C. English Proficiency

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

Population Percentage of Total Population

Percentage of Total 283,943 53.8% 1,056,521 52.5%

Spanish

Spanish & English Very Well/Well

172,766 32.7% 541,964 26.9%

166,428 31.5% 383,928 19.1%

Spanish & English Not Well 5,665 1.1% 111,996 5.6%

Spanish & No English

673 0.1% 46,040 2.3%

Asian-Pacific Islander Language 52,665 10.0% 307,123 15.3%

Asian-Pacific Islander & English Very Well/Well 49,252 9.3% 238,045 11.8% Asian-Pacific Islander & English Not Well 3,191 0.6% 59,068 2.9% Asian-Pacific Islander & No English 222 0.0% 10,010 0.5%

Other Indo-European Language 12,986 2.5% 83,952 4.2%

Indo-European & English Very Well/Well 12,327 2.3% 78,674 3.9% Indo-European & English Not Well 632 0.1% 4,617 0.2% Indo-European & No English 27 0.0% 661 0.0%

Other Language 5,455 1.0% 23,044 1.1%

Other Language & English Very Well/Well 5,097 1.0% 20,408 1.0% Other Language & English Not Well 278 0.1% 2,286 0.1% Other Language & No English 80 0.0% 350 0.0%

Language Spoken at Home 527,815 100% 2,012,604 100%

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.