Kateland Joseph

Professor Albuerme

Synthesis Essay

Currently, worldwide, English is dominating the language world, with over 1.5 billion people speaking it as a native or second language. Language discrimination occurs when an individual is treated poorly or unfairly due to their native language or other traits of their language-speaking skills. The English language was spread due to British colonization and the power and influence it had back in the 17th century, along with the Industrial Revolution, trade, and much more. As English became more widespread, some countries and leaders started to incorporate it into their way of running the country and encouraged the learning and speaking of the language. The dominance and globalization of the English language have led to the discrimination and mistreatment of minority and immigrant groups in the United States in institutional settings. 

The English language’s popularity wasn’t by mistake and had a strategic rise to popularity in the world. At one point in time, Britain was one of the most powerful and influential empires in the world and had colonized different parts of the world, like North America, South America, Asia, Africa, and Australia. As English settlers traveled to and from these regions during the late 16th century, Natives were forced to learn the English language. Later, the Industrial Revolution expanded the English language, as new machines and inventions were created, so were new words and phrases in English. Moving into the late 20th century, the spread of the internet and technology took the world by storm, and tech giants made their way into many American homes. This allowed the English language to spread at a rapid pace, as households had TVs, cellular devices, and radios that broadcast the language into every household. 

However, with the rapid spread of the English language through technology, colonialism, and inventions came the association of the language with power, authority, intelligence, and dominance. These associations came with their consequences, as the rise of standard English took the stage and pushed out other languages and dialects spoken by individuals who weren’t native English speakers. This caused judgment and discrimination against minority groups who didn’t say “perfect” or English that was considered “normal” in the United States. The mistreatment of minority individuals due to their broken English was profound in the healthcare system and the workplace. 

In the US, standard American English is commonly used and seen as the only “proper” way of speaking English. According to EBSO, standard English is without any grammatical errors, shortcuts, and is an exemplary state of English used by educated speakers. This type of English is often associated with white Americans who are educated and are middle-class and above in social status. Other forms of English, used by other racial groups and minorities, are often looked down upon. These include forms such as African American Vernacular English (AAVE), Cajun American English, and Hispanic Vernacular English, among others. People often dismiss these forms of English as improper or incorrect. A 1977 court case involving a school (Martin Luther King Jr Elementary School) and the Ann Arbor school district, as they stated, “ AAVE was compared to standard English to determine how much children who had grown up with AAVE were at a disadvantage compared to those who were raised with standard English.” This court case shows how the standard of standard English has made people perceive other forms of English as poor and uneducated, and being at a disadvantage if you speak it. It’s also implying that only standard English should be spoken and taught, especially in academic settings, and that it’s the only English that’s valued in some people’s eyes.

The consequences of standard American English seep into the daily lives of those who may not speak it well or have a certain accent or dialect. Individuals have struggled to get hired or be taken seriously at their current places of work. Some have been placed in language development classes to “improve” their English and have been ignored or perceived negatively because of their language. 

Language dominance has not only determined the perception of intelligence but also who receives adequate healthcare and other essential services. A prime example of this is the US healthcare system, where people who have LEP face many obstacles in receiving or getting access to adequate healthcare services. In fact, in the US, 26 million people have limited English proficiency, which means they don’t speak English well. Of the 26 million people, 62% speak Spanish, and 8% speak Chinese. In settings like a clinic or hospital, these patients may struggle to get timely help or proper treatment when a translator isn’t readily available or when staff ignore their concerns due to their language barrier. 

