Psychological and health consequences of difficult-to-translate concepts among immigrant older adults

In health care settings, immigrant older adults who are not fluent in English may not be able to fully express their problems, even with a translator, because there are important phrases about health problems in their native language that do not directly translate to concepts in English. This issue is particularly important for immigrant older adults, especially recent immigrants, who might experience limited English proficiency and rely heavily on health care services. For example, Chinese expressions, such as "" and "," and Spanish idioms, such as "sentirse agüitado" and "achicopalado," roughly translate to different types of emotional distress but do not have accurate English translations. These linguistic barriers affect both psychological and physical health outcomes. This paper briefly describes different types of culturally-embedded metaphors, idioms, and linguistic framing commonly used by immigrant older adults in the US, especially those who speak Mandarin and Spanish. We then highlight that even with a good translator, these phrases lead to barriers in effective healthcare services. As a result of these translational issues, immigrant older adults may experience misdiagnoses and improper treatments, thereby decreasing patients' willingness to seek help. We highlight the need for more research on this issue of culturally based descriptions of health issues, particularly psychological distress. While prior research documents these barriers, it does not provide direct causal evidence of how these concepts influence diagnosis and treatment outcomes. Doing so would provide a better understanding of how linguistic factors affect mental and physical health, guiding more inclusive, culturally sensitive solutions.