Working Toward Equitable Language Access | National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM)

For many refugee, immigrant, and migrant (RIM) community members, navigating the complex U.S. healthcare system is challenging, even in normal times. During the COVID-19 pandemic, existing inequities in health and access to health care have been compounded by inadequate or insufficient COVID-19 information in languages other than English. To keep RIM communities safe, it is vitally important to convey information about COVID-19 and COVID-19 vaccines that is not only timely, accurate and accessible, but also culturally and linguistically relevant.

Language Access: More Than Just Translation

One key to improving vaccination rates is understanding and responding to the specific linguistic and cultural needs of RIM communities. Organizations preparing to communicate with RIM communities about COVID-19 and COVID-19 vaccines should consider these aspects of their message:

	*Ask yourself...*	*Keep in mind...*
Language	What language(s) will your organization use to communicate with your audience?	What is (or are) the language(s) of your audience?
Content	What will be the content of your message? How will the content be arranged? If you have visual content, will the images of people look like members of your audience?	What are your audience’s health beliefs, practices, and values? What is your audience most interested in learning about COVID-19 and COVID-19 vaccines?
Media	What media channel(s) will your organization choose? Will you publish your message via flyers, posters, letters, emails, written social media posts, radio, television, video social media posts, or some other medium? Does it make sense to deliver your message in person?	What media channels does your audience use and trust? Can most of your audience read in the language they communicate in for health care, or would they rather receive messages through spoken language (audio, video, or in person)?
Messenger	What person or entity will transmit the message? Who else will be associated with your message?	Does your audience prefer to receive health-related messages from healthcare professionals, government officials, religious or community leaders, or perhaps someone like a family member, friend, or neighbor? Who is regarded as a trusted messenger?

The language of an organization’s message is certainly important: it is crucial to have messages properly translated and interpreted. But the content, media, and messenger also matter. For example, the content of a message about a state’s COVID-19 vaccine rollout might look different for a RIM community that has a general concern about the safety of the vaccine, as opposed to another RIM community that mainly needs practical information about how to get vaccine appointments. Similarly, a message about COVID-19 symptoms for an audience of RIM elders who don’t read in the language(s) they speak might use different media channels than a message about symptoms intended for RIM youth who get much of their information online. Finally, a message about COVID-19 safety guidelines for a RIM community that has historically distrusted government organizations might employ a different messenger than a message for a RIM community that has developed a positive relationship with local officials.

Advocating for Language Equity in Alameda County, California

Korean Community Center of the East Bay (KCCEB), a community organization in San Leandro, California, is involved in both direct services and advocacy collaboratives to improve the lives of RIM community members. Founded in 1977, KCCEB is currently part of the Alameda County Refugee Immigrant COVID Engagement (AlCo RICE) Collaborative. AlCo RICE consists of KCCEB and six other immigrant and refugee community organizations that partner with the Alameda County Public Health Department. Together, this collaborative represents and advocates for 16 linguistic communities: Amharic, Arabic, Burmese, Cantonese, English, Farsi, Khmer, Korean, Mam, Mandarin, Nepali, Spanish, Tagalog, Tibetan, Tigrinya, and Vietnamese. By thinking about RIM communities across racial and ethnic groups, KCCEB and its partners have recognized the commonalities and similar challenges faced by RIM communities, especially as they relate to linguistic and cultural barriers to healthcare.

Working as a collaborative has proven especially beneficial for smaller RIM communities who have less access to culturally and linguistically responsive resources and services. Pooling the organizations’ resources for data collection and analysis has been also helpful for smaller organizations as well as direct service providers, who do not usually have funding for these activities.

Together, members of the AlCo RICE collaborative have collected 559 surveys to learn about local RIM communities’ practices, preferences, and needs, and have responded by matching their communications to each audience. KCCEB’s surveys have enabled them to:

Listen to the concerns and motivations that different RIM communities have about the COVID-19 vaccine and adapt the content of their messaging accordingly.
Learn more about the range of media that local RIM communities use and choose their communication channels appropriately.
Understand who the trusted figures are in each RIM community and select suitable messengers for communications about COVID-19 and COVID-19 vaccines.

KCCEB leadership’s advice to other organizations carrying out similar work has three steps:

First, learn about your local community’s language access needs by conducting a needs assessment survey, utilizing community health workers as survey ambassadors.
Second, conduct a landscape analysis of how your local public health department is responding to language equity needs, including: (a) reviewing your health department’s website and published materials to learn which languages they prioritize for translation and interpretation; b) understanding your health department’s structure and learning which division supports RIM communities’ concerns; and c) reviewing your health department’s strategic plan, including their emergency response plans for public health emergencies.
Third, build connections with the local public health department early and often to understand what they are working toward in language equity, what they need support with, and how you can share community perspectives.