Language Barriers In Health Care

Health care expenditure accounted for an estimated 11% (214.9 billion) of Canada’s GDP in 2014 (CIHI, 2014). Canada boasts a universal, cost-effective and fair health care system to its citizens (Picard, 2010). However, despite great claims and large expenses incurred Canada’s health care system has been reported inefficient in it’s delivery to the population (Davis, Schoen, & Stremikis, 2010; Picard, 2010). As inconsistencies exist in health care delivery across the country, choosing priorities for the health of the Canadian people becomes of vital importance. In Ontario, progress toward a better health care system has been stated to be moving forward by putting the needs of the “patient’s first” (Ministry of Health and Long-Term Care [MOHLTC], 2015). This policy brief will give a background of health care issues in Canada related to Ontario. Three evidence-based priorities will be suggested for Ontario’s health policy agenda for the next three to five years. Furthermore, through a critical analysis of these issues a recommendation of the top priority issue for the agenda will be presented.

Establishing effective communication with the patient is a critical factor in promoting patient quality care. Good communication is fundamental when providing safe and effective care at the beside in order to increase the quality of patient care. One of the many communicative barriers that exists between patients and the healthcare team are language barriers. Language barriers are considered an initial problem of translation or code-switching. Individuals who speak different languages require a certain code breaker in order to facilitate effective communication (Gregg & Saha, 2007). Furthermore, language barriers may hinder the quality of patient care and interfere with optimal clinical outcomes. According to Happ et al., 2011, nurses have the unique responsibility to engage in communication with patients and have control over the timing and method of communication. Evidenced based interventions such as communication boards are needed to improve nurses’ communication skills in order to achieve effective communication.

The Purnell Model for Cultural Competence places communication as one of the dominants (Purnell, 2002). Speaking the language of the patients would be the best tool that healthcare worker can use. It helps avoid many misunderstanding that may arise.

This paper will discuss the Canadian healthcare system compared to the United States healthcare system. Although they’re close in proximity, these two nations have very different health care systems. Each healthcare system has its own difficulties, and is currently trying to find ways to improve. Canada currently uses the Universal Health Care system; which provides healthcare coverage to all Canadian citizens (Canadian Health Care, 2007). The services are executed on both a territorial and provincial basis, by staying within the guidelines that have been enforced by the federal government (Canadian Health Care, 2007).

With the increasing immigrant population a third barrier affecting access to health care is a cultural barrier. Culture barriers can include values and beliefs, language and race and ethnicity. Health beliefs and behavior can become a barrier when patients decide not to seek medical treatment and instead turn to home remedies and healers when treating illnesses. Approximately 10% of Americans speak a language other than English and can be classified ad being limited in their proficiency. For these patients language becomes a barrier and they are less likely to receive optimal medical treatment (Flores, 2006). Horton and Johnson (2010) stress the importance of communication in reducing disparities and increasing the trust of patients in the health care system. As reported by the American College of Physicians, evidence reveals that racial and ethnic minorities are more likely to receive inferior care when compared with non-minorities. This occurs even when minorities have access to insurance and adequate income (Racial and ethnic disparities in health care, 2010).

Public Policies strive to protect all citizens across the nation, includes low-income citizens who often go unrecognized in society. To make sure this happens, legislature has put forth the “The Canada Health Act”, which requires the provincial government to meet certain expectations regarding public-health care and insurance plans. Though this act states that health services are free and accessible facilities, issues arise when citizens need urgent medical attention but appointment are unavailable until weeks later. Many of these poor individuals cannot afford to pay the extra amount to receive faster care as oppose to their rich counterparts.

Canada 's healthcare system is praised globally for its universal and free healthcare. It started to take shape after World War II in 1945. Health insurance was introduced and was attempted, but was not successful even though there was an increase in the spending of health related services and goods. Fast forward a few years to 1961 where Tommy Douglas, the premier of Saskatchewan, developed the idea for an all-inclusive insurance plan. He later inspired the Medical Care Act in Canada in 1967, when he pointed out health care is a right for all Canadians. From this one thought, Canada has become of the many countries with a universal health care system. Ever since Tommy Douglas sparked the idea for health care coverage, Canada is praised for the way it carries out its system because of several key features. This system is publically funded, is universal and is accessible to everyone across the nation. Because this is a public system, funding comes from the tax payers and some federal funding, so there is no extra cost for the patients. Also, being a universal system it has offered care to all Canadians, immigrants and visitors. Unlike the U.S who does not provide healthcare to its entire population because it is a private system; access depends on how much someone could afford, and how

