A groundbreaking experiment conducted by researchers from the University of Michigan has shed light on language-based disparities in accessing cancer care. The study involved simulating patient calls to the general helplines of various hospitals, with callers speaking in English, Spanish, and Mandarin.
The results were concerning. While nearly all English-speaking callers received information on the next steps for accessing cancer care, including clinic contact numbers and transfers to the appropriate department, only a third of Spanish speakers had the same success. The situation was even worse for Mandarin-speaking patients.
The study’s authors emphasized the importance of hospital general information lines as initial entry points for individuals seeking information about clinics and services. These hubs play a crucial role in evaluating cancer care access for patients from different backgrounds.
Lead researcher Dr. Debbie W. Chen of the University of Michigan expressed her concerns, stating, “Our study found significant language-based disparities in patients’ access to cancer care well before they are seen by a physician. If patients with cancer cannot access information on where to obtain the appropriate cancer care, what other critical information and services are they not able to access in our healthcare system?”
To test these services, the research team simulated calls to a random selection of 144 hospitals across 12 demographically diverse US states. The calls were made during weekdays between 8:00 am and 5:00 pm local time. Out of the 1,296 calls made, only 53 percent received the sought-after information. English speakers had the highest success rate, with 94 percent being connected to the next service, while Spanish and Mandarin speakers faced significantly lower success rates of 38 percent and 28 percent, respectively.
This study builds upon previous research conducted in 2005, which focused on Spanish-speaking callers seeking information about hospital outpatient clinics in New York City. Despite the significant increase in individuals with limited English proficiency in the United States, the study found even lower success rates for non-English-speaking individuals seeking cancer care services.
The barriers encountered by non-English-speaking callers were primarily system-level issues, including being told “no” or being hung up on by hospital staff, disconnection due to language-concordant instructions not being provided, and issues with Interpreter Services.
Dr. Chen suggests several potential solutions to address this problem. These include implementing automatic messaging with instructions in different languages and ensuring calls are directed to a person instead of disconnecting when no input is made by the patient. Additionally, having the initial general information staff member remain on the call during interpreter conversations can ensure accurate translation of relevant care service information.
Darcie Green, Executive Director of Latinas Contra Cancer, commented on the study’s findings, stating, “Spanish-speaking patients, as well as others who are not English-proficient, face preventable barriers in access to care starting at one of the most basic expectations we have when calling our health care provider – the ability to call in for an appointment or advice.” Green emphasized the need for accountability and investment in strategies and infrastructure to eliminate language-based health inequity in accessing care.
This study serves as a call to action for healthcare providers and policymakers to address these disparities and ensure that patients, especially those who need services the most, do not face unnecessary barriers in accessing them. By investing in community health workers and patient navigation, we can work towards reducing disparities in cancer care detection, treatment, and survivorship.
The study has been published in the Journal of the National Comprehensive Cancer Network.
