Policy papers
Improving Infrastructure for Equitable Healthcare Language Access Services in Kansas: A White Paper.
Rachel Showstack, Drew Colcher, Colleen Loo-Gross, Gabriela Flores, Rommy Vargas-Bezzubikoff, Nikki Keene Woods, and Mara Youdelman (in progress).
Language Access in Kansas Healthcare: A Policy Brief for KDHE and Kansas Legislators. Kansas Hispanic and Latino American Affairs Commission
Showstack, R., Kolenz, K., Negrete, A., & Martínez, G. (2021)
Books
Health Disparities and the Applied Linguist ↗
Santos, M., Showstack, R., Martínez, G., Colcher, D., and Magaña, D. (2023).
Abstract
Health Disparities and the Applied Linguist bridges theory and practice to demonstrate how applied linguists are uniquely positioned to make vital contributions towards advancing health equity in the U.S.
As language, power, and health are deeply interconnected, learning to articulate these connections is essential to understanding persistent health disparities in linguistically minoritized communities.
This book offers a nuanced portrait of the complex interactions of social and environmental factors underlying health disparities in the U.S., beginning with a brief introduction to key theories linking language, power, and health, and a historical overview of significant language-related healthcare legislation. Real-life examples from diverse contexts in clinics, classrooms, and communities reinforce the ways in which we can mobilize our knowledge as applied linguists and become engaged in social justice efforts in our communities.
The authors encourage critical conversations about health equity in multilingual contexts and emphasize the urgent need for cross-disciplinary problem-solving and collaborations. The volume is a must-read for students, scholars, and practitioners in applied linguistics and language education, and anybody interested in working at the intersection of language and health.
Journal Articles
Open Science and Accessible Research ↗
Showstack, R. (2024)
Abstract
One of the criticisms often leveled at academics is that the knowledge generated by their work is never disseminated beyond the ivory tower. Such insularity is both unfortunate and unfair considering the fact that much of our work is publicly funded. Further complicating the matter is the incentive structure in place for many if not most academics which rewards publication in outlets that are largely inaccessible to the public due to their technical language and/or to journal paywalls. The OS movement seeks to change this system by making more research available to practitioners and others outside academia who it might benefit. This chapter walks us through these and other issues while outlining paths toward greater accessibility and impact for applied linguistics research.
In Open Science in Applied Linguistics,
Edited by Luke Plonsky. Applied Linguistics Press.
Lifting the voices of Spanish-speaking Kansans: A community-engaged approach to health equity ↗
Showstack, R., Duque, S., Keene Woods, N., López, A., & Chesser, A. (2021)
Abstract
An important component of social justice research is centering the voices of those individuals whose lives the research is intended to improve, not as subjects from whom researchers collect data but as active participants in a process of understanding and addressing issues of concern to the community. This ideal of community engagement slows the pace of dissemination of traditional social science or sociolinguistic scholarship but also allows scholars and community members to collaborate to identify and implement meaningful solutions to community problems. We describe a process of engagement of Spanish-speaking patients, interpreters, and healthcare providers in developing a health equity agenda for Spanish speakers in Kansas, grounded in a community-based participatory approach called Patient-Centered Outcomes Research. Stakeholders were engaged through sharing and amplifying their testimonios, stories that tied personal experiences of encountering language barriers in healthcare with calls to action, and they contributed to decisions about what to do with the stories and how to respond to the problems they identified. The result of our engagement process is the formation of a community-based team that has amplified the voices of Spanish-speaking patients and families to reach a range of audiences and responded to a number of evolving community needs. We provide recommendations for language researchers interested in pursuing community-engaged work and explore the possibilities for aligning such work with the expectations of academic institutions.
Language as a Social Determinant of Health: Partnerships for Health Equity ↗
Emily M. Feuerherm, Rachel Showstack, Maricel G. Santos Glenn A. Martínez. (2021)
Abstract
Despite the commitment of applied linguistics research to investigate language use in real-world contexts, applied linguists have struggled to make their work accessible and relevant outside academia. Acknowledging that the field has not yet reached its full potential, this book demonstrates how applied linguists can utilize their knowledge and methods to explore contemporary social problems beyond the borders of their own discipline, to have a valuable impact on other fields, local communities and the general public. Drawing on theories, methods and methodologies in applied linguistics, chapters address pressing concerns such as equal access to education for immigrants, science education in preschool dual-language contexts, healthcare delivery to refugee families, gendered language in disability studies and social sustainability initiatives. The diversity of research contexts shows how the work of applied linguists can have tangible social impact and help to influence meaningful change. By increasing public awareness of language-related issues affecting society, this book responds to a vital gap in the field and marks and important step towards a more socially-engaged, accessible and inclusive approach to applied linguistics.
