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Spanish-Speaking and Non-Citizen Latino Parents Half as Likely to Feel Docs Are Listening

February 08 2017

A doctor in a white coat holding a clipboard

The parents of a Latino child who only speak Spanish or are not U.S. citizens are about half as likely to feel their doctor listens to them as English-speaking and U.S. citizen parents, according to a new Drexel University-led study.

Alex Ortega, PhD, a professor in Drexel’s Dornsife School of Public Health, was the lead author for a study published in Academic Pediatrics that analyzed the California Health Interview Survey to determine whether the experiences of Latino children’s parents differed depending on their U.S. citizenship status and language use. 

This is a crucial topic to explore because parents’ experiences with doctors are particularly important for keeping kids healthy.

“Evidence has shown that families that have positive experiences with their medical providers — including effective communication — are more likely to continue seeking health services for their children, particularly for preventive care, such as immunizations and health screenings,” Ortega explained.

Looking through 2011 and 2012 data for the parents of children younger than 12 years old, Ortega’s team found that children whose parents only spoke Spanish at home, or spoke a mix of English and Spanish, reported significantly worse experiences with doctors.

Parents who only spoke Spanish were half as likely as parents who spoke only English to report that their doctor listened carefully to them. Parents who spoke a mix of English and Spanish were 25 percent less likely than English-only speakers to feel they were being listened to.

Worse, Spanish-only parents were 60 percent less likely to feel that their children’s doctors were explaining things to them clearly, and 70 percent less likely over the last year than English-only parents to email or speak with a doctor via phone about any questions regarding their children’s health. Parents who spoke a mix were 75 percent less likely to feel their children’s doctors were explaining things clearly to them and almost 40 percent less likely to email or phone with a question.

With so many problems in communication, the risk of losing these parents and their children to regular health checks is alarming.

But some disparities go beyond simple language barriers.

When a child’s parents are both noncitizens, the likelihood of a good experience is extremely low. In that instance, the parents are 70 percent less likely to feel as if they’re being listened to, 65 percent less likely to feel as if they’re being explained things adequately, and 60 percent less likely to ask questions via phone or email.

Numbers are a little better for children who have one parent who is a U.S. citizen, but there are still significant negative disparities. 

“What our findings suggest is that more work needs to be done at the health system, health policy and medical provider levels to ensure that all children are having positive experiences in health care, regardless of citizenship status or language proficiency,” Ortega said.

California supports free interpreter services, and it’s also a federal policy to eliminate communication issues through access to interpreters. However, “our findings show that not all families are benefiting from these policies and programs,” Ortega said.

And those findings come from California, a state that is arguably more conscious of its Latino population and its challenges than most others. They could paint a more concerning picture if this study were conducted in some other states, according to Ortega. 

“In California, it is unlikely that access to care will change dramatically under Trump, but California’s health policy environment is much more progressive than most states, especially those with growing Latino populations in areas like the South and the Midwest,” Ortega said.

Overall, though, some hope was presented in findings regarding health care access — doctor visits and not delaying care generally trended positively, regardless of citizenship status and language barriers.

“Access was essentially equitable for all Latino children,” Ortega said. “This is a testament to the state’s value of health as a human right.”

Those interested in the full study, “Experiences in Care According to Parental Citizenship and Language Use Among Latino Children in California,” can access it here