Five Key Facts About Immigrants with Limited English Proficiency
About half (47%) of immigrant adults in the U.S. have limited English proficiency (LEP), meaning that they speak English less than very well. Immigrants with LEP come from diverse backgrounds and speak a variety of languages. The top five languages spoken by people with LEP include Spanish (63%), Chinese (7%), Vietnamese (3%), Arabic (2%), and Tagalog (2%), while the remaining roughly quarter (23%) of people with LEP speak other languages. Having LEP can impact individuals’ daily lives and access to health coverage and care. Below are five key facts about immigrants with LEP drawing on the 2023 KFF/LA Times Survey of Immigrants.
About half (53%) of immigrants with LEP say they have faced language barriers in a variety of interactions, including accessing health care.
About three in ten immigrants with LEP report that difficulty speaking or understanding English has ever made it hard for them to get health care services (31%), receive services in a store or restaurants (30%), or get or keep a job (29%) (Figure 1). A quarter say it has made it hard to apply for government financial assistance for food, housing, or health coverage, and about one in five (22%) cite difficulty reporting a crime or getting help from the police. These difficulties are more pronounced among lower income immigrants with LEP. Among immigrants who are parents with LEP (52% of all immigrant parents), about one in four (24%) report difficulties communicating with their child’s school.
Immigrants with LEP (21%) are twice as likely to be uninsured as immigrants who are English proficient (10%).
Immigrants with LEP are twice as likely as English proficient immigrants (defined as speaking English exclusively/very well) to be uninsured (21% vs 10%) (Figure 2), and parents with LEP are about three times as likely to say they have a child who is uninsured compared to English proficient immigrant parents (14% vs. 5%).This pattern reflects lower rates of private coverage among immigrants with LEP due to disproportionate employment in lower income jobs that are less likely to offer employer-based insurance. While Medicaid helps fill some of this gap, some may also face linguistic and other barriers to enrollment even if they are eligible for coverage.
Immigrants with LEP face greater barriers to accessing health care and report worse health compared to their English proficient counterparts.
Reflecting their higher uninsured rates and other barriers, immigrants with LEP are somewhat less likely than those who are English proficient to say they have a usual source of care other than the emergency room (77% vs 84%), have a trusted health care provider (68% vs. 80%) and to have seen a health care provider within the past year (74% vs. 80%). However, they are twice as likely as their English proficient immigrants to report fair or poor health status (28% vs. 14%). Community health centers (CHCs) play a particularly important role serving immigrants with LEP, with about four in ten (39%) saying that they usually rely on a CHC for care, reflecting CHCs’ role serving uninsured populations and their provision of linguistically and culturally appropriate services.
About half (55%) of immigrant workers with LEP report experiencing discrimination at work.
While immigrants with LEP are as likely as their English proficient peers to be employed (64% vs 67%), they are more likely to be in hourly jobs (60% vs. 45%) and less likely to receive a salary (21% vs 42%) (Figure 4). Reflecting these patterns, they are more likely to have lower incomes, with 55% having household incomes of less than $40,000 per year compared with 28% of English proficient immigrants. Half (55%) of immigrant workers with LEP report experiences with discrimination at work, such as being given fewer opportunities for advancement compared to people born in the U.S. doing the same job (38%), getting paid less (34%),not getting paid for all hours they worked (25%), being given undesirable work shifts or having less control over their hours than people born in the U.S. doing the same work (21%), or being harassed or threatened by someone at their work because they are an immigrant (14%).
About six in ten immigrants with LEP say they lack sufficient information about U.S. immigration policy (58%) and are unsure about public charge rules (62%).
About six in ten immigrants with LEP (58%) say they do not have enough information about U.S. immigration policy to understand how it affects them and their family compared with 34% of English proficient immigrants (Figure 5). Immigrants with LEP primarily get their information on immigration policy from a search engine such as Google (30%), a U.S. government website (26%), or an attorney or other professional (24%). They are less likely than English proficient immigrants to seek information from an internet search engine and more likely to rely on an attorney or other professional and other sources of information such as news media, social media, and family and friends. Information gaps among immigrants with LEP extend to public charge rules, with 62% saying they are unsure about whether using government programs to help pay for health care, housing, or food will decrease their chances of being approved for a green card compared with 55% of those who are English proficient, and another 17% incorrectly believing this to be the case.