Disparities in Preventive Care for Children From English- and Non-English-Speaking Households

Neary 70 million people in the United States live in households where English is not the primary language. Language barriers cause significant challenges to health care use among non-English-speaking populations. We compared the use of preventive care among English, Spanish, and non-English-non-Spanish (NENS) speaking households.

A retrospective analysis of the nationally representative 2022 National Survey of Children's Health was conducted. The main outcome measures were preventive medical and dental care and the use of a medical home. The independent variable was the primary language spoken in the household. Multivariable logistic regression models estimated the adjusted odds of the outcomes, controlling for patient clinical and demographic characteristics, using child-level sample weights that produced nationally representative estimates.

Of 72 678 635 children, 85.0% resided in English-speaking households, 10.1% in Spanish-speaking households, and 5.0% in NENS-speaking households. Children from English-speaking households reported the highest rates of preventive medical (80.5%) and dental care (79.7%) and use of a medical home (48.6%). Compared with English-speaking household, the adjusted proportions for preventive medical care were lower in Spanish-speaking households (0.69 [0.65, 0.73] vs 0.74 [0.72, 0.76]) and NENS-speaking households (0.63 [0.58, 0.68] vs 0.74 [0.72, 0.76]). The adjusted proportions for medical home use were lower in Spanish-speaking (0.18 [0.15, 0.22]) and NENS-speaking households (0.21 [0.18, 0.25]) than English-speaking households (0.33 [0.31, 0.36]).

Disparities in preventive care and medical home use remain a significant issue for children in Spanish- and NENS-speaking households. Addressing these inequities requires understanding barriers and implementing targeted strategies for equitable health care.