Abstract
INTRODUCTION: In the United States, limited English proficiency (LEP) and provider-patient language discordance are associated with poorer medical outcomes compared with English-proficient, language-concordant patients. Asian American and Pacific Islander (AAPI) populations have higher-than-average rates of LEP and may be more vulnerable to adverse outcomes. The authors of this study examined differences in risk factors, medical care, and delivery outcomes between AAPI individuals who gave birth and spoke English at home versus those who spoke an AAPI language at home. METHODS: De-identified birth and death certificate data from January 1, 2005, to December 31, 2018, were obtained from the Kansas Department of Health and Environment (N = 17,067). Risk factors, medical care, and delivery outcomes were compared between AAPI language speakers and English speakers using likelihood chi-square and Fisher exact tests. RESULTS: Non-English speakers initiated prenatal care later (p <0.0001) and received less adequate prenatal care (p <0.0001). They also had higher rates of forceps- and vacuum-assisted deliveries (p <0.0001), and third- or fourth-degree perineal lacerations (p <0.0001) compared with English speakers. Neonatal outcomes largely were similar between groups. CONCLUSIONS: Within the AAPI community in Kansas, speakers of AAPI languages experienced poorer maternal delivery outcomes, specifically higher rates of assisted deliveries and severe perineal lacerations, compared with English speakers. These disparities may reflect patient-provider language discordance, which can limit patient autonomy and influence decision-making in urgent or emergent situations, as well as broader structural determinants of health.