28-05-2025
Language Barriers Affect Kids' Access to Preventive Care
A lower proportion of children from non–English-speaking households received preventive medical care visits than their English-speaking peers.
METHODOLOGY:
Researchers conducted a retrospective analysis of data from a nationally representative survey in the United States in 2022, focusing on the use of preventive care use by children.
The main exposure was the primary language spoken at home, reported on a paper, web, telephone, or email-based questionnaire; households were categorized on the basis of language: English, Spanish, and non–English and non–Spanish (including Chinese, Russian, Vietnamese, Hindi, Tagalog, Portuguese, and French).
A total of 72,678,635 weighted surveys for children aged 1-17 years (51.2% boys) were included, comprising 85% children from English-speaking, 10.1% from Spanish-speaking, and 5% from non–English, non–Spanish-speaking households.
Primary outcome measures were preventive medical and dental care visits, based on how often a child saw a healthcare professional for a preventive checkup and whether they visited a dentist for preventive care in the past year.
The receipt of care in a medical home was also evaluated on the basis of components from 16 survey items, such as having a personal doctor, a usual source of sick care, and family-centered care.
TAKEAWAY:
The adjusted proportion of children who received preventive care visits was lower in Spanish-speaking (0.69; 95% CI, 0.65-0.73) and non–English, non–Spanish-speaking (0.63; 95% CI, 0.58-0.68) households than in English-speaking households.
No significant difference was noted in the proportion of preventive dental visits between children from Spanish-speaking and English-speaking households, but non–English, non–Spanish-speaking households had a lower adjusted proportion of dental visits than English-speaking households (0.60; 95% CI, 0.54-0.65 vs 0.69; 95% CI, 0.66-0.71).
Children from Spanish-speaking and non–English, non–Spanish-speaking households were less likely to receive care in a medical home than those from English-speaking households (adjusted proportion, 0.18 and 0.21 vs 0.33).
No significant difference in emergency department visits and hospitalizations over the past 12 months was found between non–English and English-speaking groups after adjustment.
IN PRACTICE:
'These findings underscore the need for targeted interventions to improve preventive care for children from non–English-speaking households, ensuring equitable health care for all,' the authors wrote.
SOURCE:
This study was led by Prabi Rajbhandari, MD, of the Rebecca D. Considine Research Institute at the Akron Children's Hospital in Akron, Ohio. It was published online on May 22, 2025, in Pediatrics .
LIMITATIONS:
Researchers relied on the primary language spoken at home as a proxy of language barriers. Using telephone interpreters for non–English, non–Spanish-speaking households may have affected data interpretation quality. Grouping all non–English, non–Spanish languages together limited the analysis of specific languages.
DISCLOSURES:
No funding was received for this study. One author disclosed receiving a foundation grant from Akron Children's Hospital for studying language access and health literacy among non-English patients and families.
