Rethinking the Term “Limited English Proficiency” to Improve Language-Appropriate Healthcare for All

The concept of limited English proficiency (LEP) presents significant challenges when applied to the healthcare needs of the diverse and growing multilingual population in the U.S. We expound on the following ways in which the concept of LEP is problematic: the ethnocentric notion of a “primary lang...

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Bibliographic Details
Published in:Journal of immigrant and minority health 2022-06, Vol.24 (3), p.799-805
Main Authors: Ortega, Pilar, Shin, Tiffany M., Martínez, Glenn A.
Format: Article
Language:English
Subjects:
Ambiguity
Communication Barriers
Comparative Law
Competence
English language
Ethnocentrism
Health care
Health education
Health information
Health services
Health Services Accessibility
Humans
International & Foreign Law
Interpreters
Language
Language proficiency
Limited English Proficiency
Medical personnel
Medicine
Medicine & Public Health
Non-English languages
Non-English speakers
Notes from the Field
Patient-centered care
Physician-Patient Relations
Private International Law
Public Health
Skills
Sociology
Terminology
Work skills
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Summary:The concept of limited English proficiency (LEP) presents significant challenges when applied to the healthcare needs of the diverse and growing multilingual population in the U.S. We expound on the following ways in which the concept of LEP is problematic: the ethnocentric notion of a “primary language,” the ambiguous idea of “limited ability,” and the deficit-oriented construct of “language assistance.” We provide examples that illustrate the negative healthcare impact of LEP terminology, including the unaccounted-for complexities of health communication within the concept of “primary language,” the “limited abilities” of health professionals whose language skills are often unassessed, and the ignored role of “language assistance” resources such as interpreters as essential collaborators. Finally, we propose rethinking LEP by (a) reframing patient language using the term non-English language preference and (b) assessing health professional non-English language skills. These actionable strategies have the potential to improve language-appropriate healthcare for diverse populations.
ISSN:1557-1912
1557-1920
DOI:10.1007/s10903-021-01257-w