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HomeLanguage NewsIncreased Linguistic Diversity Needed in U.S. Health Care

Increased Linguistic Diversity Needed in U.S. Health Care

More than 50 languages other than English are commonly used in daily encounters between patients and healthcare providers in the U.S., according to the 2021 Healthcare World Languages Index compiled by AMN Languages Services, a division of AMN Healthcare (NYSE: AMN). The report is based on more than 110 million minutes of interpretation services the company provided over the last twelve months for patients in hospitals, medical groups, and other clinical settings. “The pattern is clear,” said Maureen Huber, president of AMN Healthcare workforce technology solutions. “From Mandarin to Arabic to Swahili to Hmong, and many others, patients in U.S. healthcare facilities are speaking a broader array of languages than ever before.”

According to the report, the top ten most common languages nationally in healthcare encounters requiring interpretation are Spanish, languages commonly spoken in China (Mandarin and Cantonese), Vietnamese, Arabic, American Sign Language (ASL), Russian, Portuguese, Haitian Creole, and Korean. By far the most frequently used language other than English, Spanish is spoken in 74% of non-English patient–healthcare provider encounters nationally. Hawaii (Mandarin), Vermont (Nepali), and Maine (Arabic) are the only three states in which Spanish is not the most spoken language other than English. Vietnamese is the second-most spoken language, but when Mandarin and Cantonese are combined, the languages commonly spoken in China represent the second-most spoken language other than English. Huber noted recent U.S. Census Bureau data indicating that 67 million people in the U.S. now speak a language other than English at home—double the number from 1990 and triple that of 1980. This trend has resulted in a growing number of English learner patients who require interpretation services to ensure appropriate care. According to the Agency for Healthcare Research and Quality (AHRQ), language barriers put 9% of U.S. patients at risk for an adverse safety event. To ensure equal access to healthcare, Title VI of the 1964 Civil Rights Act requires that interpretation services be provided to LEP patients at facilities that benefit from federal funding.

The use of American Sign Language (ASL) in healthcare encounters is relatively common, according to the report, with it ranking second behind Spanish as the most commonly used language other than English in 13 states and the District of Columbia.

The index is available at

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