Researchers are reporting that people with chest pain and limited English proficiency are less likely to be diagnosed with heart disease in the United States compared to fluent English speakers, even if they have it. Results of the large, nationwide study provide compelling new evidence that disparities in heart disease are fueled in part by language barriers between patients and health care providers.
About 9 percent of the United States population is classified as having limited English proficiency. Past studies have found that not speaking English as a primary language is associated with suboptimal health care in the United States.
To find out more about the role of language barriers in heart disease care, the researchers collected data from about 20,000 people using five National Health and Nutrition Examination Survey (NHANES) cycles conducted from 2007 to 2016. In addition to physiological measurements, the study included a questionnaire about the presence of angina, or chest pain, a common sign of heart disease.
Of those with angina symptoms, participants with limited English proficiency were almost three times more likely to report not having a history of cardiovascular disease compared to participants who were native English speakers. Possible reasons for the discrepancy include higher rates of undiagnosed CVD in those with limited English or lower awareness of such diagnoses among those individuals, the researchers said.
More efforts to reduce communication gaps in health care settings and provide sensitive screening for heart disease among non-native English speakers are needed, the researchers suggested. The study, funded by the NHLBI, appeared in JAMA Network Open.