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Is language a barrier to the use of preventive services?
S Woloshin1, L M Schwartz, S J Katz
1VA Outcomes Group, White River Junction, VT 05009, USA.
Objective:
To isolate the effect of spoken language from financial barriers to care, we examined the relation of language to use of preventive services in a system with universal access.
Design:
Cross-sectional survey.
Setting:
Household population of women living in Ontario, Canada, in 1990.
Participants:
Subjects were 22,448 women completing the 1990 Ontario Health Survey, a population-based random sample of households.
Measurements And Main Results:
We defined language as the language spoken in the home and assessed self-reported receipt of breast examination, mammogram and Pap testing. We used logistic regression to calculate odds ratios for each service adjusting for potential sources of confounding: socio-economic characteristics, contact with the health care system, and measures reflecting culture. Ten percent of the women spoke a non-English language at home (4% French, 6% other). After adjustment, compared with English speakers, French-speaking women were significantly less likely to receive breast exams or mammography, and other language speakers were less likely to receive Pap testing.
Conclusions:
Women whose main spoken language was not English were less likely to receive important preventive services. Improving communication with patients with limited English may enhance participation in screening programs.