State Legislative Efforts to Reduce Cancer Health Disparities Among Limited English Proficient Populations

Limited English proficiency (LEP), defined as not speaking English as a primary language and having a limited ability to read, speak, write, or understand English, has been found to be a barrier to the receipt and quality of preventive and primary care services. A number of studies illustrate the impact of LEP on screening and treatment for cancer. For example, even when controlling for factors such as income and insurance status, LEP has been negatively associated with the receipt of breast and cervical cancer screening (Jacobs 2005). LEP is also associated with poor patient comprehension of mammography results (Carliner 2005).

With the increase of LEP individuals in the U.S., language access has become a pressing cancer health disparities issue. Using data from the National Cancer Institute's State Cancer Legislative Database Program, we analyzed state-level legislative data to identify states that: (1) require LEP populations to be considered in the creation of cancer prevention, screening, and treatment programs; (2) acknowledge LEP as a barrier to obtaining cancer services; (3) require educational and informed consent materials on cancer to be distributed in languages besides English; or (4) provide patients with translation services.

We also identified the primary types of cancer and specific language populations addressed in the legislation. Preliminary data reveal that as of December 31, 2007, 16 states have passed legislation addressing LEP populations and cancer. This presentation examines these efforts to reduce cancer health disparities that may stem from LEP and identifies further opportunities for states to take legislative action.