Addressing family planning disparities through language access

Across the United States, women with limited English proficiency (LEP) continue to experience inequitable and unsafe family planning services. Despite governmental legislation mandating language access and professional association guidelines to prevent linguistic disparities, language barriers continue to lead many LEP women to avoid services and to use services unsafely. One of the first statewide surveys of language access in family planning was conducted in New York. Fifty-nine family planning facilities (30% response rate) completed a written survey to describe programs, practices and policies related to language access and the factors that may explain variability in language access conditions. Respondents represented rural and urban settings throughout the state. Ninety-seven percent facilities indicated documenting if a patient needs help to communicate. While 54% reported using bilingual staff to interpret only 27% reported ways to ensure staff who interpret know to do so correctly. Seventy one percent of facilities had written policies on how to help LEP patients, while 69% indicated that they have written procedures. Administrative leadership and patient demand were positively associated (P<.05) with adoption of language access policies and provision of language services. Frequent barriers included the absence of reimbursement for language services (e.g., governmental and private insurers), and limited educational opportunities to support language access. Less than 10% of facilities examined potential disparities due to language in family planning services and patient outcomes. Research and support to increase and improve language access are urgently needed to ensure equity in family planning.