Examining language concordance and physician-patient communication around mental health needs using CHIS 2007

Background. Language-related communication barriers between minority patients and their physicians may contribute to racial/ethnic disparities in mental health. Objectives. To examine the role of language concordance in understanding the mental health needs, and discussion of those needs with a physician, among older Latinos and Asian/Pacific Islanders (A/PIs). Methods. Using the 2007 California Health Interview Survey, the analytic sample included Latino and A/PIs aged 55 years and older (N=3,003) who reported having seen a primary care provider within the last two years. Multivariable logistic regression was used to examine differences by race/ethnicity and language concordance (3 groups: English-language concordant, other-language concordant, and language discordant) in mental health needs and discussion of those needs with a physician, adjusting for age, gender, marital status, education, insurance status, and mental health status. Results. There were no significant differences in patients' reports of their own mental health needs across the three language concordance groups (ps>0.17). There were, however, significant differences in whether patients' had discussed their mental health needs with their physician by patients' race/ethnicity and language concordance (OR=0.42, p=0.01). Specifically, Spanish-language concordant Latinos were more likely to discuss their mental health needs with their physician than English-language concordant Latinos. In contrast, Asian-language concordant A/PIs were less likely to discuss their mental health needs with their physician than English-language concordant A/PIs. There were no significant differences among the language discordant. Conclusions. These findings underscore the importance of overcoming both language-related and cultural barriers to improve patient-provider discussions of patients' mental health needs.