Symptomatic Translation: Why Latinx Communities Seek Healthcare Abroad Public

Abstract

Healthcare is one of the most politically contentious discourses on the United States political stage, with widespread discontentment with a system that simply seems unable to provide for all 340 million people in the country. Often in political discourse, low-income immigrant communities such as the Latinx community are blamed for overburdening the system. However, interviews have revealed a surprisingly common decision among the Latinx community to seek healthcare outside of the United States, returning to their origin countries for most non-emergent care. Through a series of interviews with 12 people from a range of different backgrounds, I explore the reasons contributing to this phenomenon. Ultimately, I argue that a failure of translation on multiple levels creates an increasingly hostile healthcare system for Latinx people to navigate, interweaving my interlocutors’ anecdotes with existing literature to outline three principal obstacles. In the first chapter, I examine language barriers and current methods of linguistic interpretation as factors contributing to discomfort in US clinical encounters, even for some fluent English speakers. In the second chapter I analyze cultural differences as another barrier to care, underscoring the ways in which principles of cultural competence are insufficient in negotiating this challenge. Finally, in the last chapter, I evaluate the US and Latin American health systems through the lens of Max Weber’s bureaucracy, comparing my interlocutors’ experiences in both, focusing on symptomatic translation, which I define as the translation of a patient’s symptoms and complaints into a resolution. This study offers preliminary insight into the reasons contributing to this phenomenon and offers reflections on potential improvement for the US healthcare system.

Table of Contents

Table of Contents

Introduction ................................................................................................................................................ 1

           Study Overview & Methodology ……………………………………………………………….. 2

Chapter 1: Linguistic Interpretation ................................................................................................. 5

           Clinical Language Barriers and their Consequences …………………….…………….. 5

Analysis of Current Methods of Interpretation ……..…………………….……….…….. 8

Legal Context and Framework of Interpretation ………………………………………... 13

Ad hoc Interpreters .................................................................................................................... 17

Linguistic Preference for Bilingual/Fluent English Speakers ………………………. 22

Chapter 2: Cultural Translation ........................................................................................................... 26

           Cultural Barriers in Healthcare …………………………………………………………………. 26

An Analysis of Cultural Competence and Racially-Based Medicine ……………… 29

           Cultural Autoatención (self-attention) ………………………………………………………. 36

 

Chapter 3: Symptomatic Translation ……………………………………………………………………. 40

           Symptomatic Translation ………………………………………..……………………….……….. 40

           Overview of Bureaucracy and Bureaucracy in Healthcare …………………………... 44

           Minimization of Interventions ............................................................................................... 46

           Primary Care and Referrals to Specialists …………………………………………….…….. 57

           Neoliberalism and Patient Satisfaction in Health ………..…………………….………… 63

Conclusion ..................................................................................................................................................... 70

Appendices .................................................................................................................................................... 74

           Appendix I: Interview Guide & Questions ………………………........................................ 74

           Appendix II: Sample Transcript ………………………...……….……..………....………..…… 76

 

Bibliography ……………………………………...……….……..………....………..…………………………..... 90

About this Honors Thesis

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School	Emory College
Department	Spanish
Degree	B.A.
Submission	Honors Thesis
Language	English
Research Field	Latin American Studies
Mot-clé	Latinx cultural competence linguistic barriers healthcare language bureaucracy cultural barriers
Committee Chair / Thesis Advisor	Xochitl Marsilli-Vargas, Emory University
Committee Members	Karen Stolley, Emory University Geovani Ramirez, Emory University

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