"Families Are Intimidated...Really Confused...Afraid": Healthcare Service Disparities for Spanish-Speaking Patients Witnessed By Their Language Interpreters

Spanish-speaking migrants from parts of Latin America are one of the fastest growing immigrant groups in the United States. Spanish-speaking patients with limited-English proficiency (LEP) face a range of legal, cultural, and financial barriers within U.S. healthcare systems. Language barriers for Spanish-speaking LEP patients are connected to healthcare access and quality issues contributing to persistent negative health outcomes for these populations. Medical interpreters serve as a crucial link between Spanish-speaking patients and healthcare providers and staff. Observations of numerous interactions between LEP patients within a range of healthcare settings make them well positioned to advance understanding of mechanisms underlying adverse health outcomes. Twelve medical interpreters in the southwestern U.S. from a range of healthcare contexts were interviewed for this study. A grounded theory approach was used to analyze participants narratives resulting in four distinct themes: 1) Lack of prioritization of interpretation services; (2) manifestation of bias at the system level; (3) rushed clinical interactions; and (4) failure to center patient understanding. Findings have important implications for practices and policies within hospital systems pertaining to LEP patients. Practice-based knowledge of medical interpreters should be utilized to advance practice and policy solutions to outstanding health disparities within Spanish-speaking communities.