Many Asian American and Native Hawaiian and Pacific Islander Adults May Face Health Care Access Challenges Due to Limited English Proficiency

This report assesses the extent of limited English proficiency (LEP) among Asian American and Native Hawaiian/Pacific Islander (AANHPI) communities and variations in LEP across AANHPI subgroups. The authors analyzed pre-pandemic data on nonelderly adults (ages 19-64) from the 2019 America Community Survey. Key findings include: 1) About 30.8% of Asian American adults and 12.1% of NHPI adults had LEP, compared with 32.9% of Hispanic adults, 3.1% of Black adults, and 1.4% of white adults; 2) AANHPI adults with LEP were more likely than those who were English proficient to be noncitizens and to have socio-economic disadvantages such as lower incomes, lower levels of education, and higher uninsurance rates; 3) Nearly all Hispanic adults with LEP reported speaking Spanish, while the languages of AANHPI adults with LEP were much more varied; and 4) Estimated LEP rates varied widely across subgroups of AANHPI adults. To advance health equity, the authors emphasize that it will be important to improve language accessibility and employ data disaggregation in order to understand the disparate needs of various AANHPI communities, especially regarding their ability to enroll in health insurance and access quality health care. The authors also briefly discuss the importance of challenging stereotypes and the “myth of the model minority” in the diverse AANHPI community. The report also describes recent federal policy efforts to strengthen the enforcement of antidiscrimination regulations and increase digital language accessibility. Targeting of local and state-level resources and additional solutions are identified for helping to meet the specific language access needs in each AANHPI community. This type of access will become particularly relevant as some pandemic-related health insurance coverage protections expire and the need for clear communication from state health insurance agencies to enrollees continues to grow. (Robert Like, MD, MS)

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