Exploring health inequalities by language proficiency; A routine health records study set in England

Background: Within the UK, more than a million people cannot speak English well or at all. The lack of data on English proficiency means that the link between English proficiency and health status and care utilisation is not comprehensively quantified.

Objective: Describe the association between English proficiency and patients’ health status and healthcare utilisation, and demonstrate that GP data can be useful in understanding the health burdens of those with poor language proficiency.

Methods: The Northwest London (NWL) Discover-NOW database contains linked, deidentified records from General Practices (GPs), hospitals, and social care in NWL. Using this data, we examined health outcomes and healthcare utilisation of people in Brent who are not proficient in English.

Results: Prevalence of age-sex-adjusted cardiometabolic conditions was higher in groups that were not proficient in English or spoke a main language other than English. Primary and secondary healthcare utilisation was also higher in groups that were not proficient in English.

Conclusion: This work is the first to quantify healthcare utilisation of those not proficient in English using a large, representative sample in a UK setting. It highlights poorer health outcomes in this group. There is a need to improve provision of language support, starting at registration, which would allow for this group to be better understood.