A new study suggests that people with hypertension who receive care in their preferred language are less likely to have a major cardiovascular event or die from any cause [1].
Let’s find a common language
Communication between the doctor and the patient is important, and it is becoming clear how important. A new study by Canadian scientists, published in JAMA Network Open, suggests that the impact of communication quality on health outcomes can be drastic.
Few things hinder communication as much as a language barrier. In immigrant-rich countries like the US and Canada, where people speak dozens of languages and often struggle to express themselves in the dominant one, this presents a major challenge.
In a large cohort of more than 100,000 patients with hypertension, the researchers identified 5,229 who primarily spoke an allophone language, which in Canada is a language other than English, French, or an Indigenous language. The researchers asked how communicating with a regular primary care provider in the patient’s preferred language affects the incidence of major adverse cardiovascular events (MACE), which, in this study, included hospitalization with acute coronary syndrome, heart failure, or stroke along with death by a cardiovascular cause.
Populational studies cannot establish causation and have to deal with multiple variables, but the researchers did a thorough job of accounting for possible confounding factors. Those included age, sex, marital status, educational level, household income, geographic region, urban or rural residence, Indigenous identity, immigrant status, knowledge of English, smoking, diabetes, obesity, history of heart disease, and history of stroke. All in all, the respondents reported speaking nearly 100 different languages.
More understanding means less risk
The study showed that participants whose preferred language was not English or French were 36% less likely to have a major adverse cardiovascular event if they received care from their regular primary care physician in their preferred language (including via translation services). A secondary analysis showed a similar correlation for all-cause hospitalization and mortality. They were 27% and 28% lower, respectively, for people who received primary care in their preferred language.
This is not the first study to explore the connection between language-concordant care (in which the physician speaks the patient’s native or preferred language) and health outcomes. The paper notes that studies conducted in the US have shown better glycemic control, blood pressure, and low-density lipoprotein cholesterol (LDL) levels in non–English-speaking patients who received primary care from physicians in their preferred language compared to those who communicated with their doctor strictly in English [2].
Talking about solutions
Michael Reaume, a resident in the Faculty of Medicine’s Department of Nephrology at the University of Ottawa and the study’s lead author, said, “If there was a new medication that decreased the risk of major adverse cardiovascular event by 36% or all-cause mortality by 28%, this medication would immediately be offered to our patients. We need to start thinking about language barriers in our health care systems in a similar way.”
“This starts by collecting preferred language for all patients systematically,” he noted. “This information is critical as it allows us to match patients to health care providers who have proficiency in their preferred language, while also identifying patients who would benefit from professional interpretation services.”
However, there might be a simple solution: AI. Several studies have recently shown that large language models (LLMs) are superior to human primary care providers in communicating with patients. The chatbots outperform humans on nearly all parameters, including thoroughness and empathy [3]. What’s more, these models can naturally converse in multiple languages.
Literature
[1] Reaume, M., Labossière, M. N., Batista, R., Van Haute, S., Tangri, N., Rigatto, C., … & Lix, L. M. (2025). Patient-Physician Language Concordance and Cardiovascular Outcomes Among Patients With Hypertension. JAMA Network Open, 8(2), e2460551-e2460551.
[2] Fernandez, A., Schillinger, D., Warton, E. M., Adler, N., Moffet, H. H., Schenker, Y., … & Karter, A. J. (2011). Language barriers, physician-patient language concordance, and glycemic control among insured Latinos with diabetes: the Diabetes Study of Northern California (DISTANCE). Journal of general internal medicine, 26, 170-176.
[3] Goh, E., Gallo, R., Hom, J., Strong, E., Weng, Y., Kerman, H., … & Chen, J. H. (2024). Large language model influence on diagnostic reasoning: a randomized clinical trial. JAMA Network Open, 7(10), e2440969-e2440969.
