ENGLISH PROFICIENCY Limited English proficiency (LEP) is a term used to describe individuals who do not speak English as their primary language and who have a limited ability to read, speak, write, or understand English. Currently, 44.5 million people in the United States (or nearly 14% of the population) are foreign born—up from 7.9% in 1990. As this number grows, so does the amount of health utilization by LEP patients increase. An inability to speak English well can create barriers to healthcare access, provider communication, and health literacy and education. Barriers to communication can also result in fewer provider and wellness visits leading to delays in receiving preventative services, which can lead to chronic conditions and increased risk to hospitalization.
Only English
English Proficiency by Ethnicity and Age Cohort Age Cohort 5-17 Age Cohort 18-64 Percentage Percentage Population of Total Population of Total 283,943 53.8% 1,056,521 52.5%
Spanish Spanish & English Very Well/Well Spanish & English Not Well Spanish & No English Asian-Pacific Islander Language Asian-Pacific Islander & English Very Well/Well Asian-Pacific Islander & English Not Well Asian-Pacific Islander & No English Other Indo-European Language Indo-European & English Very Well/Well Indo-European & English Not Well Indo-European & No English Other Language Other Language & English Very Well/Well Other Language & English Not Well Other Language & No English Language Spoken at Home
172,766 166,428 5,665 673 52,665 49,252 3,191 222 12,986 12,327 632 27 5,455 5,097 278 80 527,815
32.7% 31.5% 1.1% 0.1% 10.0% 9.3% 0.6% 0.0% 2.5% 2.3% 0.1% 0.0% 1.0% 1.0% 0.1% 0.0% 100%
541,964 383,928 111,996 46,040 307,123 238,045 59,068 10,010 83,952 78,674 4,617 661 23,044 20,408 2,286 350 2,012,604
26.9% 19.1% 5.6% 2.3% 15.3% 11.8% 2.9% 0.5% 4.2% 3.9% 0.2% 0.0% 1.1% 1.0% 0.1% 0.0% 100%
Source: Es ri , 2019
According to recent census data, 29.2% of Spanish speaking Orange County residents aged 18 to 64 years, reported that they spoke English either “not well” or “not at all.” The same study also reported that 22.5% of Asian-Pacific Islanders in Orange County aged 18 to 64, reported that they spoke English either “not well” or “not at all.” Within the age cohort 5-17, under 4% of Orange County residents who speak Spanish, reported that they spoke English either “not well” or “not at all.” Nearly 7% of Orange County residents 5-17 who speak an Asian-Pacific Islander Language, reported that they spoke English either “not well” or “not at all.” Some of these children may be born in the U.S. but live in relatively isolated ethnic enclaves. CHOC Children’s offers translational services across dozens of languages through a combination of on-site services and third-party vendors. 24 | P a g e
