Blog

Blog with us!

The Center for Dignity in Healthcare for People with Disabilities invites your blog submissions.

General Submission Guidelines

  • We are looking for submissions about healthcare inequities faced by people with disabilities and proposed solutions to make healthcare more equitable. We want posts that will educate, inform, empower, and challenge people to think in new ways.
  • We are open for submissions year-round.
  • Guest blog posts are usually between 500 and 1,000 words. Please include a short bio and a photograph with your submission.
  • The Center for Dignity team may work with you to edit your blog. Our publication schedule varies. Please allow at least one week between submission and proposed publication date.
  • Authors and photographers have rights. Please credit others’ work in your submission and cite our blog if you republish.
  • Following publication, we will share your blog post via Facebook, Twitter, and our newsletter.

Accessibility

We are committed to accessibility. Please use alt-text and captions for images. Do your best to write in plain-language. We will only post videos that are captioned.

How to Submit

Send your 500-to 100-word posts with a suggested title wo [email protected]. Include a brief bio, picture with image description, and social media accounts that you’d like to share.

Language Access Services to Eliminate Health Disparities and Achieve Health Equity for those with Limited English Proficiency (LEP)

image of a woman with brown, curly, shoulder length hair. She is wearing a turquoise shirt and smiling at the camera.

Christina Eguizabal Love, Psy.D.
Director of Health and Language Access
Office for Health, Equity, Inclusion, and Diversity (O-HEID)
Pediatric Neuropsychologist
Kennedy Krieger Institute

In the United States, about 1 out of 5 people speak a language other than English at home,1 which equates to nearly 65 million individuals. Those with Limited English Proficiency (LEP) do not speak English as their primary language and have limited ability to read, speak, write, or understand English.2 Providing language access means ensuring that individuals with LEP can communicate effectively to participate in and receive healthcare, an important component of culturally competent services.3 In fact, Title VI of the Civil Rights Act of 1964 and corresponding regulations, including the Affordable Care Act (ACA), indicate that federal agencies and those receiving federal financial assistance are required to provide meaningful access to services for LEP individuals via trained interpreters, translation services, and more.

The ability for individuals to effectively communicate within a healthcare setting is a critical and an important step in eliminating health disparities and achieving health equity.3 Language is a social determinant of health because language barriers contribute to difficulties with accessing healthcare services.4 Language barriers can also contribute to serious health risks for those who have LEP as a result of lower quality of care.5 In the majority of situations, language-concordant care (i.e., a match between a healthcare provider and a patient’s language) improves health outcomes such as having a higher likelihood of receiving preventative health screenings or services.6 However, there is a shortage of health professionals across a variety of specialties who are fluent and able to provide healthcare services in other languages. Moreover, a reliance on unqualified interpreters such as family members can lead to misunderstandings and potentially devastating outcomes, including death.7 Overall, a lack of interpretation services for individuals with LEP in the healthcare setting may have significant effects on patient safety, quality of care, and patient satisfaction.8

The National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care are a set of 15 action steps detailed by the Office of Minority Health (OMH) at the U.S. Department of Health and Human Services (HHS). The aim of the standards is to reduce health disparities and achieve health equity by providing culturally and linguistically appropriate health services.9 For example, the standards include the provision of language assistance to individuals with LEP at no cost to them and in a timely manner, as well as informing all of the availability of language assistance services in their preferred language. Organizations need to ensure the competence of those providing language assistance services and the provision of print and multimedia materials in the languages commonly served by patients and families in the area. Increasing awareness of these standards is an important step in ensuring equitable health services for all. It is also important to consider that language access issues are often “the tip of the iceberg” for individuals with LEP who may also experience difficulties with immigration, discrimination, and poverty among others. Thus, achieving health equity between English-proficient patients and those with LEP will also require addressing root causes and social determinants of health beyond language access.

