Language Barriers

Natasha Powell
Norfolk State University

Language barriers have an impact on society. The impact can be seen in various areas of
everyday living which can include education, healthcare, and also in employment. This can lead
to inadequate education, misdiagnosis in healthcare, and overall frustration due to the inability to
adequately communicate.
The first language barrier that we will address is in healthcare. There are 49.6 million
Americans (18.7 percent) who speak a language besides English at home, 22.3 million (8.4
percent) have limited English proficiency (Flores, 2006). Many patients who may need an
interpreter do not have access and studies have shown no interpreter was used in 46 percent of
emergency room cases which involved patients with limited English proficiency (Flores, 2006).
There are few healthcare providers that receive training to work with interpreters and only 23
percent of United States teaching hospitals provide training and in most cases it is not a
requirement it is optional (Flores, 2006). The effects of language barriers can be very harmful. A
patient that has a language barrier is less likely to have a primary care physician, less likely to
receive preventive care services, and less likely to follow medication guidelines (Flores, 2006).
According to Flores, these patients are less likely to return for follow up care after emergency
room visits, have higher rates of hospitalization and drug complications, greater resources are
used in their care, and they have lower levels of patient satisfaction (Flores, 2006).
There is a reported case where inadequate communications had tragic consequences. In
this particular case the misinterpretation of one word caused delayed patient care and a
preventable paralysis (Flores, 2006). A Spanish speaking male went into his girlfriends home
and told her he was intoxicado and then collapsed. The girlfriend then called the paramedics
and told the non-speaking paramedic the word he use intoxicado and he took it to mean
intoxicated (Flores, 2006). The word was intended to mean nauseated, and after being in the

hospital for more than 36 hours being treated for drug overdose, the patient who was comatose
was re-evaluated and diagnosed as intracerebellar hematoma with brain stem compression and
subdural hematoma secondary to a ruptured artery (Flores, 2006). The hospital was required to
pay a $71 million malpractice settlement (Flores, 2006).
Another study conducted by the Health Research and Educational Trust (HRET) has
shown that there are 52 million (19 percent) people in the United States who speak a language
other than English in the home (Orlovsky, 2006). The study further determined that 80 percent of
hospitals see LEP (limited English proficiency) patients, more than 90 percent see them
frequently, 97 percent see them daily (Orlovsky, 2006). Research has also shown that more
languages are spoken than account for. Spanish was encountered 93 percent of facilities but other
languages encountered were Chinese, Vietnamese, Russian, Arabic, Laotian, and Hindi
(Orlovskly, 2006). The study also looked at the resources that are available to assist in language
competency and how frequently they are used. 92 percent of facilities had telephonic services
available but only 77 percent actually used it (Orlovsky, 2006). The appropriate resources are
needed as well as required by law typically hospitals are not reimbursed for the services they
provide (Orlovsky, 2006). Another important fact to note is that hospitals are required by law
under title six to provide language services to patients and they are prohibited from charging for
these services (Orlovsky, 2006).
The next factor that I will discuss is the language barrier in the workplace. Many
companies wish to obtain cultural diversity in the workplace by hiring individuals of different
cultures and nationalities (Joseph). Joseph believes that a multicultural workplace can offer
benefits such as broader range of perspectives and a greater ability to compete in the global
marketplace. However this also creates barriers that must be addressed and overcame (Joseph).

First, this creates a communication challenge. Cultural and language differences can cause
ineffective communication (Joseph). Individuals who are not fluent in the primary language of
the workplace can have difficulty expressing their needs or responding to work related request
(Joseph). If they are in customer service, they may have difficulty understanding the customer
which could lead to them providing inaccurate or misleading information (Joseph). I can attest
from personal experience as customer it is very frustrating when trying to handle a matter and the
customer service representative has a thick accent that makes it hard to understand what they are
saying. Next, there is always resistance to change in the workplace. Some workers may be
unwilling or unable to adapt to the ways of workers from different cultural backgrounds and may
actually resent the individuals (Joseph). Resistance creates a challenge to creating a work
environment that encourages teamwork and harmony as a result employee morale may suffer if
management is not able to find ways to overcome the barrier.
Diversity in the workplace can lead to cliques being formed of workers with similar
backgrounds (Joseph). This could cause limited social interaction with those considered outsiders
(Joseph). Also, in culturally diverse workplaces some may choose to speak their primary
language with each other instead of the primary language of the workplace, leaving other to feel
they are being excluded from conversations (Joseph). Last, managers may have to adapt their
management style to meet the needs of their employees (Joseph). Joseph gives the example of
Latin American countries where they believe that asking questions of the supervisor is a sign of
disrespect and they should do as they are told. Therefore if a manager has an open door policy
may become frustrated with the lack of input from these workers and would have to try to
convince them that their suggestions are encouraged and valued (Joseph).

There are already requirements in place to provide language services in the healthcare
field. I think the improvement could come by making sure that the most prevalent languages are
covered. This could be done by utilizing surveys and obtaining data from census bureaus in the
areas. If someone does speak a different language it is safer to realize you do not understand then
to interpret what you think they are saying. The hospitals could use data trending to see what
cultures the LEP is accounting for that are seeing and make sure they are properly staffed to
address those populations. I also think that if the individuals have health insurance they should
make sure that patient is linked with someone who is bilingual who can assist them maybe a case
manager of someone of that nature. As far as employment goes, most jobs already require
training classes in cultural diversity so that area is most likely not needed. However, in order to
hire someone who has English as a second language, the individual must be fluent in English. It
is pretty hard to assist someone when you are unable to understand what they are saying and vice
versa. Jobs should assist with classes for their LEP associates.
Cultural diversity is a growing reality in America. We can all chip in to help tackle this
problem. First, we must have patience and recognize that the same way we are having a hard
time understanding what they may be trying to convey, they too maybe feeling the same
frustration. Although we insist on them learning English, maybe we can also learn the basics of
their language to make communicating a little more effective. We can also create innovative
ways to bridge the gaps at work by understanding their culture thus in the end understanding
them.

References
Flores, G. (2006, July 20). Language Barriers to Health Care in the United States NEJM.
Retrieved May 4, 2015, from http://www.nejm.org/doi/full/10.1056/NEJMp058316
Orlovsky, C. (2006, January 1). Language Barriers on the Rise in American Hospitals. Retrieved
May 4, 2015, from http://www.nursezone.com/nursing-news-events/more-news/LanguageBarriers-on-the-Rise-in-American-Hospitals_27682.aspx
Joseph, C. (n.d.). Cultural & Language Barriers in the Workforce. Retrieved May 4, 2015, from
http://smallbusiness.chron.com/cultural-language-barriers-workforce-11928.html