Language Barriers In Health Care

Communication between healthcare providers and patients is key to providing safe, high quality care. Title VI of the Civil Rights Act of 1964 indicates that all federally funded programs need to provide meaningful access to care for limited English proficient (LEP) individuals (HHS.gov). LEP individuals are those “who do not speak English as their primary language and who have a limited ability to read, speak, write or understand English” (LEP.gov). Even though Title VI has been in effect for the last five decades, language barriers between providers and immigrants with LEP is still an ongoing issue.
It has been well-documented and well-researched that language barriers adversely affect access to health care (Schwei et al., 2016). Many

This model was first conceptualized in the 1950’s and developed for use in the 1960’s. It incorporates how the understanding of a patient’s culture can lead to more fulfilling and holistic caring for both patient and provider (Leininger, 2007). Leininger’s work bridges the gap between patients, who come from a different culture and speak a different language, and providers, who predominantly speak English and are of English descent. Three specific points by Leininger (2002) are relevant to this study and expand on the significance of solving language barriers. The first being, “culturally based care (caring) is essential for well-being, health, growth, survival, and in facing handicaps and death” (Leininger, 2002, p. 192). This first concept touches on the significance of understanding where the patients come from and using their culture as a guide to develop treatment plans that are most appropriate and efficient. The second concept is that culturally based caring is needed for curing as there can be no curing without caring (Leininger, 2002). This position by Leininger has two parts, the first focusing on incorporating patient’s cultures into their treatment plans and how this is necessary to provide

Culturally congruent care draws on the knowledge and experience from the people of the culture themselves, which Leininger calls “emic” knowledge. This allows the patient to actively participate in their own level of care, expressing what is culturally acceptable and what is not. It also takes in the views from an outsider’s perspective, which Leininger coins “etic” knowledge (Leininger, 2007). Culturally congruent care combines emic and etic knowledge to provide a more well-rounded cultural view on healing, thus giving patients more comprehensive and holistic caring (Leininger, 2007). Interpreter services would be emic knowledge, expressing cultural cares and concerns from the patients points of view (with an insider’s knowledge), and providers would be assessing and listening with etic knowledge. When providers and interpreters work together to diagnose and implement treatment plans with a good understanding of the patients’ culture and background, they are providing holistic healing and curing of the patients. Leininger’s theoretical framework is relevant because it understands that when healthcare providers heal with an open heart and open mind, patient’s are the ones who benefit from a more complete and concise approach to