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Patient-Physician Language Concordance and Cardiovascular Outcomes Among Patients With Hypertension
Michael Reaume1, Mathieu N Labossière2, Ricardo Batista3,4
1Department of Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
JAMA Network Open
|February 19, 2025
Summary
Language-concordant care may reduce major adverse cardiovascular events (MACEs) for hypertension patients. Allophone speakers receiving care in their primary language had 36% fewer MACEs, highlighting disparities in minority language healthcare.
Area of Science:
- Cardiovascular Health
- Health Services Research
- Health Disparities
Background:
- Patients from minority language communities often experience lower quality and safety in healthcare.
- The impact of physician-patient language concordance on health outcomes, particularly for cardiovascular events, remains understudied.
Purpose of the Study:
- To investigate the association between patient-physician language concordance and the risk of major adverse cardiovascular events (MACEs) in adult patients with hypertension.
- To identify potential disparities in healthcare outcomes based on language concordance.
Main Methods:
- Retrospective cohort study using Canadian Community Health Survey data (2003-2014).
- Included adults with self-reported hypertension, excluding Quebec residents.
- Linked survey responses to hospitalization and mortality records; analyzed data from October 2023 to May 2024.
Main Results:
- Among 124,583 patients, 91.7% spoke English, 3.8% French, 0.3% Indigenous languages, and 4.2% allophone languages.
- Few Indigenous language speakers received language-concordant care (<4.6%).
- Allophone speakers receiving language-concordant care had a 36% lower risk of MACEs compared to those receiving discordant care (HR, 0.64; 95% CI, 0.51-0.80). No significant difference was found for French speakers.
Conclusions:
- Significant disparities exist in access to language-concordant care and MACE risk among minority language groups.
- Language-concordant care shows potential to improve health outcomes for individuals in minority language communities, particularly for allophone speakers.
- Further research is needed to address systemic barriers and promote equitable healthcare delivery.
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