Story at a glance
- A review found non-English speakers are underrepresented in pediatric research.
- Hundreds of studies assessed specifically excluded non-English speaking participants.
- Researchers stress the disparity could worsen health challenges faced by non-English speaking communities.
A new review of more than 5,000 pediatric research articles found just nine percent include non-English speaking children or families. Findings were published in the journal JAMA Pediatrics and highlight significant underrepresentation that could be detrimental to health equity, researchers say.
“It is frankly unfair and unjust that non-English speakers are not well-represented in pediatrics health research,” said study author Maya Ragavan of UPMC Children’s Hospital of Pittsburgh in a release.
“This study is a resounding call to action: We need to be more thoughtful and inclusive about how we involve people who speak different languages in our research.”
The review included articles published in three pediatric journals between 2012 and 2021. All studies included were based in the United States. Non-English speaking communities, or those who speak English less than “very well,” often experience health disparities compared with their English-speaking counterparts. These communities also make up around 9 percent of the U.S. population.
Of the studies that did include non-English speaking participants, Spanish was the most commonly spoken language. Nearly one-third of these studies did not specify which non-English language was included.
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According to the World Economic Forum, Cantonese and Mandarin are the second-most spoken languages behind English and Spanish in the U.S., followed by Tagalog, Vietnamese and Arabic.
“Children with [non-English speaking] parents experience higher communication-related adverse events, medical errors, and mortality,” JAMA researchers explained.
“Non–English-speaking parents are also less likely to have a pediatric medical home and are more likely to report that linguistic and cultural barriers negatively affect the patient-clinician relationship.”
Just 22 percent of studies that included these underrepresented participants specified how oral communication was achieved during the research. Twenty-nine percent included how written communication occurred.
More than 400 studies specifically excluded participants who were not fluent in English.
“Excluding non-English speakers from health research means that findings are not necessarily representative of the whole community,” said co-author Annie Chen of the University of Pittsburgh School of Medicine. “Diversity in research not only makes science better, but it also helps to dismantle structural barriers.”
However, within the past decade representation has improved slightly as the proportion of studies that included non-English speakers rose from 8 percent in 2012 to 12.5 percent in 2021.
“Research is important for developing innovations to move the needle forward, but if we’re not giving non-English speakers the opportunity to participate in research, then we’re essentially silencing their voices and setting up yet another inequity,” said Ragavan.
Authors conceded including these populations is not always easy and can involve expensive translation services. Enrolling different communities in studies can also be challenging.
Although initiatives are in place to recruit different minority groups to studies, these usually don’t extend to language inclusion, they added.
Requiring researchers to specify how they plan to include speakers of different languages in their work could help address the problem, while funders could also consider offering bonus grants for inclusive research.
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