Individuals with limited English proficiency more likely to not report CVD
Among patients with anginal symptoms, those with limited English proficiency were more likely not to report having CVD than those without limited English proficiency, researchers reported in JAMA Network Open.
“Language barriers have been associated with increased hospital length of stay, hospital readmissions and limited understanding of appointment type and post-discharge medication use. In the international setting, the consequences of language barriers have been documented across countries in Europe, Africa and the Middle East, with findings similar to those detected in the United States,” Brandon M. Herbert, MPH, cardiologist trainee in the department of epidemiology at the University of Pittsburgh Graduate School of Public Health, and colleagues wrote. “Importantly, limited English proficiency and other language barriers are fundamentally detrimental to health literacy, further associated with poor health, adverse outcomes and limited communication between the patient and health care practitioner.”
The population-based cross-sectional study included 19,320 participants (mean age, 58 years; 47% men) using data from five National Health and Nutrition Examination Survey cycles from 2007 to 2016. Each cycle consisted of an interview collecting demographic, dietary and health-related data and medical examinations for physiological measurements. Researchers analyzed these data from September 2020 to April 2021.
Limited English proficiency was defined as individuals who received the survey in a non-English language or through an interpreter. Anginal symptoms were obtained through the 7-item Rose Angina Questionnaire and self-reported CVD was defined as a history of HF, CHD, angina or MI.
Of all participants, 583 (3%) reported anginal symptoms. Of these participants, 484 (96.1%) were non-limited English proficiency, 344 (62.1%) were women, 251 (66.8%) were white adults and 347 (62.8%) did not report having CVD. Among those with anginal symptoms, 79% with limited English proficiency reported no CVD history compared with 61.4% of participants with angina but no limited English proficiency (P = .002).
Researchers observed 2.8-fold higher odds of not reporting CVD history among those with limited English proficiency compared with those without (OR = 2.77; 95% CI, 1.38-5.55; P = .005).
“These findings highlight the importance of effective communication, screening and diagnostic evaluations about heart disease in individuals with and without limited English proficiency,” the researchers wrote.
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