A Voice for the Unheard

Manuel Angel Cintron, Research Year

To hear and not understand—to speak and go unheard. When most of us visit our healthcare provider, we expect to share a common language and have a conversation that is free of communication issues. Unfortunately, many Spanish-language-dominant patients find that their experiences deviate away from this ideal. In the United States, there were an estimated 62.1 million Latinos in 2020 (Bureau, 2021). This represents an increase of 23% from 2010—a notable increase when considering that the non-Latino population has only grown 4.3% during this same timeframe. This level of growth magnifies a communication issue among 81% of Spanish-language-dominant Latino adults, who would prefer to see a Spanish-speaking health care provider. The issue stems from the reality that only 7% of all physicians and surgeons are Latino (Funk & Lopez, 20222). Unfortunately, addressing the language barriers associated with this Latino physician-to-patient discrepancy is not always clear. While there are certainly times when we as providers use certified translators and translating services, we often rely on family members, uncertified staff, and limited Spanish-speaking foundations to conduct our plans of care. While these alternatives may seem sufficient from time to time, how are we sure that communications are being translated accurately? Why do we often rely on these methods when 57% of U.S.-born Latinos and 94% of Latino immigrants speak Spanish--the second most common language in our country--at home (Funk & Lopez, 20221)?

Undoubtedly, addressing systemic limitations of this magnitude will require a multidisciplinary effort that must be driven from a policy level. Government-backed programs such as Medicaid and Medicare can be used to help develop a framework that can be implemented universally in the future. For example, policy interventions such as fully reimbursed language access services can be implemented to incentivize providers to utilize such services regularly while promoting the expansion of the language access services industry. Additionally, financial incentives can be issued to practices and healthcare systems that have staff members with active language interpreter certifications that are involved in the care of these patients. This would encourage both private practices as well as larger healthcare systems to not only seek out candidates with such active certifications but also likely fund their current employees’ training to complete such accredited courses.

Certainly, we as students can also play a role in petitioning our own institutions to offer such courses throughout our medical training. For example, implementing this sort of motion would be beneficial to our institutions from a marketing perspective and would likely result in early research grants throughout the development and assessment processes. Concepts such as institution-supplied language learning resources flipped classroom sessions, and standardized patient encounters conducted in Spanish are both feasible and easy to conduct. For resource-limited institutions, regional or national collaborations can be considered.

Undoubtedly, these policy changes alone are unlikely to lead to nationwide adoption. However, they will help us establish a framework for minimizing such inequities in the

future. Thus, a voice may be the only thing preventing us from addressing such widespread inequities. So, let us come together and fight for what is right.

About the Author:

My name is Manuel Cintron and I am a first-generation medical student that was raised in a predominantly Latino neighborhood in Cicero, IL. I spent the majority of my childhood walking the hallways of a local hospital that cared for my grandfather until his dying days. Unfortunately, he passed away in his 50s from noncompliance, but I often wonder how much of his treatment plan he truly understood. I fight for those like him, and Latinos that are striving to take a stand against inequity in this world.

I currently serve on several of my institution's medical education boards, with the goal of reducing inequities among the student population as well as those that they are taught to care for. I am currently participating in the National Institutes of Health's Medical Research Scholars Program, where I am learning how to conduct research in the following areas: epidemiologic methods, geographic information systems, community-based interventions and the characterization of physiologic pathways associated with chronic diseases in minority populations. I strive to continue to improve the community efforts that I contributed to while serving as a board member of our local LMSA chapter, and sharing them with other LMSA members as a delegate.

About the Work:

An opinion piece that aims to identify language as a barrier of care and what can be done to help address it.

References

Bureau, U. S. C. (2021, October 8). 2020 census statistics highlight local population changes and nation's racial and ethnic diversity. Census.gov. Retrieved October 15, 2022, from https://www.census.gov/newsroom/press-releases/2021/population-changes-nations diversity.html

Funk, C., & Lopez, M. H. (2022, June 16). 1. A brief statistical portrait of U.S. Hispanics. Pew Research Center Science & Society. Retrieved October 15, 2022, from

https://www.pewresearch.org/science/2022/06/14/a-brief-statistical-portrait-of-u-s hispanics/

Funk, C., & Lopez, M. H. (2022, June 16). 2. Hispanic Americans' experiences with Health Care. Pew Research Center Science & Society. Retrieved October 15, 2022, from https://www.pewresearch.org/science/2022/06/14/hispanic-americans-experiences-with health-care/