Healthcare communication is very important for good care. However, it is hard when patients use different languages. Deaf patients, especially those who use American Sign Language (ASL), often face problems in healthcare. Poor health literacy in this group affects how they use emergency and preventive care. Medical staff and managers in the U.S. should understand these problems to improve services. Technology can help make patient care better and easier to manage.
About 466 million people worldwide have serious hearing loss, which is over five percent of the population, according to the World Health Organization (WHO). In the United States, many Deaf people use ASL as their main language. They often see deafness as part of their culture, not just a health issue.
Many doctors and healthcare workers do not know much about Deaf culture or ASL. This causes big communication problems for Deaf patients. They often cannot get health information in sign language. Instead, they rely on writing notes or lip reading, which do not work well. Deaf patients want professional interpreters, but many hospitals and clinics do not provide them. This may be because it costs more or is hard to arrange.
Health literacy means how well a person can get, understand, and use health information to make choices. Studies show Deaf people in the U.S. are about seven times more likely to have low health literacy than hearing people. This is because they have trouble communicating and there are few health materials in sign language.
Low health literacy causes many health problems. Deaf patients often go to the emergency room more because they may not understand symptoms or wait too long to get care. They also use fewer preventive services like vaccines, cancer checks, or cholesterol tests. This can lead to more long-term health problems and higher medical costs.
A study called the Deaf Health Survey by Dr. Michael M. McKee and others found that when Deaf patients and doctors speak the same language (ASL), patients use more preventive care. Deaf patients are over three times more likely to get preventive services with ASL-fluent doctors.
For example, Deaf people who saw ASL-speaking doctors were 4.55 times more likely to get a flu shot in the past year compared to those who did not. Also, fewer people in this group missed preventive care, compared to the group without shared language.
In healthcare, different ways are used for Deaf patients and doctors to talk. Writing and lip reading are common but not very reliable. They depend on good English reading skills and can cause mistakes. Video remote interpreting (VRI) connects patients to sign language interpreters by video. It is helpful but not used enough because of cost, technology, or other issues.
Deaf patients prefer professional interpreters because they make communication clearer. But interpreters are not always available, which makes communication harder. This can cause wrong diagnoses or wrong treatments.
For example, Reeves and Kokoruwe reported a case where a Deaf woman had an amputation without fully understanding what was happening. She was not able to give real consent because of communication problems. This shows why good communication is very important.
Many healthcare workers do not know much about Deaf culture. This gap causes “audism,” which means unfair treatment because of deafness. Audism leads to lower-quality care. Doctors and staff should learn sign language and Deaf culture. This training helps avoid confusion, builds trust, and helps patients follow medical advice better.
Deaf patients are not all the same. They have different ways they like to communicate, different reading skills, and different comfort levels with technology. A single way to communicate will not work for everyone.
Deaf patients often miss out on important health messages because of communication problems. This means they get fewer cancer screenings, vaccines, and heart health checks than hearing people.
When they miss preventive care, Deaf patients may have more emergencies and hospital visits. Emergency visits cost more and usually lead to worse health results than if the problem was caught early.
New technology, like artificial intelligence (AI) and workflow automation, can help solve communication problems. For example, AI phone systems can answer calls and help Deaf patients get the information they need. These systems can give visual or text options suited for Deaf or hard-of-hearing people.
Automation can schedule appointments, send reminders, and provide follow-up in ways patients understand. AI can quickly connect Deaf patients to ASL-speaking clinicians or interpreters, cutting down wait times and confusion.
Video remote interpreting, helped by AI to improve video quality and add captions, supports Deaf patients during doctor visits. Connecting these technologies to Electronic Health Records (EHR) helps staff keep track of communication needs, improving care over time.
Healthcare IT managers and administrators should think about using AI and automation tools designed for Deaf patients. These increase patient satisfaction, reduce mistakes, and improve health by making preventive care easier to use.
Healthcare providers must see communication problems as a system-wide issue that needs support and funding. There are not enough ASL-trained doctors and interpreters because of limited training and money.
Healthcare groups should ask for better funding for interpreter services and cultural training. Telehealth with built-in interpreters can help Deaf people in rural or hard-to-reach places. This is especially important when visiting clinics in person is hard, like during the COVID-19 pandemic.
More research should focus on new communication technologies and care methods for Deaf patients. This research will help create better rules for healthcare providers.
Medical administrators, owners, and IT managers in the United States have an important role in helping Deaf patients get better healthcare. They need to understand that poor health literacy and communication problems affect how Deaf patients use emergency and preventive care.
To improve care, practices should:
By making these changes, healthcare providers can reduce health differences, improve patient happiness, and give fair care to Deaf patients. This helps health results and makes better use of resources.
Deaf patients face significant barriers due to lack of access to health information in signed language, reliance on ineffective communication methods like writing and lip-reading, and absence of culturally and linguistically competent healthcare providers, resulting in poorer health literacy and higher risk of underdiagnosis and undertreatment.
Physicians are primary caregivers and gatekeepers for treatment access. Effective communication with Deaf patients enhances satisfaction, compliance, and trust, while poor communication increases risks of misunderstanding, medical errors, and unsatisfactory health outcomes.
Professional interpreters are preferred but infrequently used. Common methods include writing and lip-reading; video remote interpreting is least common, highlighting a gap in effective communication support.
Lack of cultural and linguistic competence leads to audism and suboptimal care. Physicians need training to understand Deaf culture, language preferences, and communication methods to improve healthcare experiences and outcomes.
Poor health literacy in Deaf individuals leads to increased emergency care utilization, lower preventive care use, underdiagnosis, undertreatment, and greater risk of preventable chronic diseases due to inadequate access to comprehensible health information.
The Deaf community (capital ‘D’) identifies as a linguistic minority using signed language, viewing deafness as cultural identity rather than a medical disability, emphasizing the need for person-centered communication approaches respecting this identity.
Factors include availability of resources such as interpreters, healthcare providers’ knowledge and attitudes, systemic policies on communication access, and broader societal awareness and accommodations for Deaf individuals.
Existing research is limited, especially on communication efficacy and preferences. More studies are needed to inform effective strategies for bridging communication gaps and improving healthcare access and outcomes for the Deaf community.
Recommendations include increasing access to professional interpreters, promoting cultural competence training for healthcare providers, adopting person-centered approaches, and integrating signed language services into healthcare settings.
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