Health care access, utilization, and quality for children in English versus Spanish-speaking households

This study examines healthcare disparities affecting children from Spanish-speaking households in the United States, focusing on the relationship between primary language spoken at home and access to care, utilization of health services, and quality of care. Using data from the 2021 National Survey of Children's Health, we analyzed responses from English- and Spanish-speaking families to understand potential language-driven gaps in healthcare. The findings reveal that children in Spanish-speaking households are more likely to lack insurance, lack a usual source of care, and to forgo needed medical attention compared with their English-speaking peers. These children also use fewer health services, particularly specialty and school-based care. Parents in Spanish-speaking households report lower-quality interactions with healthcare providers, citing insufficient time spent with their child, inadequate listening, limited shared decision-making, and a lack of cultural sensitivity. Furthermore, these findings could not be explained by group-level differences in demographics, geographic distribution, or financial condition. Our results underscore the urgent need for targeted interventions and policies to bridge language barriers, improve provider communication, and enhance health equity for families with limited English proficiency. By addressing these challenges, the healthcare system can work toward providing more equitable care for Hispanic and Spanish-speaking children and their families.