On August 11th, 2000, there was an executive order published by President Clinton to assist those who had LEP. This executive order was supposed to provide sources and improve the accessibility of services for LEP persons. When this executive order was still active, it wasn’t taken very seriously and was brushed off by many institutions. And, as Trump came into power, this order has since been rescinded and is no longer enforced. So this executive order, being canceled or not taken seriously, has led to a lot of issues with accessibility for LEP patients.  At many hospitals across the US, translator services are usually not available when needed, especially in emergencies when every second counts. This can lead to patients suffering from medical misdiagnosis, delays in getting life-saving treatment, misunderstandings between the medical practitioner and the patient, and medication errors. Over time, this can lead to LEP patients delaying their treatment or avoiding going at all since they didn’t get adequate help the first time. They may be afraid they may not get treatment at all, or be misunderstood about the cause of their pain or medical issue. For instance, a study of six U.S hospitals found “49.1% of LEP patients experienced adverse events (i.e., medication errors, patient falls, skin breakdown, injury during treatment, or equipment/instrument issues) involving some physical harm, whereas only 29.5% of English proficient patients experienced adverse events that resulted in physical harm.” This shows the impact of LEP law not being enforced and what LEP patients face when their needs are not met or when they aren’t understood. There is a 19% decrease in adverse events in English proficient patients compared to LEP patients. 

A medical interpreter who works in California shared one instance, stating, “One patient, who only spoke Henan, could not explain her symptoms because there was no interpreter available.” This can lead to the patient being discouraged from going back to the hospital or a doctor, and feelings of frustration, especially if their symptoms may not be clear or visible. This shows that the national healthcare system in America doesn’t prioritize marginalized groups and immigrants when it comes to accessibility in hospitals, revealing how the language dominance of English continues to produce inequalities today. 

The impacts of English dominance in healthcare are not only seen in the lack of translators but also in the lack of diversity among medical professionals.  According to the American Association of Colleges of Nursing, in the American healthcare system, 80% of nurses and doctors are white, and other groups like black, Latino, and asian make up less than 10% of healthcare workers in the US. This suggests that most of these professionals speak only English as their primary language, and there is a lack of knowledge or consideration of the challenges these minority groups face. This can result in poor communication and implicit bias by the medical professional, which can decrease the quality of care that a non-native English speaker receives, especially when it’s important. In Amy Tan’s “Mother Tongue,” a personal essay, she describes how her mother was ignored by medical professionals when she raised concerns about her test results. She illustrates her mother said, “She said she had spoken in her very good English, her best, no mistakes. …the hospital did not apologize when they said they had lost the CAT scan, and she had come for nothing” (2). This demonstrates how the dominance of the English language has impacted minorities who may not speak the same form in medical settings. It also shows that people in the healthcare field have such a strong preference for standard English that they devalue other forms and find them unimportant. Suppose medical professionals had ignored Tan’s mother. In that case, she may’ve been sent home with increased fear and anxiety about the results and her health, but also discouraged her from going back and fighting for her results. As Dhahima and her peers have mentioned in an article, “Patients without accurate translation services can’t describe their symptoms effectively. And, when they are discharged from the hospital, LEP patients are more likely than English-speaking patients to be readmitted.” The lack of diversity in healthcare settings can also lead to LEP patients getting readmitted and higher healthcare costs, since they have to keep coming in if their issue isn’t resolved. 

Implicit bias is when people have unconscious or preconceived assumptions about someone without knowing them or having any knowledge about them. Many people have experienced this and its consequences, especially immigrants or people with LEP. A study done by JAMA Network found that “169 residents and medical students, participants had less accurate clinical information recall and less positive attitudes toward patients after hearing biased simulated verbal handoffs than after hearing neutral handoffs.” This implies that accented language is considered unimportant and perceived as a negative trait, which leads them to treat these patients more poorly than patients without an accent. It may also show that these clinicians are less caring and empathetic towards these patients and have a higher chance of misdiagnosing or mistreating them. This research can be shown perfectly in Amy Tan’s “Mother Tongue,” where her mother went to retrieve medical results, and the staff refused her and treated her poorly until her daughter came and spoke “better” English than her mother. She states, “And when the doctor finally called her daughter, me, who spoke in perfect English- lo and behold we had assurances that the CAT scan would be found…”(Tan 2). This shows that the clinicians had an implicit bias towards Tan’s mother, because she didn’t speak “perfect” English, and thought that she wasn’t worth their time or effort in retrieving her medical documents.