Non-English speaking citizens and immigrants are receiving improper medical care because of the miscommunication. The people who cannot speak English well are misunderstood, when they go to free clinics or hospital emergency rooms and attempt to explain their symptoms and illness or cannot understand the doctors or medical profession that are trying to help them. ” Interpreters are omitting questions about drug allergies. Patients are not telling nurses the correct symptoms. A mother misunderstood by putting oral antibiotic into the ears of the child instead of the mouth. The Puerto Rican word for mumps is not the same in Central America, so a child was mistreated. A doctor mistakenly told a parent to put a steroid crème on entire child instead of just the face” (Yolanda Prtida, 2005). Language barriers in the medical field are dangerous and some times even fatal. There is definitely a need for more translators in hospitals and doctors office. Clear communication is essential for safe quality healthcare. Poor communication can lead to disastrous outcomes, especially for patients with limited or no English ability.

According to the 2011 U.S. Census, twenty-one percent of the population speaks other language at home besides English. Hence, one of the biggest challenges in Healthcare is the language barrier between the providers, Health care administrators and patients that speak foreign languages. This poses a challenge for medical entities,

Can you imagine the how the healthcare industry would be without language, what seems to be impossible to imagine is the everyday reality of some patients because of their native language. Language is a major contribution to the health disparities that some populations face, because it makes it difficult for some patients to communicate their problems as well as understand the care they provided. Language contributes to the health disparities that some populations face because it creates a barrier between the patient and the care provider, making it difficult for a patient to receive proper care. Language barriers create a communication gap between a patient and a provider, forcing the patient to feel misunderstood and unable to trust his/her provider to properly care for them. I come from a family that speaks more than one language, so I have seen the impact language barriers can have on someone who doesn’t speak fluent English.

Under Canada’s healthcare system, citizens are provided with primary care and medical treatments, as well as easy access to hospitals, clinics, and any other additional medical services. Regardless of annual income, this system allows all Canadian citizens access to medical services without immediate pay. Canada is fortunate to have a free healthcare plan since this necessity comes at a substantial expense for people living in the United States of America. For instance, the Commonwealth Fund's Health Insurance Survey mentions that “80 million people, around 43% of America's working-age adults, did not go to the doctor or access other medical services because of the cost” (Luhby). Evidently, Canada’s healthcare system is notorious in supporting the demands of the population, and creating a healthy and happy society at a manageable cost.

Canada has always taken great pride in its health care system. Publicly funded, Medicare has helped many, but has also aided in masking one of this country’s largest growing problems. Income inequality is highly prevalent throughout Canada, affecting the health of its citizens, and over-burdening its health care system. The growing gap between incomes is largely in part to the economic neoliberalism taking place within Canada. The stress placed on lower and middle income families through various social determents of health is taking its toll on society and its individuals. The oppressed state of undermined

There are 196 countries with healthcare systems across the world… Canada’s healthcare system is ranked 30th overall. Most critics keep health care related debates to the small scope of Canada and the USA. However, neither the USA nor Canada’s systems are ranked in the top 25 for overall efficiency (The Patient Factor). In order for Canada’s healthcare system to improve, there must be changes made in regards to major problems; financial aspects, timely access, and the doctor shortages. “Evidence shows that the best healthcare systems in the world are founded on a strong primary care system” (TheStar.com). Perhaps Canada can learn from these countries that are ranked higher, and provide more efficient care to Canadian citizens.

To communicate seems easy enough to most of us. We have been doing this from the moment we were born. We expressed ourselves with grunts, moans, crying, smiling and yelling. We started communicating even before we made words with our nonverbal forms of communication. Communication is important. It allows individuals to share information and messages in the form of ideas and feelings (Giger, 2013). It gives us direction and allows us to interact with others. Can you image getting the entertainment system in parts in the mail with no instructions as to how to put it together? It is essential that we all communicate effectivity in order to ensure the best quality of care. Language barriers threaten the patient safety and overall quality of care of these individuals. By having efficient practices in place it will lower those risks and increase quality care.

Availability of health care services is an important dimension in access to health care. Providers are expected to deliver quality care to patients when it is needed. They should be able to provide care to everyone based on their needs. For instance, Spanish speaking elderly people expect some one who knows their language in their physician’s office. Language barrier can cause lot of issues such as conveying wrong message about a patients or physicians. Effective communication is essential for physicians and clients to explain and understand each other. There are patients who cannot make it their physician’s office due to lack of transportation. This can negatively affect their health status. An example would be patients who miss their dialysis due to lack of transportation.