Languages Spoken by California’s Health Workforce
Over 43% of California’s Health Workforce speaks a language other than English well enough to provide care, representing more than 50 different languages across 47 key licensed health professionals.
Why are the Languages Spoken by the Health Workforce Important?
The ability to communicate in the same language as your provider is a foundational element of an effective and compassionate healthcare system. When patients and healthcare providers share a common language, it fosters trust, reduces misunderstandings, and enhances the accuracy of medical histories, diagnoses, and treatment plans. Even when interpreters are available, communication can be limited by delays, errors in translation, or nuances that are lost in interpretation.
Additionally, effective communication is crucial for minimizing the risk of misdiagnoses, treatment errors, and other complications. When patients fully understand their condition and the instructions provided by their healthcare team, they are more likely to follow through with treatments and preventive measures. Likewise, providers who clearly understand their patients’ concerns can deliver more accurate and personalized care. This language concordance—when providers and patients speak the same language—directly contributes to patient safety, satisfaction, and the overall quality of care.
To enable this comparison, the U.S. Census Bureau’s 4-Group language classifications and the Department of Health Care Services (DHCS) Medi-Cal Threshold Languages were utilized to categorize both the population’s spoken languages and the self-reported language abilities of licensed healthcare workers. The California Department of Health Care Access and Information (HCAI) uses these data to inform recruitment, training, and policy decisions aimed at reducing language barriers in healthcare settings. They are critical to advancing HCAI’s mission of building a more diverse, inclusive, and culturally competent workforce.
Key Findings
- Over 43% of California’s Health Workforce speaks a language other than English well enough to provide care, representing more than 50 different languages across 47 key licensed health professionals.
- Spanish is the most underrepresented language in the health workforce, with representation at only two thirds of the population average statewide. It is underrepresented in all six workforce categories and all nine California Health Interview Survey (CHIS) regions. This lack of representation is most severe within the Nursing workforce, where Spanish is underrepresented in 47 counties.
- Several language groups in the health workforce are represented well above their population average statewide. Asian and Pacific Islander languages are the most well represented at nearly 1.7 times the population average statewide and are at or above population concordance in 56 counties across workforce categories. Tagalog is the most common language reported within this group (54.2%).
- Many of the Medi-Cal Threshold languages are well represented in the health workforce when compared to the percent of certified Medi-Cal eligibles, however Spanish is underrepresented in 38 of the 47 counties where it qualifies as a threshold language.
- Representation amongst licensees varies greatly by age; while the percentage of licensees speaking Spanish is nearly twice as high among younger individuals (18-30) as compared to older individuals (over 75), Other Indo-European languages show the opposite pattern, while Asian and Pacific Islander languages peak amongst the 46-60 year old group.
- Survey data were collected from 86.8% of all active licenses statewide, representing more than 1 million surveys and a Decline to State rate of 10.2% or less for each of the metrics used in this dataset.
Visualization
Note: Licensees speaking more than one language are counted under each Census Language Group they belong to. Population data are only counted under one Census Language Group. See “How HCAI Created This Product” for further information. Data represents a custom tabulation of healing arts survey responses from licenses in an active status on December 3rd, 2024 who reported actively working in a position that requires their license, or were not currently working but seeking work in their field at the time of their licensure renewal. Licensees holding more than one active license are counted under each of their licenses. Population data and groupings are provided by the US Census Bureau as of 2023.
How HCAI Created This Product
- Licensure data was collected by the Department of Consumer Affairs; all data presented represents a snapshot of the active licensee population on December 3rd, 2024.
- This product is based on HCAI Health Workforce License Renewal Survey data; all data presented as of December 3rd, 2024. The responses to these surveys were adjusted using cell based weighting to create estimates of the full population. Decline to state answers were excluded from the data for each visualization, as well as licensees who did not report actively working in a position that requires their license, or were not currently working but seeking work in their field at the time of renewal. See the Response Rates tab for the percent of active licenses surveyed, as well as the decline to state rate for each question by license type and workforce category. Licenses without a valid Date of Birth were excluded from the Age Group visualization.
