Most of the time when we talk about minority health disparities , people talk about lack of health care access, cultural barriers, disparities in health insurance coverage, Medicaid coverage, etc. But my Medical Spanish professor brought several examples of even more striking–and simple disparities. We compared some quite simle forms in English and Spanish, and the results were pretty scary.

First we sampled the Stanford Hospital Emergency Room intake form, and found quite a number of cases of poor grammar (literal translations that didn’t make much sense), and a lot of assumptions about people that primarily spoke Spanish–that they didn’t have health insurance, that their jobs or employers were much “simpler.” Bad, but okay, no real health issues there.

More disturbing is a Kaiser Permanente form for “Instructions for Patients With Minor Head Injuries,” typed in English at the top and Spanish at the bottom. Some of the mistakes are pretty frightening. Our class couldn’t believe that Kaiser couldn’t find a *single* fluent bilingual person in all of California that could at possibly translate these correctly. The following are some of the English symptoms of complicating symptoms after a minor head injury, followed by the Spanish (with my rough *but correct* translation in partentheses):

bq(quote).. Severe or persisten headache. Profundo dolor de cabeza. (Deep/profound headache — ignores the “persistent” aspect completely.)
Excessive sleepiness or difficulty in arousing from sleep. Demasiado sueno o dificultad en recordar. (Too much sleepiness or difficulty in remembering – the English version says *nothing* about memory problems.)
… sleep for peiords longer than two hours for the 24 hours following the injury… no duerma mas de 2 horas en un periodo durante 4 horas (No sleeping more than 2 hours in a period of 4 hours – well, that’s pretty damn different, too.)
Unequal pupils. Si las iris estan desparejas. (If the irises are unequal – a poor translation, most people wouldn’t say “desparejas,” and the irises are not the same as the pupils.)
Tylenol (acetaminophen) may be used. Puede usar aspirina. (You can use aspirin – The kicker. Tylenol versus aspirin. How do you mistranslate *that*?)

p. And not to be left out, the English version suggests that if any symptoms appear, the patient should return to the ER immediately *or* call the Emergency Room. In the Spanish version, the patient isn’t given an option of the telephone number.

I’m hoping this isn’t a common practice at Kaiser, and that they just paid some kid to translate these. But I’m surprised that some Spanish-speaking doctor hasn’t raised a concern with the translations.

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