Impacts of Limited English Proficiency on Health Literacy and In-person Interpreter Perception for Spanish-speaking Adults in the United States: A Systematic Review
Abstract – Spanish is the most spoken second language in the United States. Of the approximately 40 million Spanish speakers in the U.S. who speak Spanish at home, approximately 16 million rate their ability to speak English as less than “very well.” Common problems limited English proficient (LEP) Hispanic adults face are hindrances in accessing healthcare services and communicating with healthcare providers (HCPs) during in-patient visits. These disparities may result in unfavorable outcomes for Spanish-speaking LEP patients, such as lower rates of screening and underinsurance. Interpreters are often used to mitigate the effects of language discordance, but interpreter availability is often unreliable due to limited supply. This systematic review aimed to assess the impacts of LEP on the health literacy and in-person interpreter perception for LEP Spanish-speaking patients and caregivers. Evidence suggests HCPs frequently fail to ensure patients and caregivers fully comprehended their conditions, treatment and available resources, which is exacerbated by the tendency for Spanish-speaking patients to not vocalize their concerns out of fear of seeming “burdensome.” Interpreters also may require improvement in technical and emotional interpretation, as interpreters often were unfamiliar with technical medical Spanish or were ignorant of the emotional needs of patients and their families. Efforts to increase cultural competency, patient input and the amount of certified Spanish medical interpreters in the U.S. should be made.