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Patient-Provider Communication

The theme of language access services under the Office of Minority Health (OMH) national standards on Culturally and Linguistically Appropriate Services (CLAS) is comprised of four standards:

  • Offering interpretation services and translated materials at no cost
  • Providing patients verbal and written notice, in their language of choice, to inform them of their right to interpreter services More >
  • Assuring competence of interpreters provided
  • Making available easy-to-understand materials and signage, in languages spoken in the community More >

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Patient provider communication is paramount to providing effective clinical care to patients from diverse populations. Language can be a barrier to accessing health care. Many patients from diverse populations are of limited English proficiency (LEP), meaning they cannot understand English in a manner that facilitates effective communication with a person who uses English as a primary language.

Language Access Services (LAS) is the collective name for any service, including interpreting (oral communication) and translation (written communication), that helps LEP patients obtain the same access to and understanding of health care services as an English speaker would have. Family and friends should not be used as interpreters, as their relationships, biases, and lack of professional role may alter the communication.

Research from the Institute of Medicine on racial and ethnic disparities showed that language barriers can cause poor, abbreviated, or erroneous communication; poor decision making on the part of both patients and providers; and ethical compromises. Studies have found adequate interpretation and translation for patients with LEP leads to fewer medical errors, increased patient compliance, increased patient satisfaction and better use of primary care services (OMH and Agency for Healthcare Research and Quality, 2002). Other studies show linguistically appropriate services save money through decreased diagnostic test costs, reductions in emergency room usage, and reductions in unnecessary admissions (Bellinger JD et al, 2005).

A 2003 Minnesota Department of Human Services study identified challenges in the availability of interpreters for Hmong and Somali patients. Even in Hispanic/Latino populations, where interpreters are more bountiful, 33 percent of study participants reported problems with availability.

Languages in Minnesota

According to U.S. Census Bureau 2005-2007 estimates, 9.5 percent of Minnesotans speak a language other than English at home. Spanish, Hmong, Somali, Vietnamese, Russian, and Laotian are the six most common languages, according to data collected from the Minnesota Department of Education for the 2007-2008 school year.

More than 80 languages are spoken in the Minneapolis Public School District, and 31 percent of students reported that languages other than English were spoken at home as reported for the 2008-2009 school year. Spanish was the most prevalent non-English language. In the St. Paul Public Schools, 45 percent of students speak a language other than English. Hmong was the most prevalent non-English language.

Diversity in languages is not limited to urban areas. Spanish was identified as a primary home language by at least one family in all but 13 counties. Russian is spoken by at least one family in 63 percent of Minnesota counties.

Diversity in Minnesota Students' Home Primary Language, 2006-2007. These two maps show the largest home primary language other than English in each school district—Spanish, Hmong, Russian, and German are among the top—and the percent of students that primarily speak a language other than English at home, based on language data from the Minnesota Department of Education. (1-page PDF)

Federal Mandate for Language Access Services

Title VI of the Civil Rights Act of 1964 provides a legal basis for CLAS standards pertaining to Language Access Services; No person shall “on the grounds of race, color, or national origin, be excluded from participation in, be denied benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance.

Culture Care Connection offers tools, training, and resources to help providers and organizations take active steps toward meeting these requirements.