The document discusses challenges deaf and hard of hearing individuals face in accessing health care. It notes that deaf individuals often have difficulty communicating with providers due to lack of interpreters and reliance on notes or lip reading. This can lead to problems receiving diagnoses or explanations of health issues. A literature review found deaf people feel excluded from standard health resources and information. The research team conducted a survey that found most deaf respondents had trouble communicating with providers and did not have regular interpreter access. Many also experienced misdiagnoses or other health issues as a result of communication barriers.

1. Health Care and the Challenges of Access for Deaf Persons in Erie County
Jenna Brick, Brittany Brown, Kennedy Lewandowski, and Amy Trabert
Social Work
The ability to access appropriate health care services is vitally important to the
physical and mental well-being of individuals (Sheppard, 2013). For the deaf
community, however, access to these critical services can be difficult. Deaf
individuals may lack opportunities to receive training to support a general
understanding of important health issues.
They often face challenges when communicating with health care providers due,
in part, to the lack of interpreters available in health care settings; heavy reliance
on written materials to facilitate understanding; and miscommunication related to
the technical nature of health information. Finally, those with particular needs
may be unable to secure specialized care because of challenges associated with
appropriate diagnosis.
Using survey data, the study team examined the unique health challenges among
local deaf individuals and discovered the barriers to health care assistance.
Recommendations for improvement are discussed as well.
Heiman, E., Haynes, S., & McKee, M. (2015). Research Paper: Sexual health
behaviors of Deaf American Sign Language (ASL) users. Disability And Health
Journal, 8579-585.
Heuttel, K., & Rothstein, W. (2001). HIV/AIDS knowledge and information sources
among deaf and hearing college students. American Annals Of The Deaf, 146(3),
280-286.
Jackson, M. (2011). Deafness and antenatal care: Understanding issues with access.
British Journal Of Midwifery, 19(5), 280-284.
Morere, D., Dean, P.M., & Mompremier, L. (2009). Mental health assessment of
deaf clients: Issues with interpreter use and assessment of person with diminished
capacity and psychiatric populations. Journal of the American Deafness &
Rehabilitation Association, 241-258.
O'Hearn, A. (2006). Deaf women's experiences and satisfaction with prenatal care: a
comparative study. Family Medicine, 38(10), 712-716.
Pereira, P., & Fortes, P. (2010). Communication and information barriers to health
assistance for deaf patients. American Annals Of The Deaf, 155(1), 31-37.
Sheppard, Kate. (2014). Deaf adults and health care: Giving voice to their stories.
Journal of the American Association of Nurse Practitioners, 26(9), 504-510.
doi:10.1002/2327-6924.12087
This research is based on preliminary findings with data still being collected.
Overall, there are barriers to accessing health care for deaf and hard of hearing
individuals mainly due to difficulty communicating with health care professionals.
The research team recommends that professionals in the health care setting receive
cultural competency and continuing education training on the deaf and hard of
hearing population. This training will help prevent problems with setting up
appointments, discussing symptoms, and encouraging health care providers to stop
relying on note taking and lip reading to share information. Ensuring access to
American Sign Language training for helping professionals is also imperative.
A review of the scholarly literature suggests that deaf and hard of hearing individuals often feel excluded
from resources that are generally available to hearing individuals in the larger society. This is
particularly true as it relates to health-related information, education, and services (Jackson, 2011).
Information about physical, mental, reproductive, and other health-related conditions is not always
readily accessible to deaf and hard of hearing individuals (Heuttel & Rothstein, 2001). In many cases,
information is distributed in paper form only and without the benefit of American Sign Language videos.
Similarly, health education is often difficult for deaf and hard of hearing individuals to secure because of
the lack of readily available interpretation assistance and limited offerings within the deaf community.
As a result, deaf and hard of hearing individuals may be unaware of the potential repercussions of certain
actions and/or may engage in behaviors that could put their health in jeopardy (Heiman, Haynes &
McKee, 2015).
Many deaf and hard of hearing individuals also face challenges when attempting to access health care
services. A common example is a deaf or hard of hearing individuals who has difficulty communicating
with office staff and may not hear his or her name when it is called for an appointment. This situation
can cause the individual to receive care well after their scheduled appointment, to miss their appointment
entirely, and/or to experience frustration (O’Hearn, 2006).
In addition to challenges communicating with office staff, deaf and hearing impaired individuals may
not be able to access professional interpreters during their appointment (Morere, Dean, Mompremier,
2009). Thus, many deaf or hard of hearing impaired individuals must rely on other methods to
communicate with health care professionals.
In some cases, deaf and hard of hearing individuals may be asked to have a family member or friend
assist with interpretation during the appointment. Many deaf or hard of hearing individuals
understandably are uncomfortable with fully disclosing their medical situation to friends or family
(Sheppard, 2014).
