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Impact of language barriers on pulmonary function and asthma control
Maria Paula Henao1, Joshua Malerich2, Daniel R George1
1College of Medicine, Pennsylvania State University, Hershey, Pennsylvania.
Summary
Language barriers worsen asthma control and outcomes for non-English speakers. Health systems must implement linguistically appropriate care, including interpreters and bilingual education, to reduce disparities.
Area of Science:
- Health disparities research
- Clinical asthma management
- Health services research
Background:
- Language barriers disproportionately affect non-English-speaking populations with asthma.
- These barriers contribute to worse health outcomes, including increased emergency department visits and hospitalizations.
- Culturally and linguistically appropriate care is essential to address these disparities.
Purpose of the Study:
- To evaluate the impact of language barriers on asthma control.
- To assess the effect of language barriers on pulmonary function testing.
- To analyze healthcare utilization patterns in relation to language barriers.
Main Methods:
- Retrospective cohort study of 28,346 asthma patients aged 12+.
- Patients categorized as English-speaking or non-English-speaking based on electronic health record language preference.
- Asthma outcomes measured via Asthma Control Test (ACT), Pulmonary Function Tests (PFTs), and healthcare utilization; atopy assessed via skin prick tests or specific IgE.
Main Results:
- Non-English speakers had higher rates of uncontrolled asthma (ACT ≤20) and lower FEV1 percent predicted.
- English speakers were more likely to have ACT and PFT data recorded.
- Non-English speakers utilized ERs more frequently but had fewer ambulatory visits; hospitalization rates were similar.
Conclusions:
- Language barriers significantly impair asthma management and lead to poorer outcomes for patients with limited English proficiency.
- Health systems should prioritize professional interpreters, bilingual education, and technology (e.g., AI translation) to mitigate these disparities.
- Further research is needed to evaluate the long-term impact of language-concordant interventions on asthma management.
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