According to Pew Research, one third of foreign born people in the U.S. do not currently have health insurance. This is likely to change when the marketplaces go into effect in 2014. Estimates from RAND suggest that in 2016, 2 million Asian Americans and 5.4 million Latinos who would otherwise be uninsured will gain or be eligible for coverage under the Patient Protection and Affordable Care Act (PPACA). Many individuals in these newly eligible communities may need language access assistance to help them understand the complex world of health exchanges and get the care they need.
Health literacy challenges of LEP and minority populations
Navigating the healthcare system, especially the new exchanges, is challenging enough for seasoned professionals, let alone for someone who doesn’t speak English as their first language. In fact, according to a recent study from Carnegie Mellon University, only 14 percent of consumers surveyed understand basic insurance terms such as “copayments,” and “deductibles.” This is further compounded by language barriers. Among the foreign born or first-generation Hispanics only 37% percent say they can read a newspaper or book in English “very well” or “pretty well” according to Pew. Similarly, only about half (53% percent) of foreign-born Asians say they speak English very well, compared with 95% percent of the U.S. born Asian-Americans.
As open enrollment begins, communicating complicated concepts of health insurance and the associated benefits with limited-English-proficient (LEP) communities requires providing them with materials in their native languages for true understanding to take place. Most of this demographic will have never had health insurance before. While some exchanges and plans may provide mandated documents including Evidence of Coverage (EOC) in the more common languages such as Mandarin or Spanish, brokers working with more niche markets may need to look a little harder for materials in these specific languages or create their own.
How to create readable health materials in any language
Research shows that LEP and minority populations are more likely than their white counterparts to lack health insurance, have chronic disease and have difficulties communicating with healthcare providers, even if qualified as highly literate in their primary language. Even for those who speak English as a second language, comprehension of new vocabulary or subject matter can be quite low. This is especially true when faced with difficult medical terminology. Best practices for creating readable health materials in any language include:
- Write clearly and in an active voice.
- Use familiar vocabulary and simple terminology.
- Use short sentences.
- Use graphics, videos or pictures that “show” rather than “tell.”
- Keep materials at a fourth-to sixth-grade reading level.
In addition, to effectively communicate with a multicultural audience, you must also consider cultural factors such as race, ethnicity, religion, age and gender. Many ethnicities don’t place the same value on Western medical practices. For example, some Asian immigrant cultures are influenced less by science, but respond well to more holistic and ritualistic views of medicine.
Maximize Your translation budget
Translation can be costly. However, by developing an efficient process and leveraging technology you can maximize your budget and get the best return on your investment.
- Bundle your translation orders with one central translation vendor for increased savings and consistency.
- Establish consistent usage of terminology and branding with style guides and glossaries.
- Build a comprehensive translation memory (a databank that captures previously translated text) and recycle translation of commonly used phrases from one document to the next, decreasing translation time and costs.
- Use machine translation software in conjunction with human review to help decrease errors and reduce costs.
- If possible, choose a vendor that provides an online portal with instant quoting, tracking and reporting to make project management more efficient.
Bridging the language gap is key to ensuring that culturally diverse communities enjoy equal access to healthcare. Many of the new insurance consumers will come from households below the Federal Poverty Level, will be less educated and more racially diverse. Therefore simply translating the materials is not enough. Behind every language is a unique culture that must be accounted for, if your message is to be positively received by that market. The state exchanges in Oregon and Washington recently learned that the hard way when their attempts at creating marketing materials in different languages were picked apart. However, by taking into account the health literacy of the target audience and following a few simple steps to streamline translation processes, brokers can efficiently and cost effectively provide custom materials for their LEP communities.