Connecting Language Access Rights and Reproductive Health Care: Section 1557 Anti-discrimination Complaint Urges Action

More than 25 million people living in the United States—over 8% of the population—have limited English proficiency (LEP), meaning that they do not speak English “very well” (including some who may speak English well, but when navigating a traumatic situation, may struggle to find or understand words in English). In health care, language barriers put patients at risk by posing challenges to accessing care and communicating with providers, often leading to delayed care, medical errors, and difficulty understanding and following provider directions. Additionally, individuals with LEP disproportionately experience gaps in health insurance coverage, as they may not receive information in their preferred language that explains how to apply for and enroll in health insurance plans and programs.

These factors, combined with other compounding barriers such as explicit and implicit biases and the lack of culturally competent services, cause disparate health outcomes for individuals with LEP: Patients with LEP are more likely to experience medical errors, events that could or did result in harm, increased hospital length of stay, readmission, and dissatisfaction with care. These barriers can overlap with other disadvantageous social determinants of health, which exacerbate racial and ethnic disparities in health care.

Despite well-documented findings that the use of professional and qualified interpreters improves clinical outcomes, communication, utilization, and patient satisfaction, many health care providers and entities fail to provide language access services. A national study found that “fewer than one-third of outpatient physicians reported regularly using a trained professional interpreter when communicating with patients with LEP [and] 40% never used professional interpreters.” About one-fourth of U.S. hospitals that serve populations with high or moderate need do not offer language services at all. This failure worsens health disparities for patients with LEP and violates federal law.

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