Mary Pilarz, Stephanie Granada, Hannah L. Harp, Adrian Zurca, Kshama Shah, Victoria A. Rodriguez
Families who speak a language other than English (LOE) are a growing population in the United States. Children of these families are at risk of disparities in clinical settings. This narrative review synthesizes evidence from outpatient and inpatient settings and outlines pragmatic strategies to improve communication and outcomes. Speaking a LOE is linked to low rates of preventive care, underinsurance, long hospitalizations, delayed escalation of care, undertreatment of pain, and adverse events. Although working with professional interpreters improves outcomes, services remain underutilized; families prefer in-person interpretation when available. Emerging modalities, such as equipment-assisted simultaneous interpretation and artificial intelligence-based translation, show promise for mitigating disparities but still demonstrate uneven performance across languages. Advancing equity will require best-practice interpretation use, investment in interpreter services and clinician language proficiency, inclusive research, and education that equips clinicians and health systems to partner effectively with families who speak an LOE.