Non-English speaking patients with COVID have a higher likelihood of needing ICU care and dying from the virus, say US scientists
At risk of worse health outcomes, non-English speaking patients – as well as racial and ethnic minority patients – continue to be disproportionally affected by COVID-19.
Researchers now also find that the language status of patients in hospital with cases of COVID-19 may also have worse impact health outcomes during their admission, as non-English speaking individuals were found to have 35% higher odds of death or requiring intensive care unit (ICU) support.
Data taken from the earliest phase of the COVID-19 pandemic compared non-English speaking patients to English-speaking patients, finding that overall, sociodemographic disparities continue to disproportionately affect COVID-19 hospitalisation and clinical outcomes of minority patients.
While improvements have since occurred, there are still needs for additional interventions at both hospital and community levels to close the equity gap.
White neighbourhoods have the lowest level of inequity – making them less vulnerable to COVID-19
Published in Journal of Racial and Ethnic Health Disparities., researchers took data from almost 10,000 primary care patients admitted to the Mass General Brigham Health System with COVID-19 between March 1, 2020 and March 1, 2021.
Splitting the data into “waves” of the pandemic, researchers found that Hispanic and Latino patients comprised close to one-third of all COVID-19-related admissions during the first wave, more than three times their pre-COVID-19 proportion.
Correspondingly, the proportion of non-English-speaking patients admitted increased fourfold from pre-pandemic rates.
Unfortunately, these results remained greatly uneven against minority and immigrant populations during the second wave, the researchers did find improved clinical outcomes – which were fewer patients admitted with COVID-19 developing severe illness or died when compared to the first wave.
Additionally, the association between language and severe COVID-19 outcome also disappeared in the second wave.
Lead author Priscilla Wang, MD, said: “This is one of the first studies to demonstrate a direct relationship between language status and health outcomes during COVID-19 hospitalizations, and we hope these findings can serve as a cautionary reminder to hospitals everywhere to proactively address the communication needs of patients with limited English proficiency prior to future surges of the virus.
“Fortunately, language-based inequities are correctable and improvements are starting to take place through, for example, greater messaging and materials in different languages provided within hospital and community settings.”
“Increased access to novel therapeutics and vaccinations may have contributed to these changes, but we believe improved support for patients with limited English proficiency within the acute care setting also played a major role in our health system.”
Language-based inequities can also reflect socioeconomic backgrounds
The changes seen at Mass General Brigham have now introduced in-person interpreter availability, investing in video-based interpretation equipment for isolation rooms, and increasing availability of informational materials translated into common languages to try and stop the waves of COVID disproportionately affecting non-English speaking patients.
As highlighted in the study, there is an urgent need to supply language-appropriate vaccination campaigns targeting highly impacted minority members within non-English speaking communities, as well as translation of relevant primary care-based educational materials.
Wang finalised: “The progress we’ve seen between the first and second waves of the pandemic suggests it is possible to close language-based disparity gaps in patient outcomes with focused interventions.
“But now is not the time to let our guard down. Serious inequities still remain, making it more important than ever for health systems to make continued investments in programs and policies that support patients with limited English proficiency.”