HANOVER, N.H. — Far from being an equalizer, the COVID-19 crisis has laid bare the inequalities that affect minority groups in the United States. Language —together with race, ethnicity, and socioeconomic status, categories with which it often overlaps— makes certain populations particularly vulnerable to the pandemic. Take the Spanish-speaking Latino population. Not only are they more likely to work in high-risk essential jobs with poor or non-existent health coverage and sick-leave policies; they are more likely to encounter language barriers in prevention, treatment and navigating safety net benefits such as unemployment.
Language barriers start with prevention. For a few critical weeks in March, The White House and the CDC websites were making the latest COVID-19 guidelines only available in English. Until late in March, the CDC portal only had partial, outdated information in Spanish and Chinese, initially, to which Vietnamese or Korean, first, and eventually a longer list of languages were added. Outreach by state and local governments in other languages also proved unequal and insufficient, with some exceptions.
Social media and bilingual media outlets stepped up to make up for the information deficit for populations left out by local, state, and federal campaigns. Univision and Telemundo turned over hours of airtime to reach particularly vulnerable segments of the Latino population.
We know Latino, African-American and Indigenous communities suffer from the virus at a higher rate. When they get sick, minority language speakers face worse odds of surviving COVID-19, due in part to the language barriers in testing, triaging, and treatment. An early version of the Google’s Project Baseline COVID-19 testing program listed being able to read and speak English as a pre-requisite for testing eligibility. Without accurate information, doctors and nurses may accidentally overlook critical information when assessing patients or discharging them.
Must speak English!!! pic.twitter.com/j6d8ekCXgs
— Northern (@WhateverUpNorth) March 16, 2020
The virus has exacerbated the endemic lack of qualified medical interpreters. During the spring peak in the New York metropolitan area, where about a quarter of the population is classified as not proficient in English and around 3 million are foreign-born, already overwhelmed hospitals were forced to cobble together ad hoc language services when seeing patients with coronavirus. In Boston, Mass General Hospital adopted the policy of assigning Spanish-speaking doctors to each team to serve their population. Not even family members, often conscripted into the role of makes-shift interpreters with uneven results, could assist or comfort their relatives because of restrictions on hospital visits.
But language barriers do not stop with health care. There are unemployment benefits, food stamps, rent and mortgage relief applications to navigate and to file. It is true that many of those benefits are administered at the state level. However, it is telling that the relevant federal agencies—the Department of Labor, the Food and Nutrition Service of the Department of Agriculture, the Department of Housing and Urban Development, or the Federal Housing Finance Agency—only offer COVID-19 resources in English.
Certainly, the lack of adequate language services is only a small part of the systemic inequalities that account for the higher fatality rate from the virus in Latino, African American, and Indigenous communities. Improving language services and designing new language policies will not, by itself, be enough to redress those inequalities.
But there is no doubt that languages matter when it comes to public health. That is why Section 1557 of the Affordable Care Act of 2010 guarantees languages services for patients with limited English proficiency. We know that languages can save lives in the pandemic—we need language policies that reflect the linguistic diversity of the population rather than a misplaced ideal of the country’s linguistic uniformity.
If the federal government wanted, it could use its considerable resources to address the language gap in public health and social services. After all, the government has been in the language teaching business for decades. Motivated by national interest, it has trained military officers, career diplomats and government employees through institutions like the Defense Language Institute or the network of federally funded National Resource Centers and Language Resource Centers.
The time has come to redefine what national interest means with regards to language along civil rather than military and corporate needs. As the current crisis has demonstrated, few things are as utterly central to the national interest as public health. Many of the languages considered critical by the National Security Education Program (NSEP) overlap with the languages spoken by communities hit hard by the pandemic and the lack of language services in health care. Other than its own policies, nothing keeps the administration from investing in training professionals in public health, food administration or labor the same way it has trained State and Defense Department officials for decades.
Given the incapacity to contain the virus the government has displayed, it seems unlikely that language policies would change in the coming weeks and months. However, it seems clear that for any competent administration, language services should be part of any plan for preparedness from now on.