Editorial by Dr. Richard D. Brecht
This piece is one of several that explore the deep societal, cultural, and human consequences of language suppression in the U.S., framing multilingualism not as a challenge, but as an asset — one that must be protected and nurtured. It ties language access to social justice, education, national identity, and public health.
There are over forty-six million foreign-born residents in the United States, arriving predominantly from Latin America but, in fact, from all corners of the earth. All immigrants settle in communities where the common language of daily living is English. Speaking languages other than English presents challenges at every turn as they go about trying to become our neighbors and friends. Inability to access vital health services can be especially frustrating and even traumatic, even though physicians and nurses are committed to life-saving care for everyone in need.
“Section 1557 provides that, except as otherwise provided in title I of the ACA, an individual shall not, on the grounds prohibited under title VI of the Civil Rights Act of 1964, title IX of the Education Amendments of 1972, the Age Discrimination Act of 1975, or section 504 of the Rehabilitation Act of 1973, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any health program or activity, any part of which is receiving Federal financial assistance…” https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-A/part-92
Nevertheless, notwithstanding this professional and legal commitment and mandate, language remains a major obstacle to equal access to healthcare and, for that matter, all social services in the U.S., particularly now, anti-immigration sentiment and aggressive deportation of recent arrivals are threatening their access to the social services on which they rely and to which they have a right. Our nation’s historic welcoming of immigrants is further undermined by the recent declaration of English as the nation’s ‘official language’ and by the elimination of English language education. The nation’s hospitals and community health centers cannot rely solely on English due to their ethical commitment and acknowledgment of the law.
This being said, quality and costs are abiding concerns for these medical services. Having a high-value ‘product’ of patients’ wellbeing that involves accelerating technology and specialization costs makes attention to ‘return on investment’ critical. Fortunately, this industry has a long-standing tradition of data collection in this area, thanks to support from internal as well as outside public and private sources.
A prominent example of rigorous data collection is Mass General Hospital/ Brigham and Women’s Hospital (MGB) efforts:
Massachusetts General Hospital is home to the largest hospital-based research enterprise in the U.S., with an annual budget of nearly $1.2 billion in 2021. The Mass General Research Institute comprises more than 9,500 researchers working across more than 30 institutes, centers, and departments.
As the oldest and largest teaching hospital of Harvard Medical School, Mass General has been a leader in bridging innovative science with highly advanced clinical care for more than 200 years. https://www.massgeneral.org/research/about/overview-of-the-research-institute
In recent years, MGB has established “Research and Innovation for Equitable Surgical Care” at the Center for Surgery and Public Health in the Department of Surgery, in association with the Harvard Medical School. Dr. Gezzer Ortega, MD, MPH, and Assistant Professor of Surgery, has been the Lead Faculty for this effort. Among other efforts, Dr. Ortega has been collaborating with Jeenie® to improve language concordance at MGB by researching the effect of Jeenie’s mobile app that gives patients accurate, immediate, and ubiquitous access to language services throughout the course of surgery, when and where it is needed.
This dataset of approximately 800 published studies from 2008 to 2025 is unprecedented in its breadth and specification, providing information on author, title, journal name, date of publication, abstract, keywords, specialty, non-English involved, number of LEP, study years, region of study population, outcomes, intervention, and pdf.
This summary is extraordinary in that it makes the case for the cost-effectiveness of language concordance, without which the justification for quality improvements is more difficult to make. Because of its importance and uniqueness, Dr. Ortega’s summary deserves to be rigorously documented and expanded, given the amount of data available in the database’s studies. Such research requires expertise and time that healthcare providers, on their own, can ill afford.
Accordingly, Jeenie® is pursuing a new partnership comprising Mass General Hospital Brigham and Women’s Hospital, the College of Information at the University of Maryland, the National Language Access Coalition, and the National Council on Interpreting in Health Care (NCIHC). Its immediate goal is the first rigorous assessment of the application, effectiveness, and cost of language in healthcare.
Its purpose is to establish a scientific basis for healthcare institutions to assess their return on investment. Success will be defined by rigorous documentation of actual needs, outcomes, and costs for enhanced quality on a sustainable financial basis through unprecedented assessment of available industry-wide data. Documentation of both quality and cost is indispensable in today’s healthcare system.