Preferred Languages Spoken in California Healthcare Facilities
Out of 19 million patient encounters statewide in 2024, patients in over three million encounters (16.2%) preferred a language other than English, an increase from 14.0% in 2021.
Introduction
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. When patients and healthcare professionals can communicate in the same language, patient safety and quality of care increase. Furthermore, preferred language spoken by patients with limited English proficiency is closely associated with health disparities.
The Preferred Languages Spoken in California Healthcare Facilities report provides data on the spoken language in which patients seeking medical care in California-licensed hospitals and ambulatory surgery clinics prefer to communicate with healthcare professionals. The data is presented across four dashboards. The first dashboard displays the number and percent of encounters in which the patient showed a preference for English, Spanish, and Other Languages in 2024, while the second dashboard provides the same for language groups other than English and Spanish (e.g., Middle Eastern, European, etc.). Facility data included in each dashboard can be filtered by county, hospital system or specific facility, several facility characteristics (size, ownership, urban/rural, and teaching designation), and Health Professional Shortage Area (HPSA). In addition, hovering over any bar within these dashboards will display a line graph showing a 4-year trend (2021-2024) for a particular language or language group in the tooltip.
The third and fourth dashboards can be used to view individual languages (e.g., Farsi, Mandarin, Polish, etc.) that patients prefer to speak, by 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. The third dashboard provides a table and map showing the number and percentage of encounters for each language among the selected languages within a specific language group by facility. Facilities with more encounters for the selected languages are shown on the map with a darker color.
The fourth dashboard displays the number and percentage of encounters for each language group by facility. Selecting facilities or language groups within the table will display the number of encounters by specific language for the selection. This dashboard includes two additional filters: one to identify facilities with at least 50 encounters in a selected language group and a second to identify facilities in the top 25% in terms of the number of encounters for a specific language group.
Key Findings
- Statewide, patients in 13.6% of encounters (about 2.6 million) preferred to speak Spanish, and in 2.6% of encounters (about 500,000) preferred to speak a language other than English or Spanish.
- In 64.1% of the encounters in which neither English nor Spanish was the preferred language, patients preferred to speak an Asian/Pacific Islander language.
- Patients preferred a Middle Eastern Language in 22.9% of the encounters in which neither English nor Spanish was the preferred language and European languages in 8.8% of those encounters.
- Between 2021 and 2024, the percentage of encounters in which English was the preferred language decreased (from 86.0% to 83.8%), while the percentage of encounters in which Spanish was preferred increased (from 11.7% to 13.6%) and the percentage for all other languages remained nearly the same.
Visualization
Note: All reported percentages are calculated using masked values. See the Applying Data De-Identification Guidelines section below for more information about masking.
How HCAI Created this Product
Method for Grouping Languages
Nearly 100 languages are captured in the “Preferred Language Spoken” data element in HCAI’s Patient Discharge Data, Emergency Department Data, and Ambulatory Surgery Center Data. Languages other than English and Spanish were grouped into six language groups based on 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 kept as separate groups due to their uniqueness. See the table below for more information on how languages were categorized into language groups. Only languages that had at least one encounter during the measurement year were included.
| African Languages | Afrikaans, Igbo, Somali, Swahili, Yoruba, and Zulu |
| Asian/Pacific Islander Languages | Assamese, Bengali, Burmese, Cantonese or Yue Chinese, Chamorro, Chinese, Chuukese, Fijian, Filipino, Gujarati, Hiligaynon, Hindi, Hmong, Ilocano or Iloko, Indonesian, Japanese, Javanese, Korean, Lao, Malayalam, Mandarin, Marathi, Mien or lu Mien, Mon-Khmer, Mongolian, Nepali, Panjabi or Punjabi, Samoan, Sinhalese, Tagalog, Telugu, Thai, Tonga, Urdu, and Vietnamese |
| English Language | English |
| European Languages | Albanian, Basque, Bosnian, Bulgarian, Catalan, Croatian, Czech, Danish, Dutch, Estonian, Finnish, French, Gaelic, German, Greek, Hungarian, Irish, Italian, Latvian, Lithuanian, Macedonian, Norwegian, Polish, Romanian, Russian, Serbian, Sicilian, Slovak, Swedish, Ukrainian, and Yiddish |
| Latin American Languages | French Creole, K’iche, Kanjobal, Mam, Mixteco, Portuguese, Triqui, and Zapotec |
| Middle Eastern Languages | Amharic, Arabic, Armenian, Egyptian Ancient, Farsi, Hebrew, Pashto, Persian, Tigrinya, and Turkish |
| Native American Languages | Navajo |
| Sign Languages | Sign Language |
| Spanish Language | Spanish |
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 for languages (e.g., Tonga or French) and Language Groups (e.g., Spanish Language or European Languages) that are non-zero but less than 30 are masked and replaced with ‘1’. When included in sums, these masked counts are also given a value of 1. Consequently, sums of counts that have all been masked will typically result in a number greater than 1 but less than 30. For instance, the sum for a Language Group that consists of five languages that have all had their counts masked will be 5. Numbers that are less than 30 should be interpreted as masked and not as the true count of encounters.
- Counts of English Language Group and Spanish Language Group encounters are rounded to the nearest tens place value.
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 Healthcare Facilities, 2024
Temporal Coverage: 2021-2024
Spatial/Geographic Coverage: Statewide
Frequency: Annually