Addison Gaines
Ms. Andrews
English 1102-008
3 December 2012
The Migrant Health Care System
Everyone has been
to the doctor to get better. You walk in and tell him or her what is wrong, and
they tell you what to do and give you a prescription to make everything better.
Everyone has also gone to some fast food place or other restaurant to order
something to eat from an employee, whose native language is not your own. You
tell the employee your order and receive nothing but a confused look in return.
A few indiscernible foreign words are uttered very quickly, and then he or she
rushes off. You are left not knowing what in the world you have ordered or how
expensive it will be.
Imagine that same
frustration at that restaurant, but in every aspect of life. Even the simple necessities
of life simply cannot be communicated. Everyday, migrants all over the world
have this problem. Many people think of the language barrier as dealing with
employment and opportunities—mostly anything to deal with economics of that particular
individual. However, few people realize that not being able to communicate
clearly could literally mean life or death. Therefore, more recourses and
education need to be provided to ensure access to vital necessities for all
people.
One of the biggest
obstacles for non-English speaking individuals is not being able to communicate
with their healthcare providers. An article from Patient Education and Counseling highlights this blind spot in our healthcare
system today with “linguistic and cultural differences make access to health
care more difficult for migrant groups compared to indigenous groups in western
and in other immigrant countries all over the world” (Elsevier). Travelers and immigrants
have a hard time as it is traveling within and through countries of foreign languages.
But what happens when something goes wrong in those countries and the
individual needs medical attention? Since small routine procedures can go
horribly wrong, and place patents in danger, communication is of the upmost
importance. Therefore the same communication struggles those travelers have,
can cause things to escalate from annoying to life threatening. A study done by
the University of California at San Francisco focuses on the language barrier
in breast cancer patients.
Although 75% felt
they were usually able to communicate effectively with LEP patients, more than
half reported difficulty discussing treatment options and prognosis, and 56%
acknowledged having less-patient-centered treatment discussions.
The sheer number of individuals who
could not communicate confidently about their own health is appalling. This
survey shows the magnitude of patients who had difficulty communicating with
their doctors. The issue of cancer is a great one; imagine not being able to
communicate what can be done about it.
To further the urgency
of this issue, almost no scholarly papers or statements from the medical field have
even mentioned the existence of a language barrier. This hidden concern has
caused many problems in the past. If a person can’t tell you what is happening
to them or can’t tell you where it hurts, they can’t get the correct help that
they need. It simply makes everything harder to do.
The issue is not
limited to America; in today’s global society this is a world issue in both
developed and undeveloped countries. The issue is greater in third world
countries where recourses such as interpreters are few and far between. A
survey done by Yasmin shows that this need for translators or interpreters is
not only limited to the world’s leading countries. He states:
A survey,
structured in-person and telephone interviews,
and patients’
comments in four hospitals in Al-Ain were conducted and participants were asked
to answer twenty open-ended questions on the state of healthcare in their city.
The rate of response was 51% (62 returned surveys). The analysis of the data
indicates a need for effective language services in Al-Ain healthcare
institutions, and perhaps across the country.
Al-Ain is a major
city in the Middle Eastern country of Oman, a country that continually finds itself
in poverty and economic trouble. This is by no means a first world country.
They have the same problems when it comes to language barriers as we do,
however their status as a third world country makes this issue much more
difficult to overcome.
When there is a
language issue in America, usually what happens is an interpreter is called in
to help out, or likely because of our melting pot background there is at least
one person in the hospital that can help out with the situation at hand. This
helps minimize the impact of a language barrier. However there is still
something that is left: a sense of uneasiness that the speakers of the two
languages sense when communicating, even through an interpreter.
A survey done in
2005 titled the Health Information
National Trends Survey (HINTS) looked specifically at how language affects trust
in what people hear in health related messages. The survey asked a group of
Hispanic Americans if English was a first language or second language, as well
as their comfort level in reading, writing, and verbal communication in
English. Taking all responses to these questions, subjects were asked about
their trust in health-related messages. These messages may include sources from
the Internet, radio, TV or any other public media sources that were available
to them. The survey revealed that the less comfortable the person was speaking
English the less likely they were to believe health messages, no matter what
the source.
This
was a large issue when the survey first came out. America had always sent
health messages about anything, H1N1 or the bird flu, in an English language.
