Linguistic Diversity and Disparate Health Outcomes

8 January, 2019

Dear All,

Happy New Year 2019 for all of you

I use this opportunity of the new year to share with you this interesting article about Linguistic Diversity and Disparate Health Outcomes and address this key question Does the linguistic background of any given patient have anything to do with the level of access, quality of care, and/or effectiveness of the medical treatment they receive?

Here below, some key points of this article:

It is important to note that health outcomes alone are not sufficient to understand the severity of health disparities; we need to understand the importance of access to care. African Americans are not simply struggling with health outcomes but in accessing healthcare in general. As a result, people who receive poor access to care have increased rates of hospitalizations for preventable and chronic diseases.

Our best assessment of the role that language barriers play regarding the perpetuation of health disparities suggests that some indirect correlations may exist, but they are not the product of willful linguistic prejudice; rather, they are the consequences of occasionally unpredictable circumstances where prospective patients and medical professionals do not share sufficiently similar linguistic experiences, nor do they have immediate or adequate access to reliable linguistic interpreters. One final caution worthy of attention takes place on some occasions where patients and medical providers speak the same language, but they do not share the same cultural background. Under these circumstances potential miscommunication may not only occur, it may go undetected.

Effective cross-cultural communication has always stressed the importance of the principles of adapting language and health materials that reflect the patient’s level of health literacy, as well as adhering to the DHHS standards of culturally and linguistically appropriate services in healthcare. However, linguistic concordance is rarely considered an essential component of effective communication between patients and medical professionals when the patient and medical professional share the same language but different dialects. This intra-English linguistic discordance can exacerbate the patient’s distrust of the medical establishment, can reinforce both explicit and unconscious bias in the medical provider, and can perpetuate health disparities. It is certainly conceivable that patients well-documented preference for medical professionals with racial/ethnic concordance may actually belie a greater desire for linguistic concordance. It is an area ripe for investigation.

Effective communication can never be taken for granted under any circumstances, but medical communication is especially important and is most likely to be successful when patients and medical professionals are native speakers of the same language. Prospects for miscommunication may increase when patients and medical professionals speak different dialects of the same language, and communication has the greatest potential to break down whenever different languages are used, especially in the absence of adequate interpretation.

Of greatest significance to our findings thus far is the remarkable spirit of goodwill that exists among medical professionals who share the ethos of doing the very best they can to insure that anyone seeking their assistance or care will receive the best available treatment. We have not yet encountered any medical providers who are dismissive of prospective patients based on their linguistic backgrounds, and we hope our efforts may help identify new policies or procedures that will enhance communication, and ultimately reduce health disparities, that may correspond the linguistic differences between medical professionals and their patients.

#I’m interested to know if you have been able to address this issue of language concordance in your work and what have been your experience?.

All my best regards and best wishes to all.

Isabelle Wachsmuth

Universal Health Coverage and Health Systems

World Health Organization

Geneva, Switzerland

Office: +41 (0)22 791 3175


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HIFA profile: Isabelle Wachsmuth-Huguet, MSc, MPH has been working for World Health Organization (WHO) since 2003 and has 20 years of expertise on international network promoting and implementing knowledge management solutions in both high and low income countries. She is currently Project manager, Health Systems and Innovation Cluster, Service Delivery & Safety (SDS), Emerging Issues, Quality Universal Health Coverage (QUHC), at WHO Geneva. She is also the coordinator and lead moderator of the WHO Global Francophone Forum - Health Information For All (HIFA-Fr: She is a member of the HIFA working group on Multilingualism.

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