title: Effect of awareness of language law on language access in the health care setting.
abstract: 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.
authors.affiliation: Division of General Internal Medicine, San Francisco General Hospital, University of California, San Francisco, CA 94110, USA. vgrubbs@medsfgh.ucsf.edu
authors.forename: Vanessa
authors.initials: V
authors.lastname: Grubbs
authors.forename: Alice Hm
authors.initials: AH
authors.lastname: Chen
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Bindman
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Alicia
authors.initials: A
authors.lastname: Fernandez
mesh_terms: D003142:Communication; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007802:Language; D007883:Legislation, Medical; D010817:Physician-Patient Relations; D012495:San Francisco