Summary
A majority of individuals with limited English proficiency (LEP) in the U.S. are foreign born, creating a complex intersection of language, socioeconomic, and policy barriers to health care access and achieving good outcomes. Mapping the research literature is key to addressing how LEP intersects with health care. This scoping review followed PRISMA-ScR guidelines and included PubMed/MEDLINE, CINAHL, Sociological Abstracts, EconLit, and Academic Search Premier. Study selection included quantitative studies since 2000 with outcomes specified for adults with LEP residing in the U.S. related to health care service access or defined health outcomes, including health care costs. A total of 137 articles met the inclusion criteria. Major outcomes included ambulatory care, hospitalization, screening, specific conditions, and general health.
This study uses California Health Interview (CHIS) data (year unspecified).
Findings: Overall, the literature identified differential access to and utilization of health care across multiple modalities with poorer outcomes among LEP populations compared with English-proficient populations. Current research includes inconsistent definitions for LEP populations, primarily cross-sectional studies, small sample sizes, and homogeneous language and regional samples.
Current regulations and practices are insufficient to address the barriers that LEP individuals face to health care access and outcomes. Changes to electronic medical records and other data collection to consistently include LEP status and more methodologically rigorous studies are needed to address health care disparities for LEP individuals.
