Multilingual, Bicultural Challenges: A Slippery Slope
The growing migration into the United States carries diversity but
brings with it access limitations to necessary healthcare services. The
foreign-born population has increased to an excess of sixty million in
the United States (Lopez & Radford, 2017). This is a population that
speaks a native tongue in their household, with English as a second
language, while half are not proficient or cannot speak English
according to the United States Census Bureau. To further compound the
issue of language as a barrier to healthcare services, less than a third
of the hospitals nationwide offer translation services while others
offer only inadequate services.
Translation services have proven to be essential in providing quality
healthcare. Many healthcare organizations rely on a dangerous
proposition of enlisting fellow patents, family members, friends,
employees, and other untrained uncertified nonclinical individuals.
Reliance on spur-of-the-moment ad hoc solutions presents a jeopardy to
the well-being of the patient and the healthcare organization.
The engagement of ad hoc translation or interpretation can introduce
uncertainty and risk for the patient and the provider. The ad hoc
measure can introduce a difference in dialect and understanding on the
basis of cultural or religious beliefs, animosity of ethnic, cultural,
religious, or other consternating factors. Safeguards must be considered
for both the patient and the provider.
The cost of translation/interpretation services is considerably
expensive, but necessary. Reluctance or refusal to provide such services
is a shortsighted failing to consider potential negative health
outcomes, relinquishing the opportunity to further provider/patient
relationships, and the risk of legal repercussions. The most convenient
and cost-effective measure might be tele-translation services provided
by a certified translator on a twenty-four-hour basis.
Lopez, G., & Radford, J. (2017).
Facts on U.S. immigrants, 2015: Statistical portrait of the foreign-born
population in the United States. Pew Research Center, Hispanic Trends. Retrieved from http://www.pewhispanic.org/2017/05/03/facts-on-u-s…
Pew Research Center. (2015, September 28). Modern immigration wave brings 59 million to U.S., driving population growth and change through 2065.
The exchange of accurate information
between the patient and the provider is a large part of medical care.
The collection of accurate and comprehensive patient-specific data
remains the basis for proper diagnosis and prognosis. Certified
interpreters facilitate communication and help in the prevention of
misunderstandings by ensuring that correct information is passed on.
Barriers to Care
The issues creating barriers to healthcare for individuals are
numerous. The greatest barrier to healthcare is health literacy. To
define the scope of the issue, research conducted by the United States
Department of Education found that thirty-two million adults cannot read
above the fifth grade level and 20 percent of high school graduates
cannot read. When foreign-born, non-English-speaking individuals are
also considered, the magnitude of the problem is considerable.
There has been a growing trend directed toward vaccines and the
American Pediatric Academy immunization schedule of immunization
administration. The hesitancy, refusal, and delay of childhood
vaccination have been associated with an elevated risk of
vaccine-preventable disease. Diseases that were once considered
eradiated or controlled are emerging in communities. The factors
influencing the emergence of these diseases are immigrant settlement
patterns, cultural factors, language barriers, religious beliefs, low
educational levels, and socioeconomic status.
T., Thomas, R., Klein, N., Chung, C., & Kulldorff, M. (2015).
Geographic clusters in under-immunization and vaccine refusal. Pediatrics, 135(2).
Financial limitations are another significant barrier to accessing
healthcare services and filling necessary prescriptions to manage
chronic diseases. In addition, a substantial number of individuals of
lower-socioeconomic status and the elderly have poor adherence to
prescription medication, fail to manage a chronic disease, or fail to
make needed lifestyle changes to mitigate declining quality of life.
Cultural differences are a challenge beyond language. Some cultures
don’t realize the need for healthcare until they start feeling ill. In
some cultures, religious beliefs prevent individuals from accepting
certain medical services such as transfusion and immunization. In
others, family dynamics center on a maternal or paternal paradigm, which
guides the activity of family members. While each example seems
extreme, the intent is to highlight the interwoven complex issues that
surround barriers to care and diversity in society.
This complex web of barriers to care needs to be addressed
collectively with a focus on demographics. The financial burden to
address all the barriers is exhaustively expensive, and for some issues,
there is no logical, or reasonable, approach. The burden of disease
over the past few decades has shifted from the acute illness to a
chronic health condition, which increases the importance of health
literary. Select areas are impacted by specific issues in varying
degrees. As such, the most significant should be addressed to have the
greatest impact. One of the most significant barriers to bridge is
health literacy. The approach to allow individuals to become more
understanding of their illness and treatment can likely have
Cultural Differences in Healthcare
There is a distinct difference between the notion of illness and
disease. The idea of illness rests within the individual’s lived
experience, while disease is a science-based event impacting
populations. In a diverse society, healthcare can be complex and
conflicting. Challenges to deliver healthcare become further complicated
when intertwined with religious, cultural, and language barriers.
Conceptually, Western and Eastern medicine vary and have subcultures
unto their own history, language, codes of conduct, expectations,
methods, and outcomes. The Western paradigm embraces science as its
biological foundation and transcends the idea of religion and culture.
Eastern wellness practices recognize the idea of the whole person,
accepting spiritual, cultural, and religious overlays to this scientific
basis. However, science demonstrates human populations are guided
biological principles that surpass cultural dogmas.
- Georgetown University Health Policy Institute. (2004). Cultural competence in health care: Is it important for people with chronic conditions? Retrieved from https://hpi.georgetown.edu/agingsociety/pubhtml/cu…
- Jacobs, E., Shepard, D., Suaya, J., & Stone, E. (n.d.). Overcoming language barriers in health care: Costs and benefits of interpreter services. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC14483…
- Quinton, S. (2017, February 13). Health care adjusts to a more diverse America.
- Discuss how a language difference can decrease the likelihood of
optimal healthcare outcomes and impact healthcare cost. In your
response, include the increased cost resulting from language barriers
and the potential risks and concerns associated with using noncertified
methods of translation.
- In addition, include one additional point that you have identified
in the readings. As a hypothetical member of the healthcare
organization’s workforce, you can suggest a policy to address the point.
To support your work, use your course and readings provided and also use the South University Online Library
if you elect to perform additional research to support your position.
As in all assignments, cite your sources in your work and provide
references for the citations in APA format.
Your initial posting should be addressed in 200–350 words. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.