Language Ecology and Health Care: Language Varieties and Communication in a Latino-serving Family Health Center

Research on Hispanics/Latinos over the past decade with respect to the role of language and culture in access to and experiences with health care has focused on three primary variables, or factors. These are (1) the language spoken by the patient, physician, and other providers, including interpreters; (2) culturally-based beliefs about health and disease and the potential impact of these beliefs on experiences with health care systems; and (3) the role and effects of socio-demographic characteristics, such as socio-economic status and having (or not having) health insurance. What is lacking in this research is a more detailed analysis of the first factor, i.e., the language(s) spoken by patients and providers in clinical settings. What is especially important to investigate is the way(s) in which language choice and use are experienced by patients and family members, and how those experiences are understood and interpreted by participants in the health care delivery system, i.e., physicians, nurses, technicians, social workers. That is the focus of this empirical investigation of a Latino-serving family medical center located in San Antonio, Texas. Five hundred clinic patients completed surveys and about 100 of them were interviewed. Medical and non-medical support staff were interviewed as well. Results indicate a high level of satisfaction with quality of health care provided, but concerns were raised about communication problems at various points of contact in the delivery of health care services. Recommendations include hiring a full-time interpreter and providing classes in medical terminology in Spanish for clinic personnel.