- Population data was retrieved from the US Census Bureau’s DP02 Selected Social Characteristics in the United States 2023 ACS 5 year estimate. Census language groups were defined using the US Census Bureau’s Four-group and Forty-Two group classifications and are listed below:
| Census Language | Census Language Group |
|---|---|
| African Languages | All other languages |
| American Sign Language | All other languages |
| Amharic | All other languages |
| Arabic | All other languages |
| Hebrew | All other languages |
| Hungarian | All other languages |
| Navajo | All other languages |
| Other (not listed) | All other languages |
| Other Sign Language | All other languages |
| Swahili | All other languages |
| Yoruba | All other languages |
| Cantonese | Asian and Pacific Island languages |
| Fijian | Asian and Pacific Island languages |
| Formosan (Amis) | Asian and Pacific Island languages |
| Hmong | Asian and Pacific Island languages |
| Ilocano | Asian and Pacific Island languages |
| Indonesian | Asian and Pacific Island languages |
| Japanese | Asian and Pacific Island languages |
| Korean | Asian and Pacific Island languages |
| Lao | Asian and Pacific Island languages |
| Mandarin | Asian and Pacific Island languages |
| Mien | Asian and Pacific Island languages |
| Mon-Khmer (Cambodian) | Asian and Pacific Island languages |
| Other Chinese | Asian and Pacific Island languages |
| Samoan | Asian and Pacific Island languages |
| Tagalog | Asian and Pacific Island languages |
| Thai | Asian and Pacific Island languages |
| Tonga | Asian and Pacific Island languages |
| Turkish | Asian and Pacific Island languages |
| Vietnamese | Asian and Pacific Island languages |
| Xiang Chinese | Asian and Pacific Island languages |
| English | English |
| Armenian | Other Indo-European languages |
| Croatian | Other Indo-European languages |
| French | Other Indo-European languages |
| French Creole | Other Indo-European languages |
| German | Other Indo-European languages |
| Greek | Other Indo-European languages |
| Gujarati | Other Indo-European languages |
| Hindi | Other Indo-European languages |
| Italian | Other Indo-European languages |
| Panjabi (Punjabi) | Other Indo-European languages |
| Persian (Farsi) | Other Indo-European languages |
| Polish | Other Indo-European languages |
| Portuguese | Other Indo-European languages |
| Punjabi | Other Indo-European languages |
| Russian | Other Indo-European languages |
| Scandinavian Languages | Other Indo-European languages |
| Serbian | Other Indo-European languages |
| Telugu | Other Indo-European languages |
| Ukrainian | Other Indo-European languages |
| Urdu | Other Indo-European languages |
| Yiddish | Other Indo-European languages |
| Spanish | Spanish |
- Medi-Cal Threshold Language data was retrieved from DHCS’ Quarterly Certified Eligible Counts by Month of Eligibility, County, and Threshold Language for the 2024-10 Month of Eligibility. Linguistic concordance was calculated as the magnitude of difference between a county’s percentage of the health workforce that speaks a census language group and the percentage of the county’s population that speaks that same census language group.
- Regions were defined by CHIS and are listed below:
| Region | Counties |
|---|---|
| Central Coast | Monterey, San Benito, San Luis Obispo, Santa Barbara, Santa Cruz, Ventura |
| Greater Bay Area | Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, Sonoma |
| Inland Empire | Riverside, San Bernardino |
| Los Angeles County | Los Angeles |
| Northern and Sierra | Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Inyo, Lake, Lassen, Mariposa, Mendocino, Modoc, Mono, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne, Yuba |
| Orange County | Orange |
| Sacramento Area | El Dorado, Placer, Sacramento, Yolo |
| San Diego Area | Imperial, San Diego |
| San Joaquin Valley | Fresno, Kern, Kings, Madera, Merced, San Joaquin, Stanislaus, Tulare |
- Workforce Categories were defined by HCAI using License Type and are listed below:
| Workforce Category | License Types |
|---|---|
| Advanced Practice Nursing | Clinical Nurse Specialist, Licensed Midwife, Nurse Anesthetist, Nurse Midwife, Nurse Practitioner |
| Allied Health | Advanced Practice Pharmacist, Audiologist, Chiropractor, Doctor of Podiatric Medicine, Licensed Acupuncturist, Occupational Therapist, Occupational Therapy Assistant, Optometrist, Pharmacy Technician, Physical Therapist, Physical Therapist Assistant, Polysomnographic Technician, Polysomnographic Technologist, Psychiatric Technician, Registered Pharmacist, Respiratory Care Practitioner, Speech Pathologist, Speech-Language Pathology Assistant |
| Behavioral Health | Associate Clinical Social Worker, Associate Marriage and Family Therapist, Associate Professional Clinical Counselor, Licensed Clinical Social Worker, Licensed Educational Psychologist, Licensed Marriage and Family Therapist, Licensed Professional Clinical Counselor, Psychiatric Mental Health Nurse, Psychologist, Registered Psychological Associate |
| Medicine | Naturopathic Doctor, Osteopathic Physician and Surgeon, Physician and Surgeon, Physician Assistant |
| Nursing | Public Health Nurse, Registered Nurse, Vocational Nurse |
| Oral Health | Dentist, Orthodontic Assistant, RDA In Extended Functions, RDH Alternative Practice, RDH Extended Function, Registered Dental Assistant, Registered Dental Hygienist |
Chiropractors, Hearing Aid Dispenser – Trainees, Licensed Midwives, Polysomnographic Technicians, Polysomnographic Technologists and Polysomnographic Trainees were removed from the dataset due to a lack of online licensure renewals resulting in less than 50% of the active licenses surveyed at the time of the data pull. RDH Extended Function were excluded from the Regional Details and Age Group visualizations per de-identification guidelines due to small sample sizes, however they are included in the Oral Health workforce group in the County Level Concordance and Medi-Cal Threshold Languages visualizations, as well as the Response Rates table.
Additional Information
Topic: Health Workforce
Source Link: Health Workforce Languages Spoken Data
Citation: HCAI – Health Workforce Languages Spoken Data – Census Languages Spoken by California’s Health Workforce, 2025
Temporal Coverage: Current as of December 3rd, 2024
Spatial/Geographic Coverage: Regional & County
Frequency: Annually