Since 1980, the Healthy People initiative has set goals and measurable objectives to improve health and well-being in the United States. The initiative's fifth edition, Healthy People 2030, builds on all the information, research, and insights gained over the past four decades to address current and emerging public health priorities and challenges.
Public health is a very broad field, and public health professionals and organizations are tasked with addressing and solving large and sweeping issues that affect the health and well-being of members of society. Because public health is so broad and covers so many aspects, the U.S. Department of Health and Human Services (HHS) created 10-year initiatives to tackle specific issues within the public health sphere.
Every 10 years, HHS assembles a task force of experts to identify the biggest threats and challenges in public health. This team analyzes data and looks at existing health concerns, then projects what the next 10 years are likely to bring.
The first report came out in 1979. Each subsequent report has learned from prior initiatives to improve the way we approach public health goals. The second report, which came out in 1980, was the first to include specific and measurable 10-year goals.
Economic stability — The ability to find and maintain steady work to be able to afford the things a person needs to remain healthy.
Education access and quality — Access to education and higher education, and job opportunities to earn a living wage.
Healthcare access and quality — The ability to get high-quality and affordable healthcare that is convenient, as well as access to nutritious food and physical fitness opportunities.
Neighborhood and built environment — Living in safe neighborhoods without polluted air, unsafe drinking water, or other health risks.
Social and community context — Positive relationships that reduce the stress and negative impacts of dangers like unsafe neighborhoods or discrimination.
When HHS releases the goals for the coming decade, they also release data on the core objectives and set specific targets to achieve in the next 10 years. The workgroup collects annual data and releases resources necessary to implement the goals. Experts decide what to focus on based on the availability of baseline data and the ability to achieve specific and measurable progress in that area.
The report also includes developmental objectives that are clear public health priorities but that do not have enough baseline data available to set specific and measurable goals. One of those developmental objectives for Healthy People 2030 is to increase the proportion of adults with limited-English proficiency (LEP) who say their providers explain things clearly.
The Impact of Clear Provider Communication
Healthcare providers know the importance of clear communication with staff and other providers, payers or administrators, and especially patients. For LEP patients, though, this can be a significant issue. They may not understand what a physician is telling them because of the language barrier. This can lead to misunderstandings about:
Communicating symptoms to the medical providers
Medication or dosage instructions
Hospital discharge instructions
Follow-up care plans
Signs or symptoms of a problem after hospital discharge
The research available on the topic reveals that patients with LEP are far more likely to experience adverse events that result in physical harm in a healthcare setting (49.1% compared to 29.5% of English-proficient patients). Those adverse events are also more likely to be from communication errors (52.4% of LEP patients compared to 35.9% of English-proficient patients).
In another study, patient stays in the hospital were almost twice as long for those who had no interpreter compared to those who had an interpreter at admission and discharge. The same study looked at 30-day hospital readmission rates. For those with an interpreter at admission and discharge, readmission rates were 14.9%. The readmission rate for patients with no interpreter was 63% higher.
This is a significant problem that leads to poor care outcomes, higher risk for patients, and higher total cost of care.
What to Expect
As public health experts study this issue, healthcare providers and systems can expect to see more data outlining the risks to LEP patients. Fortunately, with more data and awareness, HHS can provide resources and recommendations on best practices for reducing communication errors. That may include:
Specific requirements from accrediting bodies like The Joint Commission to provide comprehensive language support to every LEP patient.
Additional training resources for how and when to use language support services.
Resources to improve outreach that helps patients understand their right to a qualified interpreter in a care setting.
New technology tools that expand the way healthcare systems gather language data and evaluate care for LEP patients.
Prepare for Change
Healthcare systems do not need to wait for the final report from Healthy People 2030 or other directives from HHS to improve language services and create a more patient-centered approach to care for LEP populations. There are things you can do today to improve your services.
Invest in advanced language support. The best way to provide better care to your patients and reduce the risk of medical errors and adverse events is by offering comprehensive language support. GLOBO has medically qualified interpreters who speak more than 250 languages, available 24/7 for telephone, video remote, and on-site interpreting.
Implement the technology necessary for language services. Upgrading your technology in the clinic and the way you provide care can help make it easier to implement language services. For example, equipping your exam rooms with tablets that have a camera and WiFi connection makes it easy for patients to access video remote interpreting during an appointment. This will be especially important after COVID-19 permanently changed the way patients and providers access care with telemedicine.
Train staff and administrators. Many patients are unaware that they have the right to free language support services, so it's up to your staff and providers to help them get those services. Your team needs to know how to identify patients who need an interpreter and how to access one.
Offer printed materials in multiple languages. The Affordable Care Act Section 1557 requires that all healthcare facilities post a document explaining a patient's right to have an interpreter in the top 15 languages spoken in your state. You can also translate commonly-used materials in your clinic into the language(s) that most of your LEP patients speak.
Help Achieve Better Communication and Language Access