In the United States, around 9% of the population have limited English proficiency (LEP). Research shows language level can impact health. For example, language barriers are linked to increased time in the hospital, hospital readmissions, and limited understanding of appointments and medication use. Even with the use of interpreters, some people with LEP may have trouble understanding the interpreters. Many also feel that interpreters omit important information. In addition, people with LEP have reported racial and linguistic discrimination. As a result of these negative experiences, people with LEP often avoid care.

Heart disease and language level

For example, it is important that people with cardiovascular disease (CVD) are aware of this diagnosis because it will impact their choice of therapies. Recently, researchers studied almost 600 adults with symptoms of angina, such as chest pain. They used an inexpensive and reliable questionnaire (Rose Questionnaire first published in 1962) that identifies the presence of symptoms consistent with angina and ischemic heart pain where the heart is not getting enough blood flow. Researchers looked at how often people reported that they had CVD.

People often fail to report their heart disease

Researchers found that self-reported CVD was low among people reporting heart/chest symptoms. In fact, two-thirds of people who reported symptoms of angina on the Rose questionnaire did not report a CVD diagnosis. Furthermore, they found that people with LEP were almost 3 times more likely not to report having been diagnosed with CVD compared with those without symptoms. This association was independent of age, sex, body mass index (BMI), blood pressure, and diabetes status.

Language proficiency matters

These new research findings suggest that disparities in cardiovascular health are associated with language barriers. This highlights the importance of effective communication, screening, and diagnostic evaluations about heart disease in individuals with and without LEP.


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