Motor vehicle accidents and head injuries is an important and complex subject. There is data that Hispanics are more likely to be involved in fatal automobile accidents than whites. The cause of such a disparity is multi-factorial and beyond the scope of this blog.
Needless to say, one can easily draw the conclusion that a disproportionate percentage of Hispanics suffer head injuries from auto accidents. What happens to this population? Data has demonstrated they are more likely to decline transportation to emergency room and thus go undiagnosed.
If Hispanic head injury victims get to the emergency room, language barriers begin to have a significant effect. In most large urban areas like Los Angeles, where I practice, there are bilingual staff and some doctors are bilingual.
But making a diagnosis of a concussion is a lot tougher than making a diagnosis of a broken arm in a non-English speaking patient. The Spanish fluency of many doctors is limited and very concrete. The subtleties in making mental and neurological evaluations is more language dependent. Yes, the doctor can order the CT scan of the brain, but I have discussed in previous blogs how CT scans are highly insensitive to concussion and traumatic brain injury (TBI).
The reality is this patient population is particularly vulnerable to under-diagnosis. I frequently see many Spanish-speaking head injury patients in my practice who have never been questioned about vision, cognition, or memory. I’m the first to admit my Spanish is not great- my practice is in Mission Hills, CA, surrounded by a large Hispanic population. My entire staff is bilingual. I recognize that I must use a translator to ask abstract questions about visual and mental function. This is time-consuming but necessary to uncover the extent of TBI impairment. It is not simply asking about headaches, this only skims the surface.
Concussions/TBI and vision disturbance are tied together. I’ve made this point in many of my blogs. But the knot is even more difficult to unravel in our large Hispanic population. I have built a practice that includes ALL head injury victims and includes the Spanish-speaking population. Head injury knows no ethnic boundaries.
