conversation between patient and provider; telephonic interpreting with an offsite interpreter; and video remote interpreting, using webcams and screens to provide spoken or sign language interpretation. 

Having qualified, certified interpreters schooled in medical terminology is essential. In the past, translating often was improvised, with family members, friends or other nonqualified people serving as interpreters. Clinicians often tried to “get by” with basic language skills, but much was lost in the translation. In medical situations, that’s just not acceptable.

Aside from language, the larger responsibility is understanding diverse customs, values and beliefs that can play so heavily in hospital interactions. Some examples: 

• Health beliefs: Some cultures believe talking about a possible poor health outcome may cause that outcome to occur.
• Health customs: In some cultures, family members play a large role in health care decision-making.
• Ethnic customs: Differing roles of women and men in society may determine who makes decisions about accepting and following through with treatments.
• Religious beliefs: Religious faith may affect health care-seeking behavior and willingness to accept certain treatments.
• Dietary customs: Dietary advice will be difficult to follow if it doesn’t conform to their foods or cooking methods.
• Interpersonal customs: Eye contact or physical touch will be expected in some cultures and inappropriate or offensive in others.

Hospitals that truly work to understand their patients’ cultural values, beliefs and practices are more likely to have positive interactions. That translates into better health outcomes, reduced readmissions and a healthier population overall. 

At a time when issues like immigration and basic respect for cultural differences are so much a part of the public dialogue, hospitals and health care systems in the U.S. must continue to meet the responsibility of treating all patients – no matter where they came from or what language they speak – with dignity, compassion and the best possible clinical care. 

Veronica Torres Martin, B.A., is the Language Services Manager for Berkshire Medical Center.