Adults with limited English skills have poorer access to health care

New findings from researchers at the American Cancer Society (ACS) show that even after the Affordable Care Act (ACA) was implemented, adults in the United States with limited English proficiency (LEP ) had consistently worse access to medical care, including cancer prevention services, than adults without LEP. The study was published July 26 in the Journal of General Internal Medicine (JGIM).

“These results are disappointing because there are more than 25 million people with PLAR living in the United States, and that number is growing,” said Dr. Leticia Nogueira, Senior Principal Scientist, Health Services Research at the American Cancer Society and lead author of the study. study. “System-level interventions are critical, such as expanding access to health insurance coverage, providing language services, improving provider training in cultural competency, and increasing diversity of medical staff to help minimize barriers and be able to improve equity in access to care for this vulnerable population.

According to the authors, under federal law and the civil rights provision of the Affordable Care Act (ACA), health care providers receiving federal funds are required to provide equal access to care to people. with PML. Additionally, improving access to healthcare for adults with SLE is a public health priority included in the Healthy People 2030 development goals.

For the study, researchers identified nearly 19,000 adults with LEP and more than 98,000 adults without LEP in the United States, ages 18 or older, from the 2014-2018 National Spending Survey. medical. Associations between SLE and access to health care and preventive services were assessed using multivariate logistic regression models, stratified by age groups 18-64 and 65+ to hold health insurance eligibility threshold. The study used the government’s official definition of LEP, which includes adults who answer ‘not at all/not well/well’ to the question ‘How well do you speak English?’ » Access to care included having a usual source of care (and if so, distance from the usual source of care, difficulty in contacting the usual source of care, and provision of hours), visiting a medical provider in the past 12 months, having to forgo or delay care, and having difficulty paying medical bills. Preventive services included blood pressure and cholesterol checks, flu shots and cancer screening.

Study results showed that adults aged 18 to 64 with PML were significantly more likely to have no usual source of care, to have not seen a doctor, and to be late for treatment. preventative services including blood pressure checks, cholesterol and colorectal checks. cancer screening than adults without LEP. The results were similar in adults aged 65 and older.

“It is unacceptable that adults with LEP are less likely to have health insurance coverage, have a usual source of care, or receive preventative services compared to adults with English proficiency,” said the Dr. William Dahut, scientific director of the American Cancer Society. “Efforts to reduce barriers to care, disproportionately experienced by adults with PSI, are critical to addressing this disparity.”

“When it comes to cancer, barriers to accessing health care can become a matter of life and death,” said Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN). “ACS CAN urges the Biden administration to put in place regulations that provide greater patient protections under the Affordable Care Act, including strengthening and improving current provisions requiring people with PSI are informed of their rights and the availability of language assistance. We call on Congress to address affordability issues by closing the Medicaid coverage gap, making increased subsidies for Marketplace plans permanent, and capping Medicare Part D drug costs in their budget reconciliation agreement.

Other ACS authors on the study include: Dr Robin Yabroff, Kewei Shi and Dr Xuesong Han.

American Cancer Society resources for cancer information in other languages ​​can be found here.

This article was originally published on July 26, 2022 by the American Cancer Society. It is republished with permission.


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