Amid COVID-19, Kansas needs improved language services to support health equity
Latinos constitute almost half of the confirmed COVID-19 cases in Kansas, reflecting an existing trend of poor health outcomes for Latinos in the state. Language barriers, among many other factors, can affect the health of groups with less power in society. As the presence of languages other than English increases here, the inadequacy of language services in healthcare has an increasing negative impact on the health of Kansans.
During a recent community meeting on Latino health, Spanish-speaking patients recounted experiences of health emergencies in which they had no interpreter, either because their interpreter did not arrive on time or their provider assumed an interpreter was not needed. In some cases, these patients suffered severe health and financial consequences as a result of miscommunications (leading to potential liability).
Despite federal legislation that requires healthcare institutions to provide a qualified interpreter for individuals who need language assistance, healthcare interpreting services are offered inconsistently in Kansas.
The COVID-19 crisis has added a level of complexity to language access: Wichita hospitals have increased their use of remote telephonic interpreting, when clinicians use cell phones to connect with an interpreter in a remote location. Certain aspects of communication can be lost through remote interpreting, and special training and video technology are needed to optimize remote modalities. In addition, I have spoken with providers in Wichita who do not have the technology to include professional interpreters in telehealth encounters; instead, they use untrained interpreters or provide in-person care, despite the risk of transmission.
The Kansas healthcare system and its patients were not adequately equipped for remote services before the crisis, resulting in an unnecessary decrease in healthcare access and quality during the pandemic.
In addition to communicating during doctor visits, people need to receive health information they understand. As indicated in a recent article in The Journal, limited access to information about COVID-19 in Spanish has led to confusion about state and county orders and what essential workers can do to protect themselves and their families. Sedgwick County has recently provided translations (though not always accurate) of its COVID-19 resources for the general public, and the local radio program Planeta Venus provides information in Spanish on the air and on its website.
However, dissemination of up-to-date health information in Spanish needs to be improved in Wichita, which is about 17% Hispanic, and in Ford, Finney, and Seward Counties, where Hispanics are the majority and extensive outbreaks of the virus have recently occurred.
English language education is part of the solution, but those of us who have studied a language know that becoming proficient enough to understand complex health information or a doctor’s questions, explain symptoms, and negotiate treatment does not happen overnight. Language learning can be especially challenging for individuals who are working to make ends meet and taking care of a family. English language courses are important, and they can include activities about understanding health information, but they are not all that is needed.
To provide equitable healthcare in Kansas, language access must be prioritized. Systems for providing quality language services that incorporate current technologies must be developed, evaluated, and continually improved, and information dissemination in languages other than English needs to be strengthened. These steps can be facilitated through collaboration with scholars of language and public health, and should be supported by state funding.