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In a classic study published in early 2000, the San Antonio Heart Study, the effect of diabetes and
cardiovascular disease and mortality among Mexican-Americans, English-speaking Mexican Americans
and Spanish-speaking Mexican-Americans was explored. The results showed that US-born Spanishspeaking
Mexican-American individuals have a higher rate of cardiovascular disease and diabetes
than English-speaking Mexican-born patients. This confirms the effect of language over metabolic and
cardiovascular outcomes among Latinos.
Those individuals speaking Spanish are at highest risk in comparison to English-speakers. They are not
out in the mainstream, they cannot read English and they cannot understand medical directions. They
don’t get the general dietary and physical activity guidelines for instance. That happens with other
cultures as well.
More than 28 million Latinos speak Spanish or limited English at home. Language definitely plays a
major role in the quality of diabetes outcomes among Latinos. In the Translating Research into Action
Diabetes (TRIAD) Study, a multi-center study of diabetes care in managed care, in a multi-ethnic sample
it was clear that Spanish-speaking Latinos have difficulty communicating with their health care provider
during the medical interview. Almost 30% reported the need of a translator during the visit. Latinos with
limited English proficiency have longer hospital stays due to diabetes, cardiovascular disease, stroke and
surgery. Therefore, limited English proficiency may provoke clinical isolation in patients with diabetes.
A 2003 TRIAD (Translating Research Into Action for Diabetes) survey on diabetes included more
than 4,000 Latino and non-Hispanic White patients. Significant differences between Spanish-speaking
and English-speaking Latinos were found in regard to self-glucose monitoring, blood pressure levels,
hemoglobin A1c levels, insulin use and oral medication. Spanish-speaking Latinos checked glucose less
frequently, had higher levels of hemoglobin A1c and were using more oral anti-diabetes medication in
comparison to non-Hispanic Whites.
The following table shows the results of a study on the impact of language on health care in a managed
care system.
It doesn't matter if you are a native speaker, or foreign-born speaker, sometimes the information you get
from the pharmacy is very confusing. It is very important to make sure the patient understands why it
is important to take the medication and how to take it.
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