Language Concordance and Patient–Physician Communication Regarding Mental Health Needs

Authors

  • Kristin J. August PhD,

    1. Department of Psychology, Rutgers University, Camden, New Jersey
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  • Hannah Nguyen MSW,

    1. Department of Social Welfare, Luskin School of Public Affairs, University of California at Los Angeles, Los Angeles, California
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  • Quyen Ngo-Metzger MD, MPH,

    1. Division of General Internal Medicine and Primary Care
    2. Health Policy Research Institute, University of California at Irvine, Irvine, California
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  • Dara H. Sorkin PhD

    Corresponding author
    1. Division of General Internal Medicine and Primary Care
    2. Health Policy Research Institute, University of California at Irvine, Irvine, California
    • Department of Psychology, Rutgers University, Camden, New Jersey
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Address correspondence to Dara H. Sorkin, UCI Health Policy Research Institute, 100 Theory, Suite 110, Irvine, CA 92617. E-mail: dsorkin@uci.edu

Abstract

Language-related communication barriers between minority patients and their physicians may contribute to racial and ethnic disparities in mental health care. Accordingly, the current study sought to examine whether perceived mental health needs and discussion of these needs differed as a function of race or ethnicity and language concordance in older Latinos and Asian and Pacific Islanders (APIs). Using the 2007 California Health Interview Survey, the analytical sample included Latinos and APIs aged 55 and older (N = 2,960) who reported having seen a primary care provider within the past 2 years. Multivariable logistic regression was used to examine differences according to race or ethnicity and language concordance status (three groups: English-language concordant, other-language concordant, language discordant) in perceived mental health needs and discussion of those needs with a physician, adjusting for respondents’ sociodemographic characteristics and mental health status. There were no significant differences in respondents’ perceptions of their mental health needs across race or ethnicity or level of language concordance status (Ps > .41), although there were significant differences in whether respondents had discussed their mental health needs with their physicians according to participant race or ethnicity and language concordance status (adjusted odds ratio = 0.47, P = .04). Specifically, Spanish language-concordant Latinos were just as likely to discuss their mental health needs with their physicians as English language-concordant Latinos. In contrast, Asian language-concordant APIs were less likely to discuss their mental health needs with their physicians than English language-concordant APIs. There were no significant differences between language-discordant and English language-concordant older adults in predicting discussion of mental health concerns. These findings underscore the importance of overcoming language-related and cultural barriers to improve patient-provider discussions of older adults’ mental health needs.

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