Understanding the Role of English On Perceived Quality of Health Care Among Latino Immigrants in the United States

Purpose: Latinos with limited proficiency in English systematically report poorer health and lower quality of health care. In addition, approximately half of Latinos, the largest and fastest growing population in the United States, have difficulties with English language. Given the rapid demographic change in the U.S., understanding the relationship between language and health care quality for the Latino population has became a public health issue. This study investigates the relationship between individuals’ English proficiency and their perception of health care quality among foreign-born Latinos in the United States. Unlike previous research, we assess not only Latinos’ ability to understand English, but we pay particular attention to their reading and writing skills in navigating the health care system in the United States.

Methods: Data comes from the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Survey, a nationally representative survey of the adult Latino population (18 years of age and older) in the United States. Our final sample was comprised of 2921 foreign-born men and women who answered yes to the question: Are you, yourself, of Hispanic or Latino origin or descent such as Mexican, Puerto Rican, Cuban, Dominican, Central or South American, Caribbean, or some other Latin American background? To measure Latinos’ experiences with health services we employed their perception of quality of medical treatment of care during the past five years. Three indicators accounted for respondents’ English abilities to navigate the U.S. health care system: how often 1) Latinos needed help with reading hospital materials , 2) with filling out medical forms and 3) in reading and understanding their medical condition because of difficulties with written information. A series of multivariate logistic regression analyses were used to model Latinos’ English abilities on their perception of health care quality in the United States while adjusting for demographic and socioeconomic covariates.

Results: Experiencing difficulties learning about ones’ medical condition because of needing help understanding written information (β=2.66; p<0.001) as well as reading hospital material (β=1.43; p<0.001) significantly increased the odds of experiencing poor quality of medical treatment net of demographic and socioeconomic characteristics.

Implications: These findings support interventions that target not only spoken English to reduce health care access disparities and quality of care for the Latino population in the United States.  Nowadays information on health care (from access to services and appointments to test results) is presented mainly in written English. Health care providers can work on strategies (i.e. providing the information in Spanish) aimed to increased Latinos access to health care and to the quality of care that they receive in the United States.