Very rarely was it ever sent out in any other language. This tradition of
sending mass messages to the public was never thought of as a hindrance to the
health of the public. Now that this issue has come to light, it has been realized
that these health messages need to be accessible to everyone, even those whose
first language is not English. However America does not have a national
language and although a large majority of the population is English-speaking,
there are other minority groups that are not comfortable and fluent in speaking
English. Especially today, whether it is a jump in legal or illegal immigration,
the Hispanic speaking population has increased much more. Stuart Elliott says
in his NY Times article, “Estimates
are that the Hispanic population will exceed 50 million, 16.3 percent of the
country's total. Also according to those estimates, Hispanics accounted for
more than half of the population growth in the United States over the last
decade as their ranks increased 43 percent from the 2000 census.” This new,
large demographic must be recognized when it comes to public health.
Some
would argue that since there are so many minority groups, each with their own
language, that translating all these health messages would be costly and time
consuming. Catherine Boyle states in her post to MSNBC.com that “A decline in the number of white voters and a surge
in voters from ethnic minorities and women helped Obama on election night.” The
number of minority votes coalesced to defeat the traditionally majority white
vote. This shows a turning point in American history. It highlights the fact
that although they are considered minorities, when added together they account
for a greater portion of the population than the majority. Since minorities
have become more abundant, it is essential to spend the extra money for the
translation of public health messages.
The
old solution to the language issue was simply to throw the minority in to the deep
end and let them learn the native language and deal with it. A few years ago
Arizona passed Proposition 203, which was exactly this. The formal title of
this was the Structured English Immersion Program. The program dictated that a
child who could not speak English fluently was placed in classes full of only
English-speaking subjects, students, and content. Kellie Rostad, Jeff MacSwan,
and Kate S. Mahoney looked deeper in to the results of this program a few years
after its installment. The results show that grades of the students and the
comfort level with the language worsened and stayed that way. Small improvements
were seen, but the general trend was downward. This proves that the method of
jumping into the deep end doesn’t always work, especially not for large groups
of people. So simply making the claim that if the individual is in the country,
they likely can communicate, does not hold up. There is simply too much
deviation to chance someone’s life on. Programs to help educate doctors to
communicate better with patients or provide resources so communication should
be as essential as gloves and a mask.
Imagine
you are at your childhood home. Dad is cooking on the grill and your sister is
riding her scooter in the driveway. Suddenly there is a crash and your baby
sister needs to go to the hospital. On arrival you realize you cannot
communicate with any of the hospital staff. You cannot tell them how she was injured
or that she happens to be allergic to a particular type of painkiller. This
would be an unimaginable nightmare. This unfortunately is reality for many
migrants in America. They simply cannot communicate vital information such as
the nature of the situation or allergies to certain medications. No person
should ever have to face a situation such as this. Simple communication can
mean life or death. We have the recourses to do this. As the world leader it is
our responsibility to set an example and ensure everyone’s access to health
care.
Bibliography
Atienza, Audie1; Moser, Richard P.; Oh, April; Perna, Frank;
Shaikh, Abdul.” Health Disparities
in Awareness of Physical Activity and Cancer Prevention: Findings from
the National Cancer
Institute's 2007 HealthInformation National Trends Survey (HINTS).”
EBSCO Host Communication and Mass Media
Complete. J. Murrey Atkins Lib. Charlotte, NC 1, December 2012
Catherine Boyle. Cnbc.com. 7 Nov 2012. CNBC. 1,
December 2012. <http://www.cnbc.com/id/49722937/?Secret_to_Romney_s_Defeat_Not_Enough_Angry_White_Guys>
Elliott, Stuart. Nytimes.com. 28, March 2011. NY Times. 1, December 2012. <http://www.nytimes.com/2011/03/29/business/media/28adnewsletter1.html?n=Top/Reference/Times%20Topics/Subjects/S/Soap%20Operas?ref=soapoperas>
Elsevier. Language barriers in migrant health care: A blind spot, Patient
Education and Counseling, Volume 86, Issue 2, February 2012, Pages 135-136,
ISSN 0738-3991
Hikmet Hannouna, Yasmin. “The need for adequate community
interpreting services in healthcare multilingual settings: a case study in
Al-Ain, UAE.” EBSCO Host Communication and Mass Media Complete. J. Murrey
Atkins Lib. Charlotte, NC 1, December 2012
MacSwan,
Jeff; Mahoney, Kate S.; Rolstad, Kellie. “The Ineffectiveness of English
Immersion in Arizona.” International Journal of Language Studies; Vol. 6 Issue
2, Apr2012, p137-150. EBSCO Host Communication and Mass Media Complete. J.
Murrey Atkins Lib. Charlotte, NC 1, December 2012
