Limited English Proficiency and Low Health Literacy

By David Fetterolf, Stratus Video President

As of 2013, more than 61 million individuals within the United States spoke a language other than English at home. More than 25 million individuals reported speaking English less than “very well”, meaning that they have a limited English proficiency. Between 1990 and 2013 the LEP population grew from 14 million to more than 25 million, and that number is expected to keep rising.

The Joint Commission has repeatedly found that language barriers significantly impact safe and effective healthcare. When compared to English-speaking patients, LEP patients have:

  • Longer hospital stays when professional interpreters were not used at admissions and/or discharge.
  • Greater risk of line infections, surgical infections, falls, and pressure ulcers.
  • Greater risk of surgical delays due to difficulty understanding instructions, including how to prepare for a procedure.
  • Greater chance of readmissions for certain chronic conditions due to difficulty understanding how to manage their conditions and take their medications, as well as which symptoms should prompt a return to care or when to follow up.

Additionally, LEP patients are more likely to have low health literacy. Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.

A study on overall health, health literacy, and English proficiency published in the Journal of Health Communication reported the following information:

  • 44.9% of LEP patients reported having low health literacy.
  • 13.8% of English speaking patients reported a low health literacy.
  • 45.1% of LEP patients who reported low health literacy were found to be in poor health.

It is vitally important for healthcare providers to take extra care when it comes to treating LEP patients with low health literacy, For more information on how to best serve your LEP patients, including tips on how to utilize a Universal Precautions Approach, download our white paper here: Low Health Literacy Among LEP Patients What it means, how to recognize it, and how to ensure understanding takes place. 

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