Limited English proficient Asian Americans: Threshold language policy and access to mental health treatment

Snowden, Lonnie R.; Masland, Mary C.; Peng, Carol J.; Lou, Christine; Wallace, Nancy

doi:10.1016/j.socscimed.2010.10.027

Cited by 32 publications

(31 citation statements)

References 46 publications

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“…Examining the prevalence of behavioral health problems in comparison to other studies is more challenging. Accurately documenting the prevalence of behavioral health conditions among refugees is often complicated by language barriers and social stigma, which may prevent many people from seeking care [35, 37–39]. Furthermore, in our sample, adults from Iraq were more likely than adults from other nations to have completed a primary care-based behavioral health screening, and differences in detection may partially account for the higher rate of behavioral health problems reported for this subgroup.…”

Section: Discussionmentioning

confidence: 97%

High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy

Hebrank²,

et al. 2012

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The global rise in non-communicable disease (NCD) suggests that US-based refugees are increasingly affected by chronic conditions. However, health services have focused on the detection of infectious disease, with relatively limited data on chronic NCDs. Using data from a retrospective medical record review of a refugee health program in the urban Northeast (n = 180), we examined the prevalence of chronic NCDs and NCD risk factors among adult refugees who had recently arrived in the US, with attention to region of origin and family composition. Family composition was included because low-income adults without dependent children are at high risk of becoming uninsured. We found that half of the adult refugees in this sample had at least one chronic NCD (51.1%), and 9.5% had three or more NCDs. Behavioral health diagnoses were most common (15.0%), followed by hypertension (13.3%). Half of adults were overweight or obese (54.6%). Chronic NCDs were somewhat more common among adults from Iraq, but this difference was not significant (56.8 vs. 44.6%). Chronic NCDs were common among adults with and without dependent children (61.4 vs. 44.6%, respectively), and these two groups did not significantly differ in their likelihood of having a chronic NCD after adjustment for age and gender (AOR = 0.78, 95% CI = 0.39, 1.55). This study suggests that chronic NCDs are common among adult refugees in the US, including refugees at high risk for uninsurance. We propose that refugee health services accommodate screening and treatment for chronic NCDs and NCD risk factors, and that insurance outreach and enrollment programs target recently arrived refugees.

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Section: Discussionmentioning

confidence: 97%

High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy

Hebrank²,

et al. 2012

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“…The findings of extreme health vulnerability among those with LEP is supported by a large body of literature (Jacobs et al, 2005; Gee & Ponce, 2010; Pippins et al, 2007; Shi et al, 2009; Wilson et al, 2005) as is the health risk of low health literacy (Berkman et al, 2011; Nielsen-Bohlman et al, 2004). Despite many notable successes in California and other locations in providing in-language materials and outreach to populations with health communication challenges (Snowden et al, 2011), the high rates of poor health among individuals with dual health communication vulnerabilities indicates that considerable needs and challenges remain.…”

Section: Discussionmentioning

confidence: 99%

Low Health Literacy, Limited English Proficiency, and Health Status in Asians, Latinos, and Other Racial/Ethnic Groups in California

Sentell

Braun

2012

Journal of Health Communication

384

280

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We estimated health status by low health literacy and limited-English proficiency alone and in combination for Latinos, Chinese, Korean, Vietnamese, and Whites in a population-based sample: 48,427 adults from the 2007 California Health Interview Survey, including 3,715 with limited-English proficiency, were studied. Multivariate logistic models examined self-reported health by health literacy and English proficiency in the full sample and racial/ethnic subgroups. Overall, 44.9% with limited-English proficiency reported low health literacy versus 13.8% of English speakers. Among the limited-English proficient, Chinese respondents had the highest prevalence of low health literacy (68.3%), followed by Latinos (45.3%), Koreans (35.6%), Vietnamese (29.7%), and Whites (18.8%). In the full sample, respondents with both limited-English proficiency/low health literacy reported the highest prevalence of poor health (45.1%), followed by limited-English proficiency-only (41.1%), low health literacy-only (22.2%), and neither (13.8%), a hierarchy that remained significant in multivariate models. However, sub-analyses revealed limited-English proficient Latinos, Vietnamese, and Whites had equal or greater odds of poor health compared with low health literate/limited-English proficient respondents. Individuals with both limited-English proficiency and low health literacy are at high risk for poor health. Limited-English proficiency may carry greater health risk than low health literacy, though important racial/ethnic variations exist.

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“…The Institutional Review Board of the University of California, Berkeley approved the study procedures as the qualitative arm of a larger quantitative study evaluating California threshold language policies [12,13]. The first author conducted the Spanish-language interviews, and two additional field interviewers conducted the Vietnamese-language interviews.…”

Section: Methodsmentioning

confidence: 99%

“…California adopted a “threshold language policy” in response to Title VI and other obligations [9]. The policy requires that once a given county’s foreign language population reaches 5% of the total population, language services are required [12]. Quantitative evaluation of these policies has been promising: Asian-language LEP individuals are using mental health services at a greater rate than before the policies were enacted [12,13].…”

Section: Introductionmentioning

confidence: 99%

“…The policy requires that once a given county’s foreign language population reaches 5% of the total population, language services are required [12]. Quantitative evaluation of these policies has been promising: Asian-language LEP individuals are using mental health services at a greater rate than before the policies were enacted [12,13]. The quantitative data presented in these studies are encouraging, and yet are removed from the lived experience of LEP individuals seeking assistance.…”

Section: Introductionmentioning

confidence: 99%

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Qualitative evaluation of mental health services for clients with limited English proficiency

Patel

Firmender

Snowden³

2013

Int J Ment Health Syst

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BackgroundTo meet federal requirements under Title VI of the Civil Rights Act, the state of California instituted policies requiring that comprehensive mental health services in native languages be made available to limited English proficiency (LEP) populations when concentrations exceed “threshold” levels.MethodsThis paper builds on promising results from quantitative evaluations by reporting on qualitative interviews with Latino and Vietnamese LEP clients in mental health services (N = 20) to examine the awareness, impact, and implications of these threshold language policies.ResultsResults suggest that, while individuals are often not aware of the policies themselves, the language-related services they receive that are prompted by the policies are critical to treatment initiation and retention. Results also convey the complexities of using interpreters for sensitive psychological topics, and suggest that, for LEP individuals seeking mental health treatment, providers who speak their native languages are generally preferred.ConclusionsAccess to language-appropriate services seems to be an important part of why LEP populations seek mental health treatment. However, there are multiple variables that factor into the usage and usefulness of such services.

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Limited English proficient Asian Americans: Threshold language policy and access to mental health treatment

Cited by 32 publications

References 46 publications

High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy

High Prevalence of Chronic Non-Communicable Conditions Among Adult Refugees: Implications for Practice and Policy

Low Health Literacy, Limited English Proficiency, and Health Status in Asians, Latinos, and Other Racial/Ethnic Groups in California

Qualitative evaluation of mental health services for clients with limited English proficiency

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