About

Dr. Love is a licensed psychologist and pediatric neuropsychologist in the Department of Neuropsychology at the Kennedy Krieger Institute. She provides clinical neuropsychological services to children, adolescents, and young adults with a variety of developmental and medical conditions, primarily within the Epilepsy/Acquired Brain Injury Clinic. She serves as the neuropsychologist for the Philip A. Keelty Center for Spina Bifida and Related Conditions. Dr. Love is bilingual in English and Spanish and has a special interest in working with Spanish-speaking patients and their families. She is also the Director of Health and Language Access within the Office for Health, Equity, Inclusion, and Diversity (O-HEID) where she is working on projects to improve care for individuals and families with limited English proficiency (LEP) at the Institute. 

References:

1.  Language Spoken at Home. Census.gov. Published March 8, 2022. Accessed September 2, 2022. https://www.census.gov/acs/www/about/why-we-ask-each-question/language/

2. Commonly Asked Questions and Answers: Regarding Limited … – LEP.gov. Accessed September 3, 2022. https://www.lep.gov/sites/lep/files/media/document/2020-03/042511_QA_LEP_General_0.pdf

3. Language Access. Wyoming Department of Health. Published August 23, 2022. Accessed September 2, 2022. https://health.wyo.gov/publichealth/office-of-performance-improvement-and-health-equity/multicultural/cultural/

4.  Language as a Social Determinant of Health: An Applied Linguistics Perspective on Health Equity. Language as a Social Determinant of Health: An Applied Linguistics Perspective on Health Equity – American Association For Applied Linguistics. Accessed September 3, 2022. https://www.aaal.org/news/language-as-a-social-determinant-of-health-an-applied-linguistics-perspective-on-health-equity#

5. A Practical Guide to Implementing the National CLAS Standards. Accessed September 3, 2022. https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/CLAS-Toolkit-12-7-16.pdf

6.  Diamond L, Izquierdo K, Canfield D, Matsoukas K, Gany F. A Systematic Review of the Impact of Patient–Physician Non-English Language Concordance on Quality of Care and Outcomes. J Gen Intern Med. 2019;34(8):1591-1606. doi:10.1007/s11606-019-04847-5

7.  Chen AH, Youdelman MK, Brooks J. The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond. J Gen Intern Med. 2007;22(S2):362-367. doi:10.1007/s11606-007-0366-2

8. Goenka PK. Lost in translation: impact of language barriers on children’s healthcare. Curr Opin Pediatr. 2016;28(5):659-666. doi:10.1097/MOP.0000000000000404

9. National CLAS Standards – Think Cultural Health. Accessed September 3, 2022. https://thinkculturalhealth.hhs.gov/assets/pdfs/EnhancedNationalCLASStandards.pdf

10. Ortega P, Shin TM, Martínez GA. Rethinking the Term “Limited English Proficiency” to Improve Language-Appropriate Healthcare for All. J Immigr Minor Health. 2022;24(3):799-805. doi:10.1007/s10903-021-01257-w

Organization Aims to Address the Double Burden of Racism and Ableism within the Health Care System

For Immediate Release:                                      
August 29, 2022

Contact:
Leah Smith, Project Coordinator

Organization Aims to Address the Double Burden of Racism and Ableism Within the Health Care System

Thanks to generous support from WITH Foundation, The Center for Dignity in Healthcare for People with Disabilities will expand upon its existing work by addressing racism and ableism within the U.S. healthcare system. 

Continue reading

In Response to the Reversal of Roe v. Wade and Its Impact on People With Disabilities

The Center for Dignity in Healthcare for People with Disabilities is deeply concerned about the overturning of Roe v Wade and what it means for the control people with disabilities have over their reproductive health. As an organization that is dedicated to addressing healthcare inequities faced by people with disabilities, we know that a more reproductively just system would reduce healthcare inequities among this population. 

Continue reading

The Center for Dignity in Healthcare for People with Disabilities Comments to Communications Equality Advocates Petition for Reconsideration

The Center for Dignity in Healthcare for People with Disabilities (CDHPD) submits the following comments to Communications Equality Advocates Petition for Reconsideration.  CDHPD aims to reduce healthcare inequities faced by people with disabilities and is composed of partners from multiple University Centers for Excellence in Developmental Disabilities (UCEDD), medical and advocacy organizations. One of our four focus areas includes reducing healthcare inequities in mental health and suicide prevention. Thus, we are committed to ensuring that any system aimed at addressing suicide is accessible for all. 

