Language access in health care is just as critical now as when the Title VI of the Civil Rights Act was originally passed in 1964. The U.S. has over 26 million Americans, or about 9% of its population, who are limited English proficient (LEP), with California having the highest number of LEP persons with 6.8 million or 26% of the total LEP population in the U.S. and about 19% of the state’s total population. As the Office of Minority Health (OMH) recognized in its Notice of Funding Opportunity, LEP persons “have a higher risk for experiencing healthcare disparities in accessing healthcare and screenings, and consequently have decreased quality of care and poorer health outcomes compared to English speakers.” It is hardly surprising then that 65.2% of the sickest LEP patients in California report having a hard time understanding their doctor.
The lack of culturally and linguistically appropriate access to health care coverage and services has had a disproportionate impact on LEP communities.
Nowhere is this more apparent than in the Asian American community (A.A.) in California, where A.A.s are the fastest growing population in the state and home to the largest number of A.A.s (15% of the state or nearly 5.6 million) in the country, with over one-third living in the state. Moreover, according to the American Community Survey, 34% of all Asian Americans are LEP, ranging from Vietnamese and Korean at 50% and 46%, respectively, to 22% for Japanese and 20% for Asian Indians.
Our statewide project in California, the Asian American Language Access and Health Equity Collaborative Project (Collaborative), aims to address the critical language needs of the AA LEP and immigrant communities and to increase culturally and linguistically appropriate language assistance services for Asian American communities. Our Collaborative serves areas with the largest Asian American communities, including parts of the San Francisco Bay Area, Sacramento, Fresno, Merced, and Southern California. Our Collaborative’s goal is to increase the use of language assistance services, including interpreter and translation services, for LEP Asian Americans and improve the cultural and linguistic access for LEP Asian Americans in California through outreach, education, and advocacy. Our project will increase the number of trained medical interpreters by conducting community-based medical interpreter trainings. This objective aligns with our efforts to increase the demand for trained medical interpreters through outreach and education to community members about their language access rights and to health care providers, managed care plans, and other covered entities about their language access responsibilities. Our final objective to monitor and strengthen language access requirements and policies through advocacy for policy and systems change will also support the increased demand for medical interpreters and translators.
If health equity is to be achieved, health care must address health disparities that are experienced across racial/ethnic communities. Addressing racial/ethnic health disparities in communities of color require an in-depth understanding of the root causes of health outcomes, and one main cause of health disparities is the lack of access to health care, especially those caused by cultural and linguistic barriers.
Through our outreach and education efforts, community members, service providers, and state and federally funded agencies will hopefully increase the public’s awareness of language access rights. Furthermore, by disseminating our project results and any successes with other localities, states, and interested stakeholders, we will increase their awareness of the importance of C&L appropriate services. This will help promote organizational, institutional, policy, and practice changes to better address the needs of our diverse communities to achieve improved public health equity.