Editorial Note: Language, Framing, and Equity Free

At Hospital Pediatrics, we welcome the commentary by Yeboah et al with humility.¹  Language has the power to frame our thinking, yet it evolves over time and is dependent on context. As pointed out in the commentary, despite widespread adoption of the term “limited English proficiency” (LEP) in clinical care and research, this term implies “flawed and problematic presumptions” of this patient population in a deficit orientation. It reinforces stereotypes and emphasizes the burden of interpretation on the patient rather than viewing communication in a patient’s primary language as fundamental to high-quality and patient-centered care. Similarly, in reframing the clinical question for patients and families from “Do you need an interpreter?” to “What is your preferred language?” we can shift our mentality from focusing on the patient needs of interpretation to the patient and provider needs to effectively communicate for optimal health outcomes.

As we have done previously,^2–4  we aim to critically and continuously evaluate the words that we use and avoid terms that can reinforce discrimination and exclusion. Moving forward, we have updated our author guidelines and now ask authors submitting to the journal to avoid the term “LEP” and instead use “language other than English” (LOE) or “preferred language other than English” (PLOE) instead.

We appreciate that our readers and authors are willing to challenge the status quo in a respectful and constructive way; we will always listen to your perspectives. We remain mindful that the meaning of words and their use change over time and reflect the norms of the community and of social developments. We recognize that the pursuit of health equity is one of continuous reflection as we make visible the words, processes, and policies that reinforce bias, stigma, and the structures that perpetuate inequity, and we are determined to change our practices when necessary as we actively listen to the patients, clinicians, and communities we serve.