Texas: Children In Non-English-speaking Households Face Many Health Disparities, Researcher Concludes

Harold Schiffman hfsclpp at gmail.com
Thu Jun 12 15:08:40 UTC 2008

Children In Non-English-speaking Households Face Many Health
Disparities, Researcher Concludes

ScienceDaily (Jun. 11, 2008) — Children in U.S. households where
English is not the primary language experience multiple disparities in
health care, a UT Southwestern Medical Center researcher has found. In
a study available in June's online issue of Pediatrics, Dr. Glenn
Flores, professor of pediatrics at UT Southwestern and lead author,
used statistics from the National Survey of Children's Health to
examine whether disparities exist for non-English primary language
(NEPL) children in medical and dental health compared to households
where English is the primary language.

"Although 55 million Americans speak a language other than English at
home, there has been little research on health disparities and NEPL
children," said Dr. Flores, who holds the Judith and Charles Ginsburg
Chair in Pediatrics at UT Southwestern. "To my knowledge this is the
first analysis to examine the impact of NEPL on medical and dental
health, access to care and use of services in a nationally
representative sample of U.S. children."

Conducted by the National Center for Health Statistics, the survey
used nationwide random sampling of households with children ages 18
and under. One child from each household was selected as the survey
subject with 102,353 interviews of household caregivers completed in
2003 and 2004 in both English and Spanish. The survey is the largest
and most diverse containing data on the primary languages spoken at

The researchers found that children in households where English is not
the primary language are significantly more likely than children in
English-speaking households to be poor and Latino or Asian/Pacific
Islander. The NEPL children are also more likely to be overweight,
have only fair or poor dental health, and be uninsured or sporadically
insured. These children also made no medical or preventive dental
visits during the previous year and had problems attaining specialty

"These children are more likely to live in low-income households,"
said Dr. Flores, who also serves as director of the division of
general pediatrics at Children's Medical Center Dallas. "Clinicians
providing care for them should make sure caregivers are aware of
programs documented to benefit poor children. Providing all children
with health and dental insurance could significantly reduce barriers
to health and dental care for NEPL children."

Nonfinancial-related barriers appeared also to hamper NEPL children's
access to care. The survey showed that caregivers in NEPL households
were often dissatisfied with physicians and health care providers who
did not spend enough time with a child or explain things in an
understandable way. To identify, monitor and eliminate health care
disparities, Dr. Flores recommends health care institutions and
systems routinely collect data on the primary language spoken at home
for all patients. He says improved access to medical interpreters,
better cultural competency training and more family-centered health
care systems could eliminate barriers to care.

In a previous study, Dr. Flores surveyed hospitals in New Jersey to
assess current language services and identify policy recommendations
on meeting the needs of patients with limited English proficiency. He
found that most New Jersey hospitals had no full-time interpreters,
multilingual hospital signage or translation services. A substantial
majority of the hospitals' representatives surveyed stated that
third-party reimbursements for interpreter services would benefit
their hospitals. "In Texas alone, 7.3 million families speak languages
other than English at home," Dr. Flores said. "It's imperative that
our health care system recognizes on a nationwide scale how language
is affecting health care for NEPL children."


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