Continue reading

Supporting Equitable Access to Mental Health Services for People with Developmental Disabilities

If you think you broke your arm, would you be surprised to find that the x-ray would only be covered by your insurance if the bone was actually broken? If you needed surgery, would it feel unfair if insurance refused to pay because the surgeon used one brand of equipment instead of another? Would you be frustrated if your broken arm was eligible for physical therapy if you broke it in a car accident, but not if it was the result of a congenital condition? 

Continue reading

Clinical Trials and the Exclusion of People with Disabilities

By Stephanie Meredith

A recent federal proposal regarding research for a new class of treatment for Alzheimer’s disease has drawn sharp rebuke from an unlikely critic: a coalition of Down syndrome and intellectual disability advocacy organizations. The reason?  The Centers for Medicare & Medicaid (CMS) proposal, which is open for public comment until February 9, specifically excludes people with Down syndrome and other intellectual disabilities from participating in the clinical trials. This decision would subsequently prevent them from accessing the treatment (https://www.ndss.org/cms-comment/).

Continue reading
Multi Colored Trim on a square box. Black text on white background reads: To Promote More Informed Healthcare and Greater Equity Towards People with Disabilities: 1. Insurance Coverage of independent genetic counseling. 2. FDA Regulation of Advertising claims made by testing labs. 3. better educational infrastructure for patients to understand testing and disabilities. 4. Insurance coverage of testing contingent on the provision of better patient education and access to independent pre-test and post-test counseling

In Response to the NY Times: Prenatal Screening and the Social Bias Against Disability

By Stephanie Meredith

A recent New York Times article, “When They Warn of Rare Disorders, These Prenatal Tests Are Usually Wrong” by Sarah Kliff, indicates that when cell-free DNA prenatal screening results show that a baby has high chances for some rare genetic conditions, the baby actually does not have the condition 70-90% of the time (a false positive) (2022). Many parents at the other end of the screening results describe the experience as stressful and scary because they weren’t given sufficient information about the accuracy of the tests and the possibility of false positives. Kliff shares that one reason why expectant parents misunderstand the screening tests is because testing labs describe their screening tests as “reliable,” “highly accurate,” etc. in their advertising materials. Moreover, the author asserts that the companies are highly motivated to expand testing so that they can increase profits in a highly lucrative market. Yet, this widening pool of expectant parents who are undergoing testing can leave some parents in the lurch when they don’t receive the counseling and information they need to properly understand the screening tests. Kliff effectively highlights these important issues and presents a strong case for FDA regulation of advertising claims made by testing labs and insurance coverage of independent genetic counseling.

Continue reading

Loss and COVID-19: The Toll on Children

Authored by: Tracy Waller, Esq., MPH[1]


As a result of the COVID-19 public health crisis, children are being forced to shoulder an incomprehensible burden of loss. Many children have experienced health issues due to COVID-19 infections or long COVID-19 symptoms. They have also encountered a loss of innocence and protection, as they shoulder the weight of a parent coping with long COVID-19—or worse, the death of a parent or primary caregiver from COVID-19. This loss disproportionately affects young children and children with developmental disabilities because of the increased reliance on their caregivers. 

Continue reading

Evusheld Offers Hope for Many, but Access Remains an Issue

On December 8, 2021, the U.S. Food and Drug Administration (FDA) issued Emergency Use Authorization (EUA) for Evusheld (formerly AZD7442) for emergency use in the United States for pre-exposure prevention of COVID-19. The EUA approval seems to provide long-awaited hope for adults and children 12 years of age and older who are moderately to severely immunocompromised and may not mount an adequate immune response and for those who have been advised against the available COVID-19 vaccines due to severe allergies with components of the vaccine or a history of adverse reactions. However, over the last month, many people have expressed frustration and disappointment with the lack of access to Evusheld and transparency about the distribution process.

Continue reading