Language-associated disparities in skin biopsy rates

Summary: Abstract Body: Language barriers are a recognized obstacle to equitable healthcare, but their role in skin biopsy access and the effectiveness of current phone interpretation services in dermatology remains unclear. This study the effect of language barriers on skin biopsy utilization and evaluates whether phone interpretation services are effective in mitigating these barriers. This retrospective cohort study of 25629 English-speaking and 5019 non-English-speaking patients at Tufts Dermatology between December 2022 and December 2024 compared biopsy rates between English-speaking and non-English-speaking patients. Pairwise comparisons of biopsy rates among non-English-speaking subgroups, including Cantonese, Mandarin, Spanish, Toishanese, Portuguese, Russian, and Vietnamese patients were also conducted. Statistical analysis was performed using R version 4.4.1. A greater proportion of English-speaking patients (9.99%, 2560/25629) received a skin biopsy, compared to non-English-speaking patients (7.83%, 393/5019 ) (p<0.001), with English-speaking patients 1.31x more likely to receive a skin biopsy (Fisher’s exact test, p<0.001). Among non-English-speaking groups, biopsy rates did not differ (pairwise test of proportions with Holm–Bonferroni correction). There were no disparities in the distribution of languages spoken among those receiving a biopsy for dermatitis, the most common reason for biopsy in this sample (p=1). The higher biopsy rate in English-speaking patients may reflect the increased malignancy risk among White patients, most of whom speak English. Notably, the lack of biopsy rate differences between non-English-speaking subgroups and the representative distribution of languages for dermatitis biopsies suggests equitable care across different language-speaking groups. These encouraging findings highlight the effectiveness of on-demand audio interpreter services and suggest that integrating phone interpreter services could help reduce language barriers, ensuring better access to essential diagnostic care. Allison Bai¹, Courtney Chau², Rachel Granovsky³, Gabriela Cobos¹ 1. Dermatology, Tufts Medical Center, Boston, MA, United States. 2. Icahn School of Medicine at Mount Sinai, New York, NY, United States. 3. Tufts University School of Medicine, Boston, MA, United States. Minoritized Populations and Health Disparities Research