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Elizabeth A. Jacobs, MD, MPP, Kelly Karavolos, MA, Paul J. Rathouz, PhD, Timothy G. Ferris, MD, MPH and Lynda H. Powell, PhD

Elizabeth A. Jacobs is with John H. Stroger Jr Hospital of Cook County and Rush University Medical Center, Chicago, Ill. Kelly Karavolos is with the Section of Biostatistics, Department of Preventive Medicine, Rush University Medical Center, Chicago. Paul J. Rathouz is with the Department of Health Studies, University of Chicago, Chicago. Timothy G. Ferris is with the Department of Medicine and Pediatrics, Harvard Medical School, and the Institute for Health Policy, Massachusetts General Hospital, Boston. Lynda H. Powell is with the Department of Preventive Medicine, Rush University Medical Center, Chicago.

Correspondence: Requests for reprints should be sent to Elizabeth A. Jacobs, MD, MPP, 1900 W Polk St, 16th Floor, Chicago, IL 60612 (e-mail: ejacobs{at}rush.edu).

Objectives. We examined the relationship between ability to speak English and receipt of Papanicolaou tests, clinical breast examinations, and mammography in a multiethnic group of women in the United States.

Methods. We used longitudinal data from the Study of Women Across the Nation to examine receipt of breast and cervical cancer screening among Chinese, Japanese, Hispanic, and White women who reported reading and speaking (1) only a language other than English, (2) another language more fluently than English, or (3) only English or another language and English with equal fluency. Logistic regression was used to analyze the data.

Results. Reading and speaking only a language other than English and reading and speaking another language more fluently than English, were significantly and negatively associated with receipt of breast and cervical cancer screening in unadjusted models. Although these findings were attenuated in adjusted models, not speaking English well or at all remained negatively associated with receipt of cancer screening.

Conclusions. These findings suggest that language barriers contribute to health disparities by impeding adequate health communication.

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