How state language access policies and communications mediate access to critical healthcare information

Abstract

Objectives

To examine the role of state language access policies and state agency communications practices in facilitating access to vaccine information for Limited English Proficient (LEP) populations in the U.S.

Methods

State language access policy data were linked to audit study field experiment data documenting the experiences (n = 455) of individuals of differing racial/ethnic identities and language use interacting with state health agencies to access COVID-19 vaccinations in the 50 states and District of Columbia. Regression analyses investigate whether state language access policies are associated with these outcomes: access to translation or interpretation, state health agency use of recommended communication practices, and receipt of information on how to access the vaccine.

Results

Government agency requirements for language access were associated with 17% higher availability of translation and interpretation services and greater use of recommended communications practices by state agencies. The use of nudges and absence of racialized or judgmental language in communications increased receipt of vaccine information by 13–26%. Interpretation was lacking in more than 40% of Spanish-language speaker phone encounters with state agencies.

Conclusions

LEP populations are among the least likely to be vaccinated and disproportionately experienced negative consequences of the COVID-19 pandemic. Enacting state language access requirements and instituting training programs for health agency employees involved in vaccine distribution could help to increase vaccine access and avert some of the harmful, racialized impacts of future pandemics.