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Rethinking the Term "Limited English Proficiency" to Improve Language-Appropriate Healthcare for All.

Pilar Ortega1, Tiffany M Shin2, Glenn A Martínez3

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Summary

The term limited English proficiency (LEP) is problematic in healthcare. Rethinking patient language as "non-English language preference" and assessing provider skills can improve care for multilingual populations.

Keywords:
Healthcare communicationLanguage assistanceLanguage barriersLanguage concordanceLimited English proficiencyMedical interpretersPatient-centered communication

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Area of Science:

  • Health Services Research
  • Linguistic Anthropology
  • Sociolinguistics

Background:

  • The concept of limited English proficiency (LEP) poses challenges for healthcare access for the U.S.'s diverse, multilingual population.
  • Current terminology like "primary language," "limited ability," and "language assistance" is problematic and deficit-oriented.

Purpose of the Study:

  • To critically analyze the limitations of the limited English proficiency (LEP) construct in healthcare.
  • To propose actionable strategies for improving language-appropriate healthcare delivery.

Main Methods:

  • Conceptual analysis of the term "limited English proficiency" (LEP).
  • Examination of the negative healthcare impacts of LEP terminology through illustrative examples.
  • Proposal of alternative terminology and assessment strategies.

Main Results:

  • The concept of "primary language" overlooks communication complexities.
  • "Limited ability" ambiguously assesses health professionals' language skills.
  • "Language assistance" undervalues interpreters as collaborators.

Conclusions:

  • Reframing patient language as "non-English language preference" is recommended.
  • Assessing health professionals' non-English language skills is crucial.
  • These strategies can enhance language-appropriate healthcare for diverse populations.