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October 19, 2020

Language Barriers and Hospitalized Children: Are We Overlooking the Most Important Risk Factor for Adverse Events?

Author Affiliations
  • 1Health Services Research Institute, Connecticut Children’s Medical Center, Hartford
  • 2Department of Pediatrics, University of Connecticut School of Medicine, Farmington
JAMA Pediatr. 2020;174(12):e203238. doi:10.1001/jamapediatrics.2020.3238

More than 67 million people in the US (22%) speak a language other than English at home, and 25.6 million Americans (8%) have limited English proficiency (LEP), which is defined as a self-rated ability to speak English less than very well.1 Language barriers have been shown to impact multiple aspects of health care, including access to health care, health status, use of health services, patient-clinician communication, satisfaction with care, quality of care, patient safety, and clinical research.2 Nevertheless, far too often, language barriers have been left out of the conversation on patient safety. For example, although the landmark National Academy of Sciences book, To Err is Human: Building a Safer Health System,3 arguably spurred a revolution in patient safety, there is not a single mention of language barriers, interpreters, or translators in the book.

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    1 Comment for this article
    Paul Nelson, MS, MD | Family Health Care, P.C.
    In addition, whether or not they can read that language is equally important. During a 41 year career as a primary physician, our small-group private practice developed a First Visit data-set to screen for several issues including illiteracy. Importantly, an illiterate person finds ways to hide this adaptive skill. It is a special issue because it contributes to their inability to apply trust, cooperation, and reciprocity for their health care.