BACKGROUND
Health literacy is a multidimensional set of skills (e.g., narrative, numeracy, digital, medication) that patients need to access and understand health information timely and accurately to make evidence-based informed decisions.


CONTENT
Multiple barriers prevent patients from effectively interacting with health information. The most salient barriers are poor overall health literacy skills and linguistic proficiency in English. As patients prefer direct access to laboratory test results, especially those of routine tests, contextualization and provider-directed interpretation of results are required to foster shared decision-making to address their healthcare issues and improve health outcomes.


SUMMARY
The use of systematic approaches that account for poor health literacy skills and include culturally and linguistically appropriate planning and availability of resources is warranted at individual and population health levels (e.g., human-centered design of patient portals).

When Positive is Negative: Health Literacy Barriers to Patient Access to Clinical Laboratory Test Results.

I would like to thank Venkatesan et al for their article on deconstructing the practical challenges that obstruct safe, effective and respectful patient–physician communication in the context of increasing ethnic plurality in patient population.1 The authors have outlined weaknesses in the current processes employed to bridge language barriers—difficulties in identifying patient need for translation services, gauging the level and form of assistance required and accessing in-person translation services, and the lack of training on optimal usage of available services. The article suggests equipping medical students with knowledge of available translation resources and methods to navigate difficult consults with limited English proficient (LEP) patients as one of the ways to address this language barrier. Drawing from my clinical exposure in the UK, and experiences with Bangladeshi transient workers in Singapore as a Law student, I have seen first hand the bearing of language barrier in communication. Hence, my letter will expound on …

https://pmj.bmj.com/content/postgradmedj/early/2021/09/28/postgradmedj-2021-140799.full.pdf

Bridging patient-physician language barrier starts in medical school.

Management of chronic non-communicable diseases: qualitative study of the practices and challenges in the Volta Region, Ghana

With globalization and the increased need for cross-cultural communication, it appears that multilingualism has become more entrenched than ever and that the capacity to speak multiple languages is a significant advantage in most societies. However, the ability to speak multiple languages is not evenly distributed and having a dominant language as an alternative often leads to social disparities. The current paper explores how languages are used currently around the world, and how language dynamics works these days. It then identifies the prevalent issues that could be caused by language barriers and inequalities affecting individuals and communities worldwide in the field of education, employment, healthcare, and other social opportunities. The paper finally suggests the need for a universal language in the globalized world to tackle the individual and social issues caused by linguistic barriers, introducing ‘Unish’, an artificial language designed to overcome the limitations of natural languages in terms of ease of acquisition and equality of use, as a potential lingua franca. 

/pdf/multilingualism-social-inequality-and-the-need-for-a-3r5ftjau.pdf

Multilingualism, Social Inequality, and the Need for a Universal
 Language

The COVID-19 pandemic has sharply brought to light the need to address inequalities in health. Language barriers have been demonstrated to be a major determinant in the inequality in healthcare received by Black, Asian and Minority Ethnic (BAME) and migrant patients.1–3 While working in a busy, multicultural London hospital, bridging language barriers have been one of the biggest challenges to delivering healthcare in this setting.

In this short article, we wish to deconstruct what we believe to be the fundamental practical challenges to successfully communicating with Limited-English-Proficient (LEP) patients. We identify that although this is a complex issue, there are several key areas that need to be addressed. Although we do not have a comprehensive solution, we hope that through outlining the major issues, we can empower a mandate for change.

At face-value, overcoming language barriers is simple: use a translator. However, the reality is more complicated. The timings of interactions with patients are often unpredictable (eg, a busy ward round, a medical clerking, an acutely unwell patient), alongside the nature of the barrier (eg, language spoken, English proficiency) and information that needs conveying. Understanding and accepting these practical difficulties are important and requires a flexible approach. Therefore, in any given scenario, there are two dimensions to assess: knowing the options available and making the right selection.

Currently, there are a number of different modalities with which doctors can use to bridge a language barrier. They are roughly listed as follows:

1. Nil (broken English, hand signals, gestures, written info, pictures)

2. Phone translator apps (eg, Google translate, Babel fish)

3. Over the phone translation services (eg, Big Word, Language Line)

4. In-person translator services.

5. Allied health professionals (AHPs).

6. Next-of-kin /relatives.

Each modality has its own specific advantages and limitations, both of which are important for the user to understand. For example, phone …

Deconstructing language barriers in healthcare: where are we going wrong?

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Deconstructing language barriers in healthcare: where are we going wrong?