When it comes to health care, we all want to be able to access the care we need, communicate with ease, and leave with a clear understanding of what comes next. Access means more than availability – it means receiving care in your own language that is rooted in an understanding of your needs. For people whose primary language is not English, navigating the health system can be demoralizing, confusing, and even dangerous. Too often, these barriers discourage people from seeking the care they need.

Across the country, language barriers and anti-immigrant policies are pushing people out of care. These are not isolated glitches – they are political choices baked into a system that excludes the very people it’s meant to serve. Nearly 68 million people in the U.S. speak a language other than English and 25 million people have Limited English Proficiency (LEP). Many are multilingual immigrants, represent the first generation in their families born in the United States, or are part of families with roots in the U.S. long before English was the dominant language. On top of this, two-thirds of U.S. born adults struggle with low English literacy skills.

Language justice is central to health justice – we must remove power dynamics created by language barriers and build spaces where all people can participate in their health care.

Language justice vs language access: they work together but are different.
  • Language justice is an intentional approach that considers the privilege behind certain words and identities. It embraces cultures and intersectional identities to build inclusive and accessible spaces.
  • Language access ensures that people who do not speak English can access the same services and information as English speakers – including languages without a writing system, like American Sign Language.
Language access is not a courtesy – it’s a lifeline – and one fundamental step towards justice.

The Cost of Exclusion

Imagine sitting in a hospital waiting room, worried about a loved one’s health, and not being able to understand what the doctor is saying. You don’t know what tests are being ordered what they will cost, or whether they are covered. You ask for help, but no interpreter is available – or the dialect is incorrect. Families often end up filling the gap, creating emotionally distressing situations and risking miscommunication.  

Right now, access to clear, understandable health care is under threat in ways that will harm us all. At a time when people are demanding more transparency and accountability in health care – not less – we are experiencing mounting attacks on language access and efforts to block care, especially for immigrant communities. These failures are not just bureaucratic —they are costly choices that fuel worse health outcomes, higher emergency room use, and preventable complications.

A Civil Rights and Race Equity Issue 

Title VI of the 1964 Civil Rights Act prohibits discrimination based on national origin – including the failure to provide meaningful access to services for people with LEP. But compliance is inconsistent, and for many, discrimination intersects with race and ethnicity. One in eight adults with LEP report unfair or disrespectful treatment from providers because of their race or ethnic background.  

Recent efforts to make English a gatekeeper to care are part of broader campaigns that put immigrant communities and people with LEP at risk. The result:  longer ER wait times, higher mortality, and deepened distrust in the health system. 

Language Access is a Smart Investment 

The lack of plain language and culturally competent care can affect anyone who struggles to understand medical jargon. But evidence shows that investing in language access pays off. One peer-reviewed study found that patients with LEP who received professional interpreter services had a 39% lower 30-day hospital readmission rate than those who did not. Health systems that invest in language access see better outcomes, higher satisfaction, and fewer costly errors or liability risks.

Language access is not only a civil rights issue – it’s also a smart investment. Every dollar spent on interpretation and plain-language materials reduces costly errors, improves patient trust, and strengthens system performance.

Our Vision: A Health System that Centers Language Justice

Health care should be clear, accessible, and safe for everyone – no matter what language you speak. That means stronger language access protections, plain-language communication, and deeper partnerships with community-based organizations as trusted resources.

Language justice isn’t a niche concern; it’s central to delivering high-quality, cost-effective care. A health system that communicates clearly not only saves dollars, it saves lives.