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.
Key words limited English proficient - interpreter - health policy - language barrier
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).
Funding: New California Media’s project “Bridging Language Barriers in Health Care” was funded by The California Endowment.
This study was funded in part by a Physician Faculty Development in Primary Care Grant (#D55 HP 05165-01-00) from Department
of Health and Human Services. Dr. Fernandez’s efforts were supported by an NIH Career Development Award (K23 832401).
Bendixen & Associates: a survey and communications consulting group that focuses on the characteristics of the Latino population
and market in the United States and Latin America.
New California Media: a statewide multi-ethnic media association run by the nonprofit Pacific News Service.