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Federal Exchange Unprepared for Hispanic Health Care Consumers


Smiling Hispanic FamilyA recent report on NPR recounted problems faced by Spanish-speaking health care consumers on the federal government’s Spanish-language mirror site, Even as technical glitches were being repaired and connection difficulties were smoothed out on the English-language version, glaring translation mistakes and user-interface issues reportedly remained common on the Spanish site.

This raises a question: are American health care providers doing enough to serve the needs of those consumers who rely primarily on Spanish to communicate? Moreover, what about the needs of speakers of other languages?

Health care information is complex as it is. Imagine trying to sort through it if the writing were incoherent.

It’s easy to push aside the needs of the few to concentrate on meeting the needs of the many. Health care professionals are tasked with treating as many patients as possible, as fast as they can and without errors. In such an environment, slowing down your West African patient’s treatment to wait on an interpreter to arrive on the ward, or holding up a marketing campaign in order to vet and send each component for outside translation into Spanish, could seem like an unnecessary delay.

It’s much easier to cut corners, isn’t it? Have a nurse who speaks passing French? Your West African patient speaks passing French, too, albeit not as her first language– the nurse can stand in until you get a Wolof translator on the dual-handset phone– where is that phone anyways? Anyone know?

Are you really going to reach that many more consumers by double-printing your brochures in Spanish? A strict translation without cultural context can be lost on Spanish speaking patients.  Why can’t we just hand out the English language piece and Patient Relations can call down the interpreter to help any Spanish-speaking patient who asks questions about it?

It’s astounding, but these things do happen in health care.  It’s not right, and in some instances it may be illegal. The reality of limited resources may slam up against the ideal practice environment, but health care organizations face significant liabilities if they fail to provide appropriate interpreting services.

In the case of Spanish-speaking consumers, how much benefit could be realized?

It has been estimated that there are 37 million Latinos living in the United States for whom Spanish is still a primary means of communication. Some of these consumers are newly arrived; many of them have been living in the United States for years. Their reasons for relying on Spanish as a primary language can vary; they often have little to do with the assertion that these persons do not wish to assimilate into American society.

Newly arrived immigrants often lack previous immersion in an English-speaking environment, and they merely require time to pick it up. A new language could simply harder for an older Spanish speaker to learn. Both groups often face barriers to accessing the web.

But their children don’t always face these same barriers. Children who grow up in primarily Spanish-speaking American households go to American schools. They quickly become familiar with English, and often surpass their parents’ bilingual abilities. Children of Spanish-speaking individuals represent a significant avenue of engagement for healthcare providers. But you can’t rely solely on younger family members’ potential bilingual abilities to reach older Spanish-speaking consumers; you must also engender trust in your services by meeting those consumers’ communication needs.

One-on-one approaches can help.

If your organization serves a significantly sized Spanish-speaking population, you might consider reaching out to them by going in to the community and conducting personalized marketing.

To that end, a cost-effective solution may be to hold biannual or quarterly health fairs geared specifically for the consumer population you wish to reach, with translators available at the fair to help consumers on an individual basis.

One of the problems most often reported by users on was the lack of individualized, Spanish-speaking customer service representatives to walk users through the process of signing up for health coverage.

Mistakes in translation can and will happen, but they are much easier to manage—and easier for your consumers to forgive— if you are staffing on-demand, competent customer service representatives who speak the language in question.


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