Key messages

• minority language users face communication barriers that contribute to misdiagnosis, inadequate care and exclusion
• lack of cultural and linguistic competence among professionals exacerbates disparities
• minority language users are underrepresented in health and social care research
• language and cultural barriers directly affect care equity and outcomes
• improved training, interpretation services and inclusive research practices are recommended.

Policy implications

• health and social care systems may need to strengthen interpretation and translation provision
• professional training should address both linguistic and cultural competence
• research funding and design should support inclusion of minority language users
• service design should consider language access as a core equity issue.

Gaps

• limited evidence on the effectiveness of different language support models
• lack of data on experiences across specific language groups
• limited evaluation of culturally competent training interventions.

Commentary
This systematic review highlights how language functions as a structural barrier within health and social care systems. Minority language users experience exclusion through communication failures that affect diagnosis, treatment and overall quality of care.

The findings also point to gaps in professional capacity. Without adequate training or resources, services struggle to meet linguistic and cultural needs, reinforcing inequities in access and experience.

From a care equity perspective, underrepresentation of minority language users in research further compounds disadvantage. When lived experience is absent from the evidence base, policy and practice risk reproducing assumptions that do not reflect diverse needs.

The review underscores the need for system-level change. Embedding language access and cultural competence into service delivery and research practice is central to reducing inequities and supporting fairer outcomes for minority language users.