Dr. Pablo Rodriguez has been trying to bridge gaps in health care his whole life.
Born in Puerto Rico, he came to the United States for medical school and became a health care leader in Rhode Island, his home for the past nearly 40 years. Working with patients and, in particularly, non-English-speaking patients, Rodriguez started noticing one common theme.
“What I found throughout my career is the difficulties that patients have with the health care system,” Rodriguez said. “People were having a very difficult time getting the right care at the right place.”
According to census data, over 22% of Rhode Islanders speak a language other than English at home, with 12.7% speaking Spanish. This often can create a whole new set of barriers when accessing health care, which in turn can have negative impacts on health outcomes.
He has seen this in many forms: from patients that have no idea what surgery they underwent to patients with medication to take and no clue what the instructions are. Some of these obstacles were caused by language barriers, but it goes beyond simple translations, he says. It’s about health literacy.
While bridging cultural, language and educational gaps between populations is always important, it is particularly urgent for Latinos, who are reported as having the lowest health literacy among all racial and ethnic groups.
This is why Rodriguez has made it his mission to spread information and help Latinos in Rhode Island improve their health literacy: first, through his career as a radio host, founding Latino Public Radio, the state’s first public radio station in Spanish, and then founding Nuestra Salud Productions LLC, a production company for a health-related radio show he hosts on Latina 100.3 FM. But soon he realized the radio was not enough, as its scope was too limited.
This became particularly evident during the COVID-19 pandemic, when misinformation started spreading vastly through the internet and social media. Studies show that Latinos were 57% more likely to use social media as a primary source of information for COVID-19.
“I realized, I need to expand and make this into [a] local site. Because people don’t know where to find the information. They get it on Whatsapp, on Instagram, on YouTube. And we have to compete in the same arena,” Rodriguez said.
From his long-running radio show, Rodriguez expanded his reach. In March, he launched a website associated with the radio show, called Nuestra Salud, the first Spanish-language health website in Rhode Island. On the website, he includes episodes of his podcasts, YouTube videos, and pages of content to help people find the health-related answers they need.
“People just basically need the opportunity to find the right information in an easily, accessible way,” he said. “You can actually change the lives of people.”
A social venture company, Nuestra Salud Productions is funded by sponsors, including Commonwealth Care Alliance Health Rhode Island and Neighborhood Health Plan of Rhode Island, and donates half of its profit to Clinica Esperanza/Hope Clinic, where Rodriguez is vice chairperson.
Rodriguez is not the only one in the Ocean State trying to address language and cultural barriers in health care. The Rhode Island School of Design recently launched a website to help non-English speakers communicate their pain to providers.
“Say Your Pain: The Universal Pain Translator,” produced in collaboration with Seattle-based global creative agency WongDoody, allows people to translate words describing pain in three languages – Spanish, Ukrainian and Mandarin Chinese.
“The health care system is designed around English, but we’re a multicultural society, so people are coming into health care spaces with different languages,” said Justin W. Cook, founding director of the Center for Complexity at RISD. “But it’s not just languages; it’s the kind of idioms we use to describe things like pain.”
The website translates specific words indicating various types of pain, such as “burning,” “searing,” “dull” and “piercing” to allow those using it to be as specific as possible when expressing themselves. It is mostly meant to be used in emergency settings whenever a human translator is unavailable. It also uses design and images to help convey visualizations of pain, to make understanding across cultures easier.
Cook said they decided to start with ways to express pain because it is “something we all experience.”
But this is just a starting point for what he hopes will be a much larger project: in the future they would like to add levels of intensity, to help people communicate on a numerical scale how intense the pain is.
“It can be quite dangerous to not speak the language of your care providers,” Cook said.
And like Rodriguez, he agrees that translating words is not enough to guarantee equivalent care. Because of the complexity of cultures and of ever-changing language, solutions need to also be complex.
“We make a big assumption when we say having a translator on the phone will lead to equivalent care,” Cook said. “It’s the complexity we’re interested in.”