A Role for Health Literacy in Protecting People With Limited English Proficiency Against Falling: A Retrospective, Cohort Study

Objective: To identify risk factors related to falls within the scope of speech-language pathology (SLP) using assessments from the Inpatient Rehabilitation Facility-Patient Assessment Instrument over a 4-month period in 4 inpatient rehabilitation facilities (IRFs).

Design: Observational retrospective cohort study.

Setting: Four IRFs as part of a larger learning health system.

Participants: Adults aged ≥18 years admitted to the IRFs from October 1, 2022 to February 28, 2023 were included.

Intervention: N/A.

Main outcome measures: Occurrence of falls.

Results: Analyses of 631 patient records revealed that the odds of falling were almost 3 times greater in people with limited English proficiency than in English speakers (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.09-6.85). People with limited English proficiency who reported poorer health literacy had 4 times higher odds of falling (OR, 3.90; 95% CI, 1.13-13.44) than English speakers who reported adequate health literacy. People with limited English proficiency who reported adequate health literacy had the same risk of falling as English speakers (OR, 0.98; 95% CI, 0.16-6.12), suggesting the protective role of health literacy for people with limited English proficiency.

Conclusions: Language barriers have a significant effect on falls among patients in IRFs. SLPs improving health literacy and providing language support may play a crucial role in mitigating fall risk, thereby enhancing patient safety and outcomes.