Increasing veterinary access by mitigating language barriers

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Various social and cultural factors can impact the use of veterinary care among different groups of pet owners. Communication is key, and practices may need improved strategies to overcome language barriers with existing and potential clients.

Prevalence of Spanish speakers

After English, Spanish is the most common language spoken in the United States. In 2011, 38.3 million Spanish speakers comprised more than 63% of non-English speakers, more than 5 times greater than any other non-English language.^1,2 An estimated 16.1 million US Spanish speakers over 5 years of age speak English less than very well, and among all US adults with poor English proficiency, 63% speak Spanish.^1,2

Latino individuals currently comprise 18.5% of the US population and are projected to increase to 31% by 2060.^1-3 The United States had the second-largest Latino population in the world, after Mexico, in 2010.^1,2 Hispanic individuals are the largest and fastest-growing minority group in the United States, and Latino individuals are the largest minority group in 21 US states.^1-4

An estimated 36% to 38% of US Latino individuals own a pet, and within this group, 6 million are Spanish speakers who speak English less than very well.^1,2 About 43% of Hispanic individuals are monolingual Spanish speakers. Of farm workers, 29% said they could not speak English “at all,” and 39% said they could speak “somewhat/a little bit” of English.³

Veterinary professionals in minority groups

In 2000, 2251 doctorate degrees in veterinary medicine were granted in the United States.⁵ Of these, 2064 were awarded to White non-Hispanic individuals, 49 to Black individuals, 74 to Hispanic individuals, 14 to Native American individuals, 38 to Asian American individuals, and 12 to nonresidents.⁵ In 2001, only 2% of students graduating from veterinary school were Black, and only 3% were Latino.⁵

Until 2016, only 5% of US small animal veterinarians self-identified as Latino or Hispanic, and fewer than 20% of veterinary students nationally described themselves as able to provide medical information to a client in Spanish.^1,6 In 2018, 86% of veterinarians in the United States were White and non‐Hispanic.⁷

Overall, this low percentage of minority representation in the veterinary field may hinder ethnic groups from obtaining veterinary services if they only seek veterinarians who share their culture. Understanding and addressing the needs of potential clients should be the ongoing priority in initiating new strategies to develop a broader‐based inclusive environment. The veterinary profession may benefit from fostering an environment that actively addresses these considerations, creating a more comprehensive and accessible approach to pet care.⁷

Language studies

In 1 study, dog and cat owners with limited English proficiency were not significantly different from owners with English proficiency regarding their satisfaction with the communication and care at veterinary practices. However, pet owners with limited English-language proficiency were substantially more likely to notice the presence of Spanish-speaking veterinarians and staff members and to want written information in Spanish than owners with English proficiency.¹

In the study, the most common responses from pet owners when faced with a lack of Spanish-speaking veterinarians at an animal hospital were that they would call a friend or relative to help translate (29.1%); communicate with body language, gestures, or drawing (16.5%); or go somewhere else where staff members spoke Spanish (12.0%). Significantly more dog owners with poor English proficiency said they would sign a consent form even if they did not understand it, ask for telephone interpreter services or an on-site interpreter, or go elsewhere than owners with English proficiency.¹

More practices in states with large established Latino populations were likely to have Spanish-speaking staff to help in an emergency than those in states with fastgrowing Latino populations. Significantly more veterinarians from states with large established Latino populations were very satisfied or extremely satisfied with their communication with Spanish-speaking clients with poor English proficiency than were veterinarians from states with fastgrowing Latino populations.²

Plausible solutions

Access to veterinary care for Spanishspeaking pet owners and caretakers, as well as other non-English speakers in the US, can be improved. Human medicine and veterinary medicine reports have numerous suggestions and actions about increasing access to care as it relates to language barriers and minority pet ownership, as follows:

• Veterinary staff can ask their clients which language they prefer to receive their pet’s health information in.¹
• Bilingual veterinarians and veterinarians with an appreciation for Latino culture will greatly help the Latino clientele.1 Data have shown that across all participating practices, the median number of Spanish-speaking personnel per practice for every position was 0.2 Further, among practices in 1 study, 89% had Spanish-speaking clients with poor English proficiency, and 52% received such clients weekly.² Eight percent of practices had veterinary personnel who were conversant or fluent in spoken Spanish. Of note, 4% of veterinarians described themselves as Latino, and 3% spoke Spanish as their first language. Among practices, 17% of veterinarians described themselves as conversant or fluent in Spanish or a native Spanish speaker. Fifteen percent of Caucasian and 31% of non-Caucasian veterinarians reported that they could converse in Spanish with their clients with poor English proficiency.²
• Trained interpreters can be used, especially for medical translation, and this is considered the gold standard in human medicine.^1,6 Additionally, using a toll-free telephone service to provide a trained medical interpreter (pay-as-you-go telephone interpreters) is a cost-effective means of adding professional interpretation to the veterinary clinic.⁶
• The promotion of Spanishspeaking training for veterinary professionals who don’t speak the language can include peer-assisted learning; veterinary schools introducing medical Spanish into the doctorate of veterinary medicine (DVM) core curriculum; a “needs analysis” or “languages for specific purposes” (for language teaching and syllabus design, whereby a systematic process of inquiry about the language needs of learners takes place before the program is designed); “Spanish for specific purposes” or a “Spanish for veterinarians language program” courses; and online Spanish-language courses, Spanish-English dictionaries, and Spanish phrase books.^1-3,6,8 More than three-fourths of all respondents in a study of small animal veterinary practices agreed or strongly agreed that such a course should be offered as an elective in the registered veterinary technician and DVM curricula.²
• The following commonly used items in veterinary practice should be available in Spanish: consent forms, discharge instructions, pill cards, client-education materials, industry-generated educational and product brochures, and practice-generated handouts.^1,2 In 1 study, findings showed that 42% of respondents wanted written Spanish information despite being proficient in English.¹ Industry- and practice-generated Spanish-language materials were offered at 32% and 21% (81/383) of practices, respectively.²
• Spanish text can be pasted into translation software or apps on a smartphone, tablet, or computer, then played back (in Spanish) for the client to relay information before they sign any forms.^1,6
• Various agricultural agencies and land grant universities have developed culturally sensitive education, translation, and training tools.³
• Leveraging ad hoc interpreters (untrained individuals such as a family member or a bilingual staff member who can provide interpretation) is perhaps the most common method that veterinary clinics use. However, such individuals could inaccurately interpret the conversation or cause bias. In human medicine, federal law requires hospitals to ensure the competence of individuals who provide interpretation.⁶ Among practices, 61% of all veterinarians would ask a client’s friend or family member to translate if confronted with an emergency in which a new Spanish-speaking client with poor English proficiency arrived with a sick dog. Veterinarians who depended on clients’ friends or family to translate were significantly less satisfied with client communication than those who could converse in Spanish with clients directly. With regard to Spanish-speaking pet owners, 44% of owner veterinarians and 61% of associate veterinarians indicated that they believed the quality of care had been compromised because of a language gap. Practices with the highest probability of a veterinarian believing that they communicated satisfactorily with Spanish-speaking pet owners with poor English proficiency were those in which the veterinarian was at least conversant in Spanish, at least 1 Spanish-speaking registered veterinary technician was on staff, clients’ friends and family were not relied upon to translate, and gesturing or drawing was not relied upon to communicate.²
• Telehealth platforms that provide monolingual and bilingual Spanish speaking veterinarians for any species offer a powerful means of increasing access and the spectrum of care for underserved communities. Additional languages, including French and Arabic, are also available on the market.

Acknowledging and addressing language barriers, socioeconomic status, and cultural beliefs is vital for accessing veterinary services and influences pet ownership. The veterinary profession can enhance inclusiveness and diversity by expanding and enriching its veterinarian teams to reflect their communities’ age group, race, and ethnicity trends.

References

1. Landau RE, Beck A, Glickman LT, Litster A, Widmar NJ, Moore GE. Preparedness of small animal veterinary practices to communicate with Spanish-speaking pet owners with limited proficiency in English. J Am Vet Med Assoc. 2016;248(6):690-699. doi:10.2460/javma.248.6.690
2. Landau RE, Beck A, Glickman LT, Litster A, Widmar NJ, Moore GE. Use of veterinary services by Latino dog and cat owners with various degrees of English-language proficiency. J Am Vet Med Assoc. 2016;248(6):681-689. doi:10.2460/javma.248.6.681
3. Aguiriano AJM, Salazar L, Pietrosemoli S, Schmidt M, Awosile B, Garcia A. Understanding communication barriers: demographic variables and language needs in the interaction between English-speaking animal professionals and Spanish-speaking animal caretakers. Animals (Basel). 2024;14(4):624. doi:10.3390/ani14040624
4. Treviño FM. The representation of Hispanics in the health professions. J Allied Health. 1994;23(2):65-77.
5. Asare A. The attitudes of minority junior high and high school students toward veterinary medicine. J Vet Med Educ. 2007;34(2):47-50. doi:10.3138/jvme.34.2.47
6. Tayce JD, Burnham S, Mays G, et al. Developing cultural competence through the introduction of medical Spanish into the veterinary curriculum. J Vet Med Educ. 2016;43(4):390-397. doi:10.3138/jvme.0915-148R
7. Zhang X, House L, Salois MJ. An examination of US pet owners’ use of veterinary services, 2006–2018. Vet Med Sci. 2024;10(3):e1370. doi:10.1002/vms3.1370
8. Poss JE, Bader JO. Attitudes toward companion animals among Hispanic residents of a Texas border community. J Appl Anim Welf Sci. 2007;10(3):243-253. doi:10.1080/10888700701353717