Effect of awareness of language law on language access in the health care setting.
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.


METHODS
In June 2003, a telephone survey of 1,200 Californians was conducted in 11 non-English languages.


METHODS
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).


CONCLUSIONS
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.
Grubbs
Vanessa
V
Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA. vgrubbs@medsfgh.ucsf.edu
Chen
Alice Hm
AH
Bindman
Andrew B
AB
Vittinghoff
Eric
E
Fernandez
Alicia
A
D003142:Communication; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D007883:Legislation, Medical; D010817:Physician-Patient Relations; D012495:San Francisco