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Language & Social Determinants of Health: Impact on Health Equity

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The more healthcare providers work to implement value-based care and ensure all populations have access to quality care, the more evident it becomes that disparities exist between groups. 

While great strides have been taken to address health disparities, there are still many factors that play a significant role in social determinants of health. The COVID-19 pandemic highlighted that not all social groups get the same care during a public health crisis, especially those with language barriers. According to research by the JAMA Network, while most people were comfortable seeking care remotely during the pandemic, patients with limited-English proficiency (LEP) were far less likely to take advantage of telehealth services. 

Social determinants of health are clear, and understanding this could be the key to ensuring health equity on a widespread level.  


What Are Social Determinants of Health?

The health of any individual is influenced by a list of factors, but they can be generally sorted into five specific categories:

  • Genetics
  • Behavior 
  • Environmental and physical influences 
  • Medical care
  • Social factors 

Social factors that influence a patient's health are deemed social determinants of health. These are underlying socioeconomic factors that contribute to health inequalities between different groups or sects of the population. Socioeconomic factors stem from both social status, such as culture, language, and value, as well as economic status. This particularly unique determinant of health covers a multitude of factors in a patient's everyday life. 


Major Social Determinants of Health 

The major social determinants of health can also be divided into five more focused categories: economic stability, education, health and health care, social and community context, and neighborhood and built environment. Within these five broader categories can be a wide range of specific, poignant factors. Here is a look at a few of the most noteworthy:


Discrimination can mean different things to different groups of people. For example, some patients may experience a lack of health equity due to direct discrimination because of their race, culture, or sexual preference. Likewise, some patients develop a mistrust of medical professionals because of how their race has been treated in the past. In any situation where discrimination is involved or could be involved, the patient can be less likely to achieve health equity, whether it is due to direct discrimination or perceived discrimination. 

Language Barriers 

Limited-English proficiency is far more prevalent in the U.S. than many healthcare providers anticipate. Unfortunately, a patient that does not speak or comprehend English can face numerous health disparities, such as not knowing where to go when treatment is needed or being readmitted to a hospital after release because of a lack of understanding of aftercare plans. 

Education and Health Literacy 

Limited health literacy (LHL) is estimated to affect as much as one-half of the entire U.S. population. LHL is explained as a limited ability to get, process, and even understand both health information and what health services are available when a patient needs to make an informed medical decision. Language barriers and health literacy can go hand in hand. 

Limited Social Support 

Limited social support means a patient does not have a lot of support from their general social network. For example, an individual who is limited-English proficient may not get a lot of social support in their own community because language barriers prevent ample communication between neighbors, acquaintances, or otherwise. 


What Role Does English Proficiency Play in Patient Wellness?

There is a strong link between health equity, language access, and cultural competency in healthcare. Patients who are not English-proficient are less likely to get the care they need because of lacking language access and cultural competency. Therefore, the health disparities among LEP groups can be especially prominent. According to the American Journal of Ethics, LEP patients experience inequitable care and oftentimes face severe health consequences because of it. 


Addressing Disparities: How to Intervene

The first plan for providers looking to achieve health equity among their own patient groups is to better understand which social determinants of health are present in their community. With a greater understanding of how certain determinants play a role, providers can better adjust care plans to cater to the specific needs of specific populations. 

For example, with language or diversity being such a major component of social determinants of health, a provider can get more familiar with how to keep LEP patients safe and ensure they get the care they need. They can then take steps such as: 

  • Tending to cultural competence in the practice 
  • Improving language access services for LEP patients 
  • Monitoring LEP patient care outcomes and safety over the long term 


Improving Health Equity through Optimal Language Access 

Addressing social determinants of health can be a very complex and layered process. At GLOBO, our mission is to help organizations counteract the negative effects that limited-English proficiency has on a person's health by providing accessible, high-quality language support. If you're interested in improving health equity for the vulnerable populations in your community, download our free Health Equity Checklist—with it, we'll also send our guide, Best Practices for Working with an Interpreter.

Checklist social-Best Practices

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