The Census Bureau reports that the share of the US population who speak English less than "very well" was 9 percent in 2009 and 8 percent in 2019. For those patients, understanding a diagnosis or a discharge plan depends on language access actually being available, not just offered in theory.
A 2018 study of one public hospital in Sydney, Australia, in one of the country's most culturally and linguistically diverse regions, found a wide gap between identified need and delivered service. An interpreter was identified at admission as required in 15.7% of overnight-stay episodes of care, but an interpreter was provided in only 3.7% of episodes. Among the episodes flagged at admission, 17.1% went on to receive one.
A statewide survey of New Jersey hospitals published in 2008 found that only 3% of the 67 responding hospitals had full-time interpreters, a ratio the authors put at one interpreter for every 240,748 New Jersey residents with limited English proficiency. The response rate was 55%, and the answers were self-reported by hospitals.
A third study, of 234 hospitalized Spanish- and Chinese-speaking patients with limited English proficiency, asked the patients directly. Only 17% reported that a professional interpreter was used with their physician at admission, 14% with physicians since admission, and 4% with nurses.
None of these studies set out to measure whether interpretation improves outcomes. What they measured is simpler and more uncomfortable: whether the service that's supposed to close the language gap is actually reaching the patients who need it. The three used different measures in very different settings, and each pointed to a gap between need and supply.
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