Scope of language barriers stressed

Edna Gutierrez said she was biopsied for cancer on the wrong breast.

Martha Castro recalled helplessly watching her daughter's uncontrollable seizures, unable to understand the doctor's English.

And Lian Zhen Li, suffering from excruciating abdominal pain that turned out to be ovarian cancer, said Los Angeles County hospital staff told her to come back with someone who could interpret for her.

The three Southern California immigrants reflect the widespread problem -- and the potentially devastating consequences -- of language barriers in healthcare. The problem's massive scope was illuminated Thursday, when the Asian Pacific American Legal Center in Los Angeles released a new study documenting the language barriers faced by nearly one in three Los Angeles County residents, or 2.5 million people.

The data, based on the 2000 census, show that most of residents in five of the county's eight service planning areas -- which are used to plan and deliver health and social services -- speak a language other than English at home. The top languages spoken are Spanish, Chinese, Tagalog, Korean, Armenian, Vietnamese, Persian, Japanese and Russian.

The largest number of limited-English speakers are in the San Gabriel Valley, totaling 482,310, including roughly 200,000 Mexicans and 100,000 Chinese. In the metro Los Angeles area, which includes downtown and other core areas of the city, the primary language spoken by 70% of residents is not English and 43% reported speaking limited English, the county's highest rate.

Despite the broad need -- and federal legal requirements for language assistance -- immigrant advocates said Thursday that scores of patients still fall through the cracks. The result is delayed care, misdiagnoses and unnecessary procedures leading in some cases to death, advocates said.

"We want to shine a spotlight on how large a problem this is," said Karin Wang, the Asian Pacific center's vice president of programs. "We don't want language to be the reason people don't get quality healthcare."

Miya Iwataki, director of diversity programs for the county Department of Health Services, said the language needs in the county's four public hospitals were "overwhelming." In 2006, 49% of the system's 3.9 million patient visits involved people with limited English skills who primarily spoke one of 98 languages. Spanish speakers accounted for 1.9 million visits, followed by 17,000 visits by Korean speakers.