Limited English Proficiency (LEP) in Health Disparities: Considerations for Infusion Providers

The core objectives of the National Infusion Center Association (NICA) include promoting strategies to improve treatment adherence and reducing disparities in quality of care and patient safety. However, our ability to achieve these objectives relies on the basic premise that healthcare teams are able to effectively communicate with patients receiving provider-administered medications.

One in five people in the United States speaks a language other than English at home, and this number is expected to grow in the coming years.¹

Medical jargon can seem like a foreign language even to native English speakers.

Since almost 10% of the U.S. population reports limited English proficiency (LEP)² —that is, difficulty speaking, reading, writing, and understanding English— it is easy to see how language discordance contributes to health care disparities.

Did you know...?

  • Patients with LEP receive a lower quality of care, experience poorer health outcomes, and utilize fewer primary care services when compared to patients who are proficient in English.³
  • One study examined the nature and frequency of adverse events affecting patients with LEP versus native English speakers and found that “[a]bout 49.1% of limited-English-proficient patient adverse events involved some physical harm whereas only 29.5% of adverse events for patients who speak English resulted in physical harm.” These events were more likely to be correlated with miscommunication for LEP patients than with English-speaking patients.⁴

In sites of care where provider-administered medications are given, complex medical terminology abounds, and patients are required to take an active role in their health care journey. As such, NICA aims to reduce the risk of harm caused by miscommunication with patients with limited English proficiency in these specialized care settings through this educational activity.

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Developed in partnership with Med Learning Group. ACCREDITATION STATEMENT: Med Learning Group is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with the ACCME Essentials. CREDIT DESIGNATION STATEMENT: Med Learning Group designates this web-based activity for a maximum of 1.0 AMA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the enduring activity. NURSING CREDIT INFORMATION: CNE Credits: 1.0 ANCC Contact Hour. CNE ACCREDITATION STATEMENT: Ultimate Medical Academy/CCM is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. Awarded 1.0 contact hour of continuing nursing education of RNs and APNs. This activity is supported by a grant from Bristol Myers Squibb.

Check out this video from our 2021 conference to hear our Director of Advocacy break down NICA's LEP program:

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Click the image above to help advance and sustain culturally and linguistically appropriate services.

Additional Language Resources

NICA partnered with Language Line Solutions to translate some of our most valuable resources into Spanish, simplified Chinese, and Vietnamese.

Special Deal for NICA Members Tile

NICA Provider Members get access to LanguageLine Solutions interpretation services at a low per-minute rate, with no minimums or monthly fees. Click the image above to learn more!

¹LanguageLine Solutions. (2019, July 29). LanguageLine Solutions. Retrieved November 09, 2020, from

²U.S. Census Bureau. Detailed Languages Spoken at Home and Ability to Speak English for the Population 5 Years and Over for United States: 2009-2013. 2015.

³Diamond L, Izquierdo K, Canfield D, Matsoukas K, Gany F. A Systematic Review of the Impact of Patient-Physician Non-English Language Concordance on Quality of Care and Outcomes. Journal of General Internal Medicine. 2019;34(8):1591.


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