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Linguistic disparities in health care access and health status among older adults

  • Populations At Risk
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Abstract

BACKGROUND: English proficiency may be important in explaining disparities in health and health care access among older adults.

SUBJECTS: Population-based representative sample (N=18,659) of adults age 55 and older from the 2001 California Health Interview Survey.

METHODS: We examined whether health care access and health status vary among older adults who have limited English proficiency (LEP), who are proficient in English but also speak another language at home (EP), and who speak English only (EO). Weighted bivariate and multivariate survey logit analyses were conducted to examine the role of language ability on 2 aspects of access to care (not having a usual source of care, delays in getting care) and 2 indicators of health status (self-rated general health and emotional health).

RESULTS: Limited-English proficient adults were significantly worse off (1.68 to 2.49 times higher risk) than EO older adults in 3 of our 4 measures of access to care and health status. Limited-English proficient older adults had significantly worse access to care and health status than EP older adults except delays in care. English proficient adults had 52% increased risk of reporting poorer emotional health compared with EO speakers.

CONCLUSIONS: Provision of language assistance services to patients and training of providers in cultural competence are 2 means by which health care systems could reduce linguistic barriers, improve access to care, and ultimately improve health status for these vulnerable populations.

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Author information

Authors and Affiliations

  1. UCLA Center for Health Policy Research, Los Angeles, CA, USA

    Ninez A. Ponce MPP, PhD

  2. UCLA School of Medicine, Los Angeles, CA, USA

    Ron D. Hays PhD & William E. Cunningham MD, MS

  3. RAND Health Program, Santa Monica, CA, USA

    Ron D. Hays PhD

  4. UCLA Department of Health Services, 31-254B Center for the Health Sciences, 90095-1772, Los Angeles, CA

    Ninez A. Ponce MPP, PhD, Ron D. Hays PhD & William E. Cunningham MD, MS

Authors
  1. Ninez A. Ponce MPP, PhD
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  2. Ron D. Hays PhD
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  3. William E. Cunningham MD, MS
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Corresponding author

Correspondence to Ninez A. Ponce MPP, PhD.

Additional information

Dr. Ponce was funded by a pilot investigator Grant from the UCLA/Drew Center for Health Improvement in Minority Elders(CHIME)/Resource Centers for Minority Aging Research (RCMAR), National Institutes of Health, National Institute of Aging (AG-02-004). Drs. Cunningham and Hays were supported by UCLA/Drew CHIME and RCMAR (AG-02-004) and the UCLA/Drew Project EXPORT, National Institutes of Health, National Center on Minority Health & Health Disparities (P20-MD00148-01). We are grateful to the faculty and community-based partners of the UCLA/Drew CHIME and Project EXPORT who reviewed earlier drafts of this work.

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Ponce, N.A., Hays, R.D. & Cunningham, W.E. Linguistic disparities in health care access and health status among older adults. J Gen Intern Med 21, 786–791 (2006). https://doi.org/10.1111/j.1525-1497.2006.00491.x

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  • DOI: https://doi.org/10.1111/j.1525-1497.2006.00491.x

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