IS LANGUAGE A BARRIER TO THE USE OF PREVENTIVE SERVICES

OBJECTIVE:To isolate the effect of spoken language from financial barr iers to care, we examined the relation of language to use of preventiv e services in a system with universal access, DESIGN: Cross-sectional survey. SETTING: Household population of women living in Ontario, Cana da, in 1990. PARTICIPANTS: Subjects were 22,448 women completing the 1 990 Ontario Health Survey, a population-based random sample of househo lds. MEASUREMENTS AND MAIN RESULTS: We defined language as the languag e spoken in the home and assessed self-reported receipt of breast exam ination, mammogram and Pap testing. We used logistic regression to cal culate odds ratios for each service adjusting for potential sources of confounding: socioeconomic characteristics, contact with the health c are system, and measures reflecting culture. Ten percent of the women spoke a non-English language at home (4% French, 6% other), After adju stment, compared with English speakers, French-speaking women mere sig nificantly less likely to receive breast exams or mammography, and oth er language speakers were less likely to receive Pap testing. CONCLUSI ONS: Women whose main spoken language was not English were less likely to receive important preventive services, Improving communication wit h patients with limited English may enhance participation in screening programs.