Language and Health (In)Equity in US Latinx Communities

Language is a social determinant of health, no less so in the case of Latinx persons, who make up the second largest ethnic group in the United States.In US health care, language and linguistic difference are often conceived in discrete, instrumental, and monolithic terms.This article characterizes this conception of language as administrative logic, which is in sharp contrast to language conceived as a richly complex, heterogeneous, communally lived human experience.This article emphasizes the importance of system-level language awareness and epistemic humility for promoting equity, as well as the need to avoid toonarrow focus on linguistic assessment.Administrative Logic Many residents of the United States, including health care workers, are aware that Latinx make up the second largest ethnic/racial minority group in the United States.Less often realized is the heterogeneity that underlies this classification.1 (We use the label Latinx throughout primarily for reasons of thematic and conceptual coherence with the rest of the contributions in the thematic issue, while recognizing the social significance and political salience of relevant competing or interrelated notions, such as Latinidad and Indigenidad.)In what follows, we outline the implications of the sociolinguistic context of US Latinx for their clinical care.More specifically, we consider the ways in which the quality and equity of care provided to US Latinx are affected by a profound tension between the Anglo-centric and often monolingual administrative logic of health care institutions, on the one hand, and the complexities of Latinx' linguistic lived experience of health and illness, on the other.More specifically, we offer a critique of this administrative logic in the context of health care, and we examine how a less regulative-centered conception of language and linguistic agency can better serve health care policies and practices committed to equality, diversity, and inclusion and likewise guide their development, implementation, and assessment.Heterogeneity in Latinx Linguistic Identities The goal of equitable health care delivery to US Latinx-and to other US demographic groups-has a critical linguistic dimension.Most studies show that linguistically concordant care improves health outcomes.2,3 Linguistically discordant care often leads to patient dissatisfaction, lower quality of care, inappropriate follow-up, and worse health outcomes.4,5 That is, care in a language other than that preferred by the patient

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