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Why the next census needs to ask about language

BMJ 2005; 331 doi: (Published 11 August 2005) Cite this as: BMJ 2005;331:363
  1. Peter J Aspinall, senior research fellow (
  1. Centre for Health Services Studies, University of Kent, George Allen Wing, Canterbury CT2 7NF

    Delivery of culturally competent health care and other services depends on such data

    Estimates of the numbers of people in England who have difficulties with the English language vary widely from around 400,000w1 to 1.7 millionw2; evidence from surveys shows that only 16% of Bengalis, 44% of Gujaratis, 29% of Punjabis, 41% of Chinese, and 32% of refugees would reach a "survival level" of competence.1 A recent skills audit of adult refugees from the Far East, Iraq, Somalia, and other parts of Africa found that just a quarter understood spoken English and a fifth could speak English.2 Unmet language need is one of the key drivers of social exclusion, barriers to employment, education and training, and inequity in access to services. Information on this is therefore urgently needed, to plan interpretation and translation services and the delivery of culturally competent health care.

    It is surprising, then, that in spite of demand no comprehensive information is available for the UK population on the use of community languages and proficiency in English. Many users in consultations expressed a requirement in the 1991 census for a question on language other than English usually spoken at home. The …

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