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Understanding Health Disparities Among Limited-English Speakers

Graphic with text: Understanding Health Disparities Among Limited-English Speakers.

Millions of Americans struggle to speak, read, and write English, hindering their ability to obtain even basic healthcare. With over 70% of sentinel events caused by communication failures, action is needed to ensure the safety of all patients, no matter what language they speak.

Language barriers result in fewer visits to the doctor and delays in preventative care and services; it can also lead to new or worsening chronic health conditions, as well as hospitalization that might have been prevented with better care. And as the use of virtual care trends upward, what was already a significant problem has become even more challenging.

The first step toward improving language access and decreasing health disparities for this vulnerable segment of the population is to understand the issue from a holistic viewpoint. From there, we can begin the necessary work of filling in the gaps. 

Limited-English Proficiency by the Numbers

An estimated 67.8 million people — born both inside and outside the U.S. — speak a language other than English at home. While millions of these people also speak proficient English, there is a significant portion that does not. The limited-English proficient (LEP) population in the United States has grown rapidly in recent years, increasing over 80% between 1990 and 2013 from 14 million to over 25 million.

Limited-English proficient individuals:

  • Represent more than 8% of the total U.S. population ages 5 and up
  • Account for as much as 19% of the population in California, 14% in Texas, and 13% in Hawaii and New York
  • Include approximately 50% of all immigrants who arrive in the U.S
  • Speak more than 350 different languages
  • Are almost 2x as likely as English-proficient individuals to have an annual income below the poverty line, with one in four living in poverty

Links to Health Disparities and Vulnerabilities

For millions of people, even the simple act of going into a clinic can be challenging. They don't know if someone will speak their language and understand what they are saying, or if they will be able to understand the doctor. While healthcare facilities are required by the Department of Health and Human Services to provide language access, not all of them comply. In 2016, Reuters reported that as many as one in four hospitals in the U.S. — even in areas with a large LEP population — did not offer appropriate language services.

LEP patients who seek care are more likely to be hospitalized longer, be misdiagnosed, or experience medical errors. Without qualified medical interpreters, many people rely on friends, family members, or bilingual children to interpret, but someone without the right medical experience and education can easily miss subtle nuances in language or important medical distinctions that lead to misunderstandings. Hospitals and clinics that rely on untrained staff to interpret are more likely to make significant mistakes in care. 

Closing the Gap

Health systems can improve language access to patients by offering medically qualified interpreters who speak the patient's language fluently and are available at any time. Before signing up for a language service, it's best to take the time to create a comprehensive Language Access Plan. With that plan in place, you can identify what services are most beneficial to your patients and when. Services should be offered in multiple modalities:

  • Telephone Interpreting for situations such as medical appointment scheduling, check-in, billing, or in an emergency when a video or in-person translator is not on site.
  • Video Remote Interpreting for care in geographically remote areas, as well as urgent medical situations or public health emergencies when an in-person translation isn't possible.
  • Multilingual Support for Telehealth to equip virtual appointments with the technology necessary to support interpreting.
  • On-site Interpreting when it is important to have someone there in person. For example, when working with children or cognitively impaired patients.
  • Document Translation for written materials, such as medication instructions, discharge instructions, and/or patient education materials. 

Expanding Access for Your LEP Patients

People with limited-English proficiency face significant health disparities and barriers to accessing healthcare. Eliminating those barriers requires healthcare administrators and providers to make language services a high priority and take a patient-centered approach to ensure that all services are available in all the languages their patients speak. 

Want to learn more?

Discover how GLOBO can help your health system improve health equity and reduce disparities with better language support for your limited-English speaking patients.


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