Description
Although there are federal and state legal frameworks in place in the U.S. that protect the right of Limited English Proficient (LEP) individuals to receive health care services in a language they understand, research suggests that the language services provided in health care organizations remain insufficient or nonexistent. This study focuses on the state of California and uses data from the 2013-2015 California Health Interview Survey (CHIS) to test two hypotheses: (1) LEP individuals experience less timely care, as measured by treatment delays, than English Proficient (EP) individuals, and (2) Among LEP individuals, those who are unaware of their legal rights to language services experience additional barriers to timely care than those who are aware. In this study, treatment delays are examined through pooled, weighted logistic regression models adjusted for patient and organizational factors based on the Andersen Behavioral Model of Health Services Use. Results demonstrate an inverse association between English language proficiency and awareness of rights to language services and treatment delays, with LEP respondents facing lower odds of treatment delays compared to EP respondents regardless of awareness or not of the language law (AOR 0.55 and 0.56; p-value .0005 and .0012). Thus, the two hypotheses were not supported. Conversely, respondents reporting public or no insurance or public or no usual source of care had greater odds of experiencing treatment delays (20% and 30-60% respectively). Social cohesion was found to be protective for the outcome. While the study did not reveal access barriers for LEP respondents, limitations in sample size may suggest need for improved understanding of the role of insurance type and usual or no source of care among LEP persons to understand why health inequities in the distribution of health care services persist.
