Language Barriers Impact Care Access for Elderly Mexican Americans

July 19, 2021 - For elderly Mexican Americans living in neighborhoods with low English-speaking proficiency, language isolation can lead to care access issues, poor health outcomes, and higher mortality rates, according to a study published in Health Equity.

Language barriers are a persistent roadblock to quality care in the United States, often leading to often preventable adverse health outcomes. Inequities include limited access to health information, missed health screenings for chronic disease, and higher rates of poor mental health.   

Researchers from the University of Georgia specifically focused on elderly Mexican Americans because they have the lowest rates of English proficiency compared to other Latino subgroups. The study found that those who live in linguistically isolated neighborhoods have mortality rates up to 1.25 times higher than those who do not.

The study defines linguistic isolation with three main components: solitary living, limited English proficiency, and limited English of other adult household members.

“If you are linguistically isolated, you’re very likely to be isolated socially, and we know social isolation contributes to mortality,” Kerstin Emerson, PhD, one of the study’s co-authors, explained.

“It’s not just that you’re not using the health care system; you’re very likely not to have a large social network outside of your neighborhood. The bigger your social networks are, the more likely you are to find out about services.”

Researchers analyzed survey data from the Hispanic Established Populations for the Epidemiologic Studies of the Elderly. The survey followed over 1,100 Mexican Americans over the age of 65 for 13 years, tracking smoking status, alcohol use, as well as community poverty rates and other individual and community-level factors.

Results revealed a strong correlation between linguistic isolation and mortality, pointing to an urgent need to address health disparities. Poor language proficiency is a social determinant of health that can have especially deadly effects on older people in marginalized populations.

Most of the study cohort consisted of Mexican Americans who live in a neighborhood where almost one-third of residents are immigrants. Approximately 17 percent of participants lived in a linguistically isolated neighborhood, and over 30 percent lived in a high-poverty neighborhood. Additionally, 39 percent reported two or more chronic conditions.

While individual factors like chronic disease and alcohol use certainly contribute to mortality, the study concluded that living in a linguistically isolated community also significantly increases mortality rates. In addition, language barriers make it increasingly difficult for isolated individuals to get the care they need to treat chronic diseases. This compounds on the existing struggles that many American seniors face in relation care access.

Access to language assistance, home visits, and other services are crucial to mitigating health disparities, especially among linguistically isolated communities, the study says. Healthcare providers should be trained to provide culturally adaptive services, and community outreach is crucial to ensuring access to screenings and quality care.

The study pointed out that a shortage of translation services in isolated neighborhoods along with the fact that most payers do not reimburse for interpretation services are only adding to the problem.

“We focus on the easy thing, which is translating a pamphlet, but we’re actually talking about entire neighborhoods that are socially isolated, so not just the one home or one person. Translating pamphlets isn’t going to cut it,” Emerson continued.

“It would mean targeting those communities with specific interventions that are linguistically and culturally appropriate. So, let’s spend our money there and do it culturally, competently.”