Pursuing Testimonial Justice: Language Access through Patient-Centered Outcomes Research with Spanish Speakers ↗
Martínez, G., Showstack, R., Magaña, D., Hardin, K., and Dejbord-Sawan, P. (2021).
Abstract
Patient-Centered Outcomes Research (PCOR), rooted in the more established tradition of Community-Based Participatory Research (Deeb-Sossa 2019), seeks to empower patients in determining the most appropriate healthcare options by including and amplifying their voices in every aspect of the research process. In this article, we report on the outcomes of a four-year PCOR engagement effort in the US Midwest that aimed to include and amplify patient voices in language in healthcare policy. Our findings revealed feelings of patient disempowerment, discomfort with the social distance created by remote interpreting, and a mismatch of knowledge and expectations among interlocutors in medical interactions. Our discussions also underscored women’s work in addressing healthcare issues within the family and their resilience in describing systemic inequities in health communication. We argue that participation in PCOR empowers patients through the enactment of testimonial justice. We conclude by discussing implications and recommendations for language researchers who are interested in working toward social justice in language in healthcare policy in USA and building a multi-stakeholder platform for PCOR.
Interprofessional Education for Students of Translation/Interpreting and the Health Professions. ↗
Showstack, R., Nicks, S., Keene Woods, N., and Martínez, G. (2021).
Abstract
Patient-Centered Outcomes Research (PCOR), rooted in the more established tradition of Community-Based Participatory Research (Deeb-Sossa 2019), seeks to empower patients in determining the most appropriate healthcare options by including and amplifying their voices in every aspect of the research process. In this article, we report on the outcomes of a four-year PCOR engagement effort in the US Midwest that aimed to include and amplify patient voices in language in healthcare policy. Our findings revealed feelings of patient disempowerment, discomfort with the social distance created by remote interpreting, and a mismatch of knowledge and expectations among interlocutors in medical interactions. Our discussions also underscored women’s work in addressing healthcare issues within the family and their resilience in describing systemic inequities in health communication. We argue that participation in PCOR empowers patients through the enactment of testimonial justice. We conclude by discussing implications and recommendations for language researchers who are interested in working toward social justice in language in healthcare policy in USA and building a multi-stakeholder platform for PCOR.
Making Sense of the Interpreter Role in a Healthcare Service-Learning Program. ↗
Showstack, R. (2021).
Abstract
This study examines the interpreter role among students who serve as interpreters in a community health clinic system in the Midwestern USA as part of a community health-themed service-learning course for advanced Spanish students. Drawing on Positioning Theory (Davies and Harré 1990), I consider the ways in which three second language learners and three heritage speakers who participated in the program describe their roles as interpreters with reference to the Code of Ethics, negotiate their roles with the medical students and doctors also serving at the clinic, and make sense of moments in which they chose to advocate for the patients, or otherwise provide assistance to them, beyond interpreting. Each student encountered different types of challenges that reflected their individual backgrounds and experiences, and these challenges led to reflection, learning, and new perspectives on their roles in providing patient care. The article problematizes the role of bilingual student interpreters in community health programs and offers recommendations for preparing students to provide the highest possible quality of healthcare for speakers of minoritized languages.
Improving Latino Health Equity Through Spanish Language Interpreter Advocacy in Kansas ↗
Rachel E. Showstack, Kelly Guzman, Amy K Chesser, Nikki Keene Woods. (2018)
Abstract
Introduction: Federal law requires any agency receiving federal aid to take “reasonable steps” to provide meaningful access to qualified limited English proficient (LEP) individuals. However, policies for the provision of language access services, including medical interpretation, vary substantially by state. The Latino population and the number of LEP individuals in the U.S. state of Kansas have grown substantially over the past 20 years, necessitating increased attention to the state’s language access policies.
Method: Though a review of previous research, we present health disparities affecting Latinos in Kansas, examine the state’s language access policies for health care, and argue that health disparities could be reduced through improved language access.
Findings: While Kansas reimburses health care entities for interpreter services associated with Medicaid, the state has no health care interpreter competency requirements. As a result, LEP persons, primarily Spanish speakers, may be left to navigate through complex hospital systems with inadequate guidance in their language and may be at an increased risk for medical errors due to language barriers.
Conclusion: We suggest changes that could be implemented to improve access and reduce health disparities affecting Latinos in Kansas and across the United States, and we describe work that is currently underway to support these changes.
Keywords: Latino health; health care language policy; health equity; health literacy; interpreters; language access.
Addressing the Big Picture as a Community-Engaged Linguist: Community-Engaged Scholarship and Applied Learning for Systemic Change
Showstack, R. (forthcoming)