Approximately 63 million Americans speak a language other than English at home, and more than 26 million have limited English proficiency (LEP, defined as a self-reported ability to speak English less than very well).1,2 Approximately 12 million school-age children (22%) speak a language other than English at home, a number that has tripled since 1979.2 In the city of Houston, at least 145 languages are spoken at home.3 The marked growth in non–English primary language (NEPL) and LEP families is attributable to the rapid increase in America of the foreign-born population, which grew from 9.6 million in 1970 to 41.3 million in 2013.1,2 Numerous studies document that language barriers affect multiple aspects of health care, including access, health status, use of services, patient-physician communication, satisfaction with care, participation in clinical research, quality, and patient safety.1,2,4,–...

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