The every-growing immigrant population in the United States is presenting new challenges for the medical community. A recent Brandeis University study shows that hospitals could lower medical risk and enhance their treatment of immigrant patients by providing interpreters to translate a diagnosis or procedure. The study was conducted by the Access Project, a resource center for community health initiatives.
Access Project Executive Director Mark Rukavina says the study highlights the advantages language interpreters provide for the patient and the hospital and the dangers when they do not. "One of the more troubling findings from our report was that people who needed but did not get interpretation were much more likely to leave the encounter with the clinicians without a clear understanding of the medication or the instructions or how to pay for the care that they received," he said.
The Access Project surveyed 4,000 uninsured patients at 23 hospitals in 16 American cities, including many individuals who did not speak English well.
One in five of those who responded that they did not have an interpreter said they did not understand how to take the medicine they received. Only two percent of those who needed and got a proper interpreter cited this as a problem.
Often, immigrant families who speak little English depend on their child or relative who does. But Washington attorney Mara Youdelman of the National Health Law Program says that can create added family tensions and more problems:
"First and foremost, many children do not have the competency in English or medical terminology to accurately translate," he pointed out. "Secondly, many children are brought in at inappropriate circumstances. For example, a ten-year-old child was asked to translate and explain to his mother that she had just been diagnosed with cancer."
Access Project director Mark Rukavina says many hospitals may agree on the need for the service but see the added cost as an obstacle. Ironically, he says, only five U.S. states currently take advantage of federal health insurance programs that will subsidize interpreter services for their public hospitals.
Ms. Youdelman says the federal government reminded state health services two years ago of the availability of federal funding. "We still believe there is an educational effort that needs to be undertaken so that states are aware of the federal reimbursement and make them understand that providing interpretation up front can reduce health care costs in the long term." she said.
Ms. Youdelman's law center recently studied 14 community health programs that use interpreters to see how handle the problem.
Mr. Rukavina says many urban hospitals and clinics that service large immigrant communities already have come up with a variety of programs to meet their needs and their budgets from pooling interpreter services or using telephone language hotlines, to training bilingual, non-medical staff in medical terminology.
"There is an emerging field of study on how to effectively and efficiently provide these interpreter services and there is more attention being paid in the medical community as well," said Mr. Rukavina.
Immigration activists say it is not just the medical community that needs to take action. Last month, hundreds of immigrants in New York City marched to show their support for legislation that would require the city's health, welfare and employment agencies to use interpreters too.