Bring Down Those Walls: If Language Barriers to Health Care Were Lowered, it Could Improve Quality of Care While Reducing Costs

Identifying gaps in the research literature on language barriers to health care

A research team led by Elizabeth Jacobs, MD, MPP, of the Rush University Medical Center and Cook County Hospital, Chicago, examined the medical literature in order to:

  • Summarize what was known about language barriers in health care.
  • Outline gaps in published and ongoing research.

The project built on earlier work by Jacobs and colleagues on an annotated bibliography of research on language barriers in health care settings, supported by the California Endowment.

Key Findings: In a report to the Robert Wood Johnson Foundation (RWJF), entitled "Gaps in the Research Literature on Language Barriers in Health Care," Jacobs and colleagues reported the following key findings:

  • The current body of literature on language barriers in health care focuses on documenting:
    • Language barriers to access to care.
    • Interpreter practice by physicians and health care institutions.
    • Patient- and provider-reported need for linguistically accessible services.

    These studies indicate that:
    • Language barriers have a negative impact on care.
    • Although patients and providers would like better services, they frequently are not provided.
  • A much smaller proportion of the literature focuses on:
    • The impact of interventions to improve linguistic access, health care outcomes, costs and quality.
    • The type of research that tends to motivate providers, policy-makers and health care administrators to make changes to improve the linguistic accessibility of health care.
    • These studies indicate that interventions that provide professional interpreter services and/or physicians proficient in a language other than English improve delivery of care.
    • Increase patient satisfaction.
    • Decrease costs—without a huge outlay of financial resources.

Key Recommendations: Research should be more balanced between documenting linguistic barriers to access to health care and investigating the role that interventions can play in reducing these barriers.More research is needed on the cost of language barriers to access to health care and the costs and benefits of improving linguistic access.

  • Researchers should strive to improve the methodological rigor of their work.
  • Research funders and policy-makers should lower barriers to conducting quality research on this topic by funding high-quality research initiatives and mandating collection of language data in large databases frequently used in population-based research.