As the U.S. Census Bureau continues to collect demographic and other data on the U.S. population on a continuous basis (rather than only once every 10 years) through the American Community Survey, there is now much more current data on English language proficiency available to health care policymakers, administrators and planners. The Census asks respondents to self-rate their spoken English language proficiency as “very well”, “well”, “not well” or “not at all”. There is general consensus that, in the context of health care services, a patient (or family member or caregiver) needs language assistance services (such as multilingual clinical staff or interpreters) if he or she speaks English less than “very well” because of the complexity of the vocabulary and communications required in a health care encounter.
Here is the latest one-year estimate for English language proficiency by state from the 2009 American Community Survey (accurate for geographic areas with a population of 65,000 or more):
The overall national percentage of persons 5 years and older who do not speak English “very well” – and need language assistance services in health care – is 8.6%, with a high of 19.8% in California and a low of 0.7% in West Virginia.
And here is the latest three-year estimate for English language proficiency by state, using combined data from the 2006, 2007 and 2008 American Community Survey (accurate for geographic areas with a population of 20,000 or more):
The overall national percentage of persons 5 years and older who do not speak English “very well” – and need language assistance services in health care – based on this (more accurate but less current) estimate is also 8.6%, with a high of 19.9% in California and a low of 0.7% in West Virginia.
More detailed data by counties, “places” (cities), metropolitan statistical areas, Congressional districts and other more granular categories are available on the American Community Survey website.
Ignatius Bau 