LIMITED English proficiency leads to worse outcomes in patients with asthma, with poorer lung function, a higher risk of uncontrolled asthma, and more emergency department visits, according to a retrospective cohort study. These findings highlight the need for culturally and linguistically appropriate care.
The study, which aimed to analyse the impact of language barriers on asthma control and pulmonary function, included data from 28,346 patients with asthma (aged ≥12 years), who were categorised as English-speaking or non-English-speaking based on language preference in their electronic health records (26,833 English-speaking and 769 non-English-speaking). Researchers used pulmonary function tests, asthma control tests (ACT), and healthcare utilisation patterns (emergency department visits, hospitalisations, and outpatient visits) to measure asthma outcomes. They also used skin prick tests or specific IgE to assess atopy when available.
Data showed that patients who spoke English were more likely to have ACT scores in their health records (odds ratio [OR]: 1.43; 95% CI: 1.11–1.83). Non-English-speaking patients, however, had lower FEV1 percent predicted (mean: 70.7 versus 78.4; p=0.007) and were more likely to have uncontrolled asthma (ACT ≤20; OR: 4.3; 95% CI: 2.61–7.09). Furthermore, they were more likely to seek care in an emergency department (OR: 1.36; 95% CI: 1.17–1.58), rather than attending ambulatory visits (OR: 2.00; 95% CI: 1.56–2.57). Researchers noted similar hospitalisation rates and atopy prevalence between the two groups.
The team concluded that language barriers significantly impact asthma management, and that professional interpreters, technological solutions such as AI-based translation models, and bilingual education need to be utilised to diminish these disparities. More research is needed to look into long-term effects of language barriers on asthma outcomes, as well as exploring which interventions could be effective, including telehealth services, AI, and real-time translation applications.
Reference:
Henao MP et al. Impact of language barriers on pulmonary function and asthma control. Ann Allergy Asthma Immunol. 2025;DOI: 10.1016/j.anai.2025.06.003.
