Preferred Languages Spoken in California Facilities

Out of the 16 million patient encounters statewide in 2021, patients in more than two million encounters preferred a language other than English.

Why is Preferred Language Spoken Important?

Effective communication is critical for a successful relationship between patients and their healthcare providers. Communicating in the same language, even through an interpreter, is essential for reducing misdiagnoses and complications. Furthermore, patient safety and quality of care increase when patients and health care professionals speak the same language. Finally, preferred language spoken by patients with limited English proficiency is closely associated with health disparities.

The first visualization shows preference for English, Spanish, and Other Languages, the second and third visualizations divide the non-English and non-Spanish preferred languages into categories (e.g., Middle Eastern, European, etc.), while the last visualization can be used to view individual preferred languages (e.g., Farsi, Mandarin, Polish, etc.).

What Percentage of Patients Prefer to Speak a Language Other Than English and Spanish?

Statewide, over 11 percent (1.9 million) of the patients seeking medical care in California-licensed hospitals and ambulatory surgery clinics preferred to speak Spanish, and 2.6 percent of the patients (over 400,000) preferred to speak a language other than English or Spanish. The visualization below shows the number and percent of English Language speakers, Spanish Language speakers, and speakers of Other Languages, which can be filtered by county and facility.

Note: Physician-owned ambulatory surgery clinics do not report their data to HCAI and are not included here.

Note: All reported percentages are calculated using de-identified and masked values. See section 6b: Applying Data De-Identification Guidelines.

What Other Languages Do Patients Prefer to Speak?

Of the encounters where neither English nor Spanish was the preferred language, nearly 65 percent preferred to speak an Asian/Pacific Islander Language. Patients preferred a Middle Eastern Language in over 22 percent of the encounters while European Languages comprise over 9 percent of the Other Languages preferred. The remaining language categories – African, Latin American, Native American, and Sign Languages – each make up fewer than five percent of encounters. The visualization below shows the number and percent of patients that preferred a language other than English or Spanish and can be filtered by several facility characteristics (size, ownership, urban/rural, and teaching designation), Health Professional Shortage Area (HPSA), and county.

Note: All reported percentages are calculated using de-identified and masked values. See section 6b: Applying Data De-Identification Guidelines.

Where Are the Facilities with Patients Who Prefer to Speak Languages Other Than English?

For each facility in California, the visualization and map below show the number and percentage of encounters for each group of languages. Facilities can be filtered by county, Health Professional Shortage Area (HPSA), language group, or by selection on the map. Facilities with more encounters for the selected language group are shown on the map with a darker color.

Note: All reported counts and percentages are calculated using de-identified and masked values. See section 6b. Applying Data De-Identification Guidelines.

What Are the Specific Preferred Languages Spoken in Each Facility?

Knowing the preferred languages spoken by patients in each facility can assist facilities in planning for interpretive services and, possibly, hiring medical staff who speak those languages. Below is a table that shows the number of patients who prefer to speak each language. The first column presents the language categories in each facility and the second column includes the individual language counts for that language category at that facility. This table can be filtered by facility, county, and Health Professional Shortage Area (HPSA). Filters to identify facilities with the highest number (top 25%) of encounters in each language group and facilities with at least 50 encounters in a language group are also included.

Note: All reported counts and percentages are calculated using de-identified and masked values. See section 6b. Applying Data De-Identification Guidelines.

How HCAI Created this Product: Method for Grouping Languages

Nearly 100 languages are captured in the “preferred language spoken” data element in the Patient Discharge Data, Emergency Department Data, and Ambulatory Surgery Data in 2021. Languages other than English and Spanish were grouped by geography, assuming that languages from a shared geographic region are similar to each other. These languages were split into 6 geographic regions: Asian/Pacific Islander Languages, Middle Eastern Languages, European Languages, African Languages and Latin American Languages. The only exceptions to this approach were Native American Languages and Sign Languages, which were grouped by cultural similarity. See the table below for more information on how languages were categorized. Only languages that had at least one encounter during the measurement year were included.

African LanguagesAfrikaans, Igbo, Somali, Swahili, Yoruba, Zulu
Asian/Pacific Islander LanguagesAssamese, Bengali, Burmese, Chamorro, Chinese, Chuukese, Mandarin, Fijian, Filipino, Gujarati, Hiligaynon, Hindi, Hmong, Ilocano or Iloko, Indonesian, Mien or lu Mien, Javanese, Japanese, Korean, Lao, Malayalam, Marathi, Mon-Khmer, Mongolian, Nepali, Panjabi or Punjabi, Sinhalese, Samoan, Telugu, Tagalog, Thai, Tonga, Urdu, Vietnamese, Cantonese or Yue Chinese
English LanguageEnglish
European LanguagesAlbanian, Basque, Bosnian, Bulgarian, Catalan, Czech, Danish, Dutch, Estonian, Finnish, French, German, Gaelic, Irish, Greek, Croatian, Hungarian, Italian, Latvian, Lithuanian, Macedonian, Norwegian, Polish, Romanian, Russian, Slovak, Servian, Swedish, Ukrainian, Yiddish
Latin American LanguagesFrench Creole, Mixteco, Portuguese, and Zapotec
Middle Eastern LanguagesAmharic, Arabic, Armenian, Egyptian Ancient, Elamite, Hebrew, Persian, Farsi, Pashto, Tigrinya, Turkish
Native American LanguagesNavajo
Sign LanguagesSign Language
Spanish LanguageSpanish

Applying Data De-Identification Guidelines

To protect patient personal information, the California Health and Human Services Agency has adopted a policy of statistically masking or de-identifying sensitive data (CalHHS Data De-identification guidelines). For the visualizations above, several rules have been applied to prevent providing the exact count of encounters for small groups of individuals.

The rules are as follows:

  • Other/Unknown/Missing Languages are not included.
  • Counts of languages (e.g., Tonga and French) and Language Groups (e.g., Spanish Language or European Languages) that are less than 30 are replaced with ‘1’.
  • Counts of English Language Group and Spanish Language Group encounters are rounded to the nearest tens place value.

Note: All percentages and aggregated counts are calculated using these updated numbers, not the original number of encounters.

Additional Information

Topic: Healthcare Utilization
Source Link: Healthcare Utilization- Patient-Level Administrative Data
Citation: HCAI – Patient Discharge Data, Emergency Department Data, Ambulatory Surgery Center Data – Preferred Language Spoken in California Facilities, 2021
Temporal Coverage: 2021
Spatial/Geographic Coverage: Statewide
Frequency: Annual