Language, Family & Health:
Enhancing Treatment Adherence Among Latino Immigrants Diagnosed with Chronic Illnesses

Dr. Lissette Piedra’s research has found that Latino immigrants with limited English proficiency (LEP) who are experiencing obesity, diabetes, and heart disease face worse health outcomes than their English-speaking counterparts. Part of the problem can be traced to language and culture barriers. For chronic conditions, bilingual health communications have to convey knowledge that calls for changes in everyday behaviors—changes which includes taking medication, eating an appropriate diet, and exercising. Yet, much is lost in translation. The lack of national standards for interpreters and the diversity of types of medical interpreters contribute to the uneven efficacy of interpretation services in medical settings. Recent conceptualizations of bilingual health communications have suggested that rather than focusing on interpreters as the pathway to better communication, a more realistic approach is to recognize the diversity of interpreters and to focus on the interrelationships between interpreters and healthcare professionals (Hsieh, 2006).

In addition to the daunting obstacles that language and cultural barriers pose, the individualistic nature of health care services further contributes to the problem of treatment adherence in unforeseen ways. In matters of public health, the individual is never the sole unit of analysis (Levins and Lewontin, 1985). Because most human beings live their lives in connection with families and groups, the harm created by chronic illness radiates from individuals to their family members. Yet, most health providers fail to capitalize on this reality in discussing treatment plans. Diagnosis and treatment of chronic illnesses are handled on an individual basis which reflects the cultural value orientations embedded in the American health care system. Latino immigrants who operate from a different cultural value orientation often will prioritize family well-being over individual well-being.

This study aims to enhance the treatment of chronic illness by investigating how sociocultural factors affect communication in clinical encounters and whether reframing chronic illnesses as family problems and engaging trusted family members and friends in treatment plans will enhance patient motivation to manage their chronic illnesses.