Providing health care to the poor increasingly means providing health care to non-English speakers, and that’s a challenge that is about to get more challenging.
According to the US Census, more than 55 million people speak a language other than English at home. In Massachusetts, the number is 1.2 million. In the City of Boston, one in three residents speak another language.
At Cambridge-based Senior Whole Health, which provides health care to people who quality for both MassHealth and Medicaid and is known as a Senior Care Options plan, two out of three of our members do not speak English. The number of languages spoken by our membership is more than 30.
Navigating our complicated health care system is a challenge for anyone. For a non-English speaking person, the task is overwhelming – and can be deadly.
Non-fluency in English is associated with lower use of preventive services, higher utilization of expensive emergency room care, less ability to self-manage chronic diseases – and higher mortality, according to the Journal of the American Medical Association. In fact, according to JAMA, reading fluency is a more powerful variable than education for examining the association between socioeconomic status and health.
Navigating the system will get even more complicated next year when individuals and small businesses will be required to purchase health insurance under federal health reform. That will require them to compare and contrast various private health insurance policies through exchanges set up by the new law.
Meanwhle, immigration reform could add another seven million people, many of them not fluent in English, to Obamacare.
But there is a path to success. We have already helped over 10,000 people successfully navigate the health care system. Our model provides all-inclusive care directed by a case manager who provides one-stop shopping for the patient and his or her family in their native language. We emphasize preventive care and provide non-medical services, such as bilingual exercise classes, that support a healthy lifestyle.
Not only is this model keeping people healthier, but it’s saving taxpayer dollars by keeping poor seniors out of nursing homes longer and reducing hospital admissions by 25 percent, according to a study conducted for MassHealth.
Providing health care to the poor will require a new mindset about how to deliver — and define — health care.