This paper provides a high-level overview of findings from studies that examine how language concordance affects health care and health outcomes and presents national findings on language concordance, the difficulty of finding language-concordant providers, and preferences for language-concordant providers among Spanish-speaking Hispanic nonelderly adults, drawing on the Urban Institute’s June 2022 Health Reform Monitoring Survey.

WHY THIS MATTERS

People with limited English Proficiency (LEP) are more likely than those who are proficient in English to be uninsured and to lack a health care provider or usual source of care, which can lead to differential access to preventive services and ongoing care for chronic conditions for people with LEP. Improving language concordance between providers and patients—which, for this brief, we define as access to interpretation services or providers who speak patients’ preferred languages—is an important step toward mitigating language barriers and their associated health inequities for people with LEP.

WHAT WE FOUND

• Most studies we reviewed found a positive association between patient-provider language concordance or interpretation services and health care and health outcomes; some found no association, and a few found a negative association.
• One in 10 Spanish-speaking Hispanic adults did not have a language-concordant provider, and 1 in 4 reported difficulties finding a language-concordant provider in 2022.
• About 4 in 5 (83 percent) Spanish-speaking Hispanic adults said it was very or somewhat important for their health care provider to speak the same language or provide translation services.
• Spanish-speaking Hispanic adults who were concerned about future unfair treatment in health care were more likely than those without such concerns to prefer a language-concordant provider (90 percent versus 78 percent, respectively).

HOW WE DID IT

We used the Urban Institute’s 2022 Health Reform Monitoring Survey, a nationally representative survey of 9,484 adults ages 18 to 64 examining health care coverage, access, and other health topics. We estimated the share of adults with a usual provider who reported having a language-concordant provider. We also estimated the share of adults who reported that finding a language-concordant provider is “very” or “somewhat” difficult for them and the share of adults who report it “very” or “somewhat” important to have a language-concordant provider. Finally, we determined how concern about being treated unfairly because of race, ethnicity, or primary language in health care settings in the future is related to preferring a language-concordant provider.