In the absence of an interpreter, a health care professional may attempt to communicate with a deaf or
hearing impaired individual via lip reading. This is highly problematic given the skill needed to be a
successful lip reader as well as the frequent use of medical terminology in the health care environment
(Pereira & Fortes, 2010). Similarly, health care professionals may resort to note writing – which is also
problematic given the use of jargon and the fact that note writing can also be very time consuming and
inaccurate.
Unfortunately, health care professionals may not have the time and/or patience to properly communicate
with deaf and hard of hearing individuals, leading to a lack of rapport, comfort, and trust between the
health care professional and their patient (Jackson, 2011). Challenges with communication can also
make it difficult for patients to fully disclose the nature and severity of their symptoms and could cause
them to be undiagnosed, underdiagnosed, or even misdiagnosed (Jackson, 2011; Morere, Dean &
Mompremier, 2009; O’Hearn, 2006).
ABSTRACT
LITERATURE REVIEW
METHODOLOGY
RESULTS
CONCLUSIONS
REFERENCES
HYPOTHESES
H1: Deaf and hard of hearing individuals experience difficulties communicating with health care
professionals about their health related to their deafness.
H2: Deaf and hard of hearing individuals do not secure regular access to an interpreter when
communicating with health care professionals about their health.
H3: Deaf and hard of hearing individuals experience health-related problems (including misdiagnosis,
being undiagnosed, or improperly diagnosed) because of difficulties communicating with their doctor.
H4: Deaf and hard of hearing individuals are not satisfied with their ability to easily access health-related
information and services.
DATA COLLECTION
The research team prepared a paper/web-based survey for use in data collection activities. Deaf and Hard
of Hearing individuals participating in meetings at Deaf Access Services (DAS) and the Buffalo Club of
the Deaf (BCD) (including sessions held in Niagara Falls and Jamestown, as well as the DAS employment
and BCD senior citizen groups) were asked to complete the survey with the help of an interpreter or
individually (availability or convenience sampling). In addition, individuals participating in the in-person
data collection were asked to provide information about the survey to friends, family members, and
acquaintances in order to increase the number of responses (snowball sampling). Each participant was
given the opportunity to be included in a raffle for one of five $25 gift cards as an incentive.
MEASUREMENT
To address each of the research team’s hypotheses, the following variables were included as part of data
collection:
Difficulties Communicating with Health Care Professionals: The survey included questions about
challenges respondents faced when communicating with health care professionals including difficulties
communicating with office staff, doctors, or nurses; reliance on notes or lip reading to share information;
lack of interpretation assistance; lack of explanation about health concerns; lack of relationship with health
care professionals; and misunderstanding about what is being communicated.
Professional Interpretation Assistance: Respondents were asked if they had regular access to an
interpreter when communicating with their doctor about their health.
Health-Related Problems: Respondents were asked if they ever experienced a health-related problem
(e.g., misdiagnosis, being undiagnosed, or improperly treated) because of difficulties communicating with a
health care professional.
Health-Related Information and Services: Respondents were asked if they were satisfied with their
ability to easily access health-related information and services related to their deafness/hearing impairment,
physical, mental, reproductive, sexual, and other health.
ETHICS AND DIVERSITY CONSIDERATION
Prior to the study, the research team received cultural competency training to ensure that members were
properly trained to work with deaf and hard of hearing individuals. The survey included information about
voluntary participation in the study including a clause stating that participants could refuse to answer any
question they were uncomfortable with or withdraw from the study at any time without fear of losing
access to resources. Privacy was ensured by asking questions specifically relevant to the study.
%
Difficulties Communicating With Office Staff 41.7%
Difficulties Communicating With Doctor or Nurse 50.0%
Reliance on Notes to Share Information 50.0%
Reliance on Lip Reading to Share Information 50.0%
Reliance on Printed Material to Share Information 41.7%
Lack of Interpretation Assistance 41.7%
Lack of Explanation About Health Concerns 25.0%
Lack of Relationships With Health Care Professional 16.7%
Misunderstanding About What Is Being Communicated 0.0%
Seventy five percent of deaf and hard of hearing individuals participating in the
study (n=18) indicated they had difficulty communicating with health care
professionals about their health. The nature of difficulties is described below.
More than fifty percent of survey respondents indicated they do not have regular
access to an interpreter when seeing their doctor. Fifty percent of deaf and hard of
hearing individual participating in the study experienced health related problems
including being misdiagnosed, underdiagnosed or receiving improper treatment
because of difficulties communicating with their doctor. Despite this, deaf and
hard of hearing individuals indicated they are somewhat satisfied with access to
health information and services.