Summary

• Long-term health of Francophone and Allophone populations benefit from receiving language-concordant physician care.
• Language concordance is key to improving long-term survival in an increasingly multilingual Canadian population.
• Research analyzed over 50,000 Canadian patients over 15 years.

OTTAWA – Sharing a common tongue is a key feature for improved long-term health for Francophone and diverse linguistic communities according to researchers from the University of Ottawa and the University of Manitoba.

The retrospective study published in the journal AJE Advances: Research in Epidemiologystudied a total of 50,375 respondents over 15 years to find both Francophone and Allophone patients had significantly lower risk of all-cause mortality if they received language-concordant physician care, or care from a regular physician who spoke their language. Allophone populations are those whose primary language is neither English nor French.

“The results of our study indicate that healthcare systems should prioritize the delivery of language-concordant physician care through patient-physician linguistic matching and/or use of evidence-based interpretation services, as this could potentially improve long-term survival in an increasingly linguistically diverse Canadian population,” said lead author Michael Reaume, who recently completed his residency in nephrology at the University of Ottawa is a now a post-doctoral research fellow at the University of Manitoba.

Previous research from the same group found that patient-doctor common tongue was the key to decreasing the risk of major adverse cardiovascular events, although that study focused on Allophone populations. The larger sample size for this research included all patients, rather than just patients with hypertension, while considering all-cause survival rather than cardiovascular disease.

“In our previous study, we found differences in cardiovascular outcomes for Allophone-speaking patients but not for French-speaking patients. This time, we found differences in overall survival for both French-speaking and Allophone-speaking patients.”

• An 11% lower risk of all-cause death among French-speaking respondents outside of Quebec with common language.
• A 27% lower risk of all-cause death among Allophone-language-speaking respondents when language was common.
• Very few Indigenous-language-speaking respondents (1.8%) received regular language-concordant physician care.

Solutions for multilingual healthcare

The findings present some understanding of the complexities of healthcare in Canada, a bilingual country with a significant array of minority communities.

“We believe the disparities identified in this study could be mitigated through a number of steps, from equitable access to medical education for underrepresented linguistic communities, to the systematic collection of patients’ preferred language and linguistic abilities of healthcare providers, as well as consistent and reliable access to evidence-based interpretation services,” adds Reaume.

‘Patient-physician language concordance and long-term mortality: a retrospective cohort study of Canadians’, by M. Reaume, B. Holahan, M. N Labossière, E. Kilabuk, S. Van Haute, J. Nkosi, H. Singh, D. Prud’homme, S. Karunananthan, S. Johnston, L. M Lix is published in  AJE Advances: Research in Epidemiology. DOI: 10.1093/ajeadv/uuag026

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