Access to Care

Lack of English ability creates a substantial barrier to Hispanic children's access to health care

The disadvantage that some Hispanic children experience in their access to health care may be related to their parents' inability to speak English well enough to interact fully with the health care system, according to a recent study from the Agency for Healthcare Research and Quality. The AHRQ researchers who authored the study conclude that interpreters or bilingual providers and office staff may be needed to help reduce disparities in children's access to care. These findings are based on an analysis of data from AHRQ's Medical Expenditure Panel Survey (MEPS).

The study's authors, Robin M. Weinick, Ph.D., and Nancy A. Krauss, M.S., explored reasons for racial and ethnic differences in children's access to care. They found that black and Hispanic children are at a substantial disadvantage compared with white children, even after accounting for health insurance and socioeconomic status. However, when their parents' ability to speak English is comparable, the differences between Hispanic and white children become negligible. These results suggest that the disadvantage in Hispanic children's access to care may be related to language ability and characteristics associated with having parents with limited English skills, including differing knowledge about the health care system.

The data used in this study were derived from the 1996 MEPS Household Component. The sample included nearly 6,900 children younger than age 18; data for more than 90 percent of these children were reported by one of their parents. The data were collected during a series of personal interviews with the families. Slightly more than 40 percent of the Hispanic families needed their interviews to be conducted in Spanish, indicating that they probably would require interpreters or health care providers and staff who could speak Spanish to help them obtain access to needed health care.

Details of the study are in "Racial and ethnic differences in children's access to care," in the November 2000 American Journal of Public Health 90, pp. 11-14.

Reprints (AHRQ Publication No. 01-R008) are available from the AHRQ Publications Clearinghouse.


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