CORE research examines language barriers in COVID-19 test positivity

April 21, 2022

In 2021, the Center for Outcomes Research and Education (CORE) completed a study that highlights the need for translation, non-English materials, and other language-related support for COVID-19 public health communication and care. The findings were published in the journal BMC Public Health.

While other studies have shown that COVID-19 disproportionately impacts communities of color and those with lower socioeconomic status, CORE conducted one of the first large studies focused on understanding the role of language barriers in COVID-19 test positivity and exploring the complex intersection of language, race, and social factors in this context.

CORE analyzed 164,368 positive COVID-19 test results from patients across Oregon, Washington, and California, including 14,170 for people who preferred a language other than English. Not only were these individuals three times more likely to test positive, the higher risk among this group persisted even after adjusting for race/ethnicity and social factors like socioeconomic status, and housing and transportation characteristics.

Existing research has identified many  barriers to care faced by people whose preferred language is not English, including an English-centric public health communication system, few available healthcare providers from similar cultural backgrounds and/or providers who speak their native language, as well as deep-rooted mistrust in healthcare arising from experiences of stigma and discrimination. Plus, despite policy requiring hospitals to provide professional language services, between a quarter to a third of hospitals do not have them in place, leaving many hospital interactions to rely on family members or other ad hoc interpreters. Likewise, written materials in a patient’s preferred language are not consistently provided across healthcare encounters and settings.

“This research shows that regardless of factors like one’s socioeconomic status or race, if your preferred language is anything other than English, you’re more likely to be impacted by COVID-19,” explained Hannah Cohen-Cline, program director of research & evaluation at CORE. “These findings strongly highlight the need for healthcare providers and systems to address structural and systemic language barriers to health and health care in the United States,” added Cohen-Cline.

Read the paper, here.

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