A cross-sectional analysis of the impact of a language barrier in the osteoarthritic Latina population

Background: Osteoarthritis (OA) is a very prominent musculoskeletal disorder that affects approximately 303 million people worldwide. Numerous studies have shown language barriers interfere with the ability of Spanish speakers to communicate their pain symptoms to non-Spanish speaking physicians. The challenge that language barriers present to the Latina population in regard to the diagnosis and treatment of osteoarthritis remain largely unknown.

Hypothesis: We hypothesize that the presence of a language barrier will negatively affect the diagnosis and treatment of osteoarthritis, leading to worse health outcomes for the Latina population.

Methods: We analyzed data from the CDC’s Behavioral Risk Screening and Surveillance System, combining the 2017-2020 cycles using sampling weights provided by BRFSS, adjusted for multiple cycles. Determination of English- or Spanish-speaking groups was based on the language of the survey submitted with 20,659 and 18,559 in each group respectively (n=39,218). We calculated population estimates for arthritis diagnosis, physical limitations, and mean joint pain among language groups and by age (40+ and 65+), and determined associations via odds ratios.

Results: Rates of arthritis diagnosis between groups were similar for both age groups; however, we found that Spanish-speaking Latinas 65+ were statistically more likely to report being limited by pain. Further, Spanish-speaking Latinas in both age groups reported higher pain scores than the English-speaking group (p < .001).

Conclusions: Results from this study show that while there were no significant differences in rates of diagnosis, Spanish-speaking Latinas were more likely to be limited by joint pain and report higher pain scores. Given potential language barriers and potentially later diagnosis, emphasizing the holistic nature of osteopathic medicine should strive to provide equitable treatment and support for Spanish-speaking women. When language barriers exist, incorporating translators in medical settings may improve outcomes.