More than 25 million people in the United States, or 8 percent of the nation’s population, have limited English proficiency (LEP), meaning that they do not speak English as their primary language and have a limited ability to read, write, speak, and understand English. Individuals with such language barriers suffer substantially worse health outcomes than their fluent counterparts, including higher rates of misdiagnosis, lower treatment adherence, and longer hospital admissions, resulting in overall lower confidence and satisfaction in the healthcare system.

For patients and providers to understand and communicate with each other more effectively, we must teach healthcare providers how to be better communicators and empower LEP communities with the skills they need to confidently navigate the healthcare system.

The latter, precisely, is our goal with the Health Fluency Project.

The Stories Behind the Health Fluency Project

We are undergraduates at Harvard College and cofounders of this student-led initiative. Our relationship as cofounders is not limited by academic formalities. We are classmates, roommates, and the closest of friends, and it was through our chats over hurried meals in the dining hall, conversations at the pool table, and deep late-night discussions in our rooms that the core of this project developed.

Personal stories provided inspiration for action. We asked each other: What are you passionate about? How do you want to make an impact on something you would like to change?

Here are our personal perspectives.

Aditya: Growing up in small-town Brookings, S.D., I was familiar with health disparities throughout my community. In such a homogenous population, linguistic and cultural differences of those in the minority tend to be overlooked. Access to healthcare infrastructure is sparse, so the focus of care often lies in efficiency: how to serve the majority rather than adapt treatment options to minority populations. 

From pervasive substance abuse among classmates to disparities on the Rosebud and Pine Ridge reservations to my own household’s experiences with miscommunication and frustrations during appointments, I saw the consequences of these barriers firsthand in my own community. Whether due to linguistic or cultural barriers, navigating the healthcare system and effectively communicating with doctors in a rural community were a challenge for my family and countless others like mine. These experiences and stories have shaped me, fueling my dedication to making any difference I can in healthcare access and outcomes — especially for those in LEP communities and communities at the margins of society. 

Beier: My mother and I immigrated to the U.S from China when I was 4 years old. I remember my mother’s experiences with healthcare vividly, how she would come home from appointments frustrated, saying things along the lines of, “I don’t feel like my doctor understands me.”

One time, my mother came home with a bleeding ear. She explained that her doctor was being too rough in her exam, but she was uncomfortable alerting the doctor to her discomfort. The continual frustrations built up over time, and my mother eventually told me that she was switching her primary care provider (PCP) to someone who speaks Mandarin—and she has been going to a Mandarin-speaking PCP ever since. These stories inspired me to address health inequities in LEP communities.