Language Matters: Race, Trust, and Outcomes in the Pediatric Emergency Department
Objective Trust in physicians and health care system has been positively associated with health care outcomes. The purpose of this study is to explore the relationships among race, ethnicity, language, trust, and health care outcomes. Methods This prospective cross sectional study took place in the pediatric emergency department of an intercity hospital. English and Spanish speaking guardians were asked to complete a demographic survey, the Pediatric Trust in Physicians Scale, and the Group Based Medical Mistrust Scale. Results Four hundred seventy five parents were surveyed, of which 21.35% identified as white, 35.05% as African American, and 53.26% as Hispanic; with respect to language: 88% English speaking and 12% Spanish speaking. No significant difference was seen in trust scores for sex, ethnicity, or religious affiliation. Non Hispanics and English speakers demonstrated an overall higher trust in their physician. English speaking participants were found to have higher percentages in all measured emergency department variables compared to Spanish speakers, including admittance (9.09% and 0.93% respectively) as well as receiving interventions (42.34% and 5.53% respectively) Conclusions Our study shows that race and ethnicity influence trust and mistrust as well as actual health care outcomes. Interestingly, language barrier proved to be one of the greatest causes of health care disparities. Therefore, more research is needed to find a way to bridge the increasing language barrier between physicians and patients.
Pediatric emergency care