White Paper: Language Access and Health in Western North Carolina - Overview, Cost and Strategic Recommendations

Amid workforce shortages, transportation challenges, insurance gaps, and rising healthcare costs, finding ways to make existing care easier to access and more efficient is an important step toward improving healthcare for people across Western North Carolina.

For many people in WNC, healthcare barriers aren’t only about whether care is available—they’re also about whether people can understand, navigate, and effectively use the care available to them.

Building a Health Care System Where Every Patient Can Be Heard and Understood

Among the approximately one million residents of rural Western North Carolina (WNC), 18.7% of adults have literacy challenges, 14% have hearing loss, about 7% speak a language other than English at home, and approximately 3% speak English less than "very well." The region also has a 44% higher proportion of older adults than the rest of NC, increasing the need for accessible communication.

A lack of health literacy, language, and hearing ability, especially as a significant percent of our population is over the age of 65, can contribute to medication errors, delayed care, avoidable emergency department visits, and hospital readmissions. And while these challenges directly affect patients and families, they also add financial and operational pressure to an already stretched rural healthcare system.

In this new report, prepared by NC Center for Health and Wellness Research Assistant Andrew Rainey, we look at language and communication access as part of healthcare infrastructure and examines practical ways WNC can improve both access and efficiency.

The report outlines eight recommendations, including opportunities to:

• Better understand regional needs through shared data and ongoing input from language communities.

• Connect existing resources and establish regional standards through a WNC Language Access Plan and stronger collaboration among healthcare and community partners.

• Strengthen workforce and trust by expanding pathways for bilingual community members, interpreters, and Community Health Workers while improving privacy and safe access to care.

• Build stronger communication infrastructure through multilingual and plain language public information, community partnerships, and resilient broadband, radio, media, and transportation networks.

These recommendations build on work already happening across WNC. The opportunity is to connect those efforts more intentionally and strengthen the resources communities already have.

Communication efforts help patients better understand their care, help providers use their time and resources more effectively, and reduce preventable costs. Better communication is an investment in better access, better outcomes, and a more sustainable rural healthcare system.

The issue of communication access is not new, nor are the organizations and individuals working to address it. This brief serves to provide an overview of how language access intersects with health in WNC and some of the opportunities available to bring those efforts together more intentionally around a shared goal of healthcare access. As regional efforts like Rural Health Transformation's NC ROOTS Hubs explore ways to create more accessible and sustainable healthcare in the mountains, information like this has never been more timely.

Thank you to the many community partners and experts who contributed their time, data, and expertise to this work. We’re grateful for the regional knowledge that helped shape the report.

Disclaimer

This content was developed by the WNC Health Policy Initiative in consultation with people and organizations with connections to the health of people of Western North Carolina. Individual or organizational opinions, findings, conclusions, or recommendations are those of the relevant author(s)/interviewee(s) and do not necessarily reflect the view of the WNC Health Policy Initiative, its host institutions of the University of North Carolina Asheville (UNCA), Mountain Area Health Education Center (MAHEC) or our funders.