Language matters: advancing linguistic equity in health research in the Americas

Embracing linguistic diversity in the Americas is core to advancing equity in health research. Yet English continues to dominate scientific research communication,1, 2 even though it is the primary language for less than one-third of the region's population.³ By contrast, Spanish (∼400 million) and Portuguese (∼204 million) together represent a much larger share.³ Despite calls to decolonise language in global health research,^1,2, 4, 5, 6, 7 persistent inequities overlook the Americas' unique diversity and shared social fabric. Regionally, English proficiency often correlates with markers of privilege and colonial power structures,⁷ limiting career progression and knowledge access for less English-proficient researchers.¹ To address this imbalance, particularly in multilingual collaborations and in non-English speaking countries, health and medical research institutions must act collectively in adopting regionally-tailored approaches that embrace the Americas' intersectional identity, spanning linguistic, cultural, and national borders.

Beyond diagnosing the issue, we present regionally scalable solutions and examples that foster multilingualism in research. While this shift implies investments (e.g., financial, labor, time), social justice often necessitates such commitment for long-term, equitable, societal benefits. Failing to act undermines core population health values: equity, open access to knowledge, and strengthening of health research and implementation in the Americas.

We define language equity as fair access to knowledge production, dissemination, and engagement in public health research regardless of English proficiency. Although Spanish and Portuguese likewise stem from colonial legacies, they remain the most widely spoken languages in the Americas.³ Thus, multilingual integration in health research should, at a minimum, include two of the region's three dominant languages: Spanish, English, and Portuguese.

Artificial intelligence (AI) has unquestionably increased the time- and cost-efficiency of translations to facilitate multilingualism,⁵ and has been proposed as a promising solution to overcome linguistic barriers in research.^4,6 However, in present day, AI alone cannot achieve language equity due to: 1) data privacy and copyright restrictions, 2) the risk of disincentivizing researchers from embracing multilingualism, and 3) environmental costs that disproportionately affect marginalised communities.⁸ AI should complement, but not replace, the systemic and human-driven investments needed to make language inclusivity enduring.

To address the language barriers in the Americas highlighted in Fig. 1, we lay out three proposals:

Fig. 1.

Mapping language inequities and strategies for action in health research in the Americas.

The first one is publishing reforms to promote language inclusivity

Journals based in the region, at a minimum, should require bilingual abstracts (English plus the study population's primary language). They also should strongly encourage full-text translations as supplementary material to facilitate policy uptake and knowledge access, ensuring reach beyond English-speaking audiences.2, 4, 6 Moreover, language translation and editing services, like the free auto-translation offered by Springer Nature for book chapters, may be offered at a discounted rate to researchers in the Americas in the case of no native English-speaking co-authors. Further, ideally, all journals should consider accepting submissions in multiple languages, following the example of the Pan American Journal of Public Health (PAJPH), which accepts manuscripts in regional languages and publishes abstracts in English, Spanish, and Portuguese for all manuscripts.

The second proposal is to strengthen scientific engagement and education in the languages of the Americas

Regional conferences and academic meetings should routinely provide simultaneous interpretation, translated materials, and multilingual moderation to enable equitable participation across language groups, as practised by the Pan American Health Organization⁹ and the Sociedad Latinoamericana de Nutrición,¹⁰ for example. This pedagogical approach could be replicated in broader platforms such as the American Public Health Association conference. While AI may be integrated into these forums for real-time translation, English-speaking researchers must also contribute to multilingualism. English-speaking research groups and departments can support journal clubs, seminars, internal communications, and community engagement in Spanish and Portuguese to promote normative change. Graduate and professional programs should require practical language training and recognise regional language proficiency as a valued competency, especially but not limited to those working with multilingual communities.⁴ UNC Chapel Hill's Comprehensive Advanced Medical Program in Spanish offers a template for bilingual training of health and medical professionals.

And the third proposal is to enhance researcher support and introduce funding incentives

Funders should incorporate translation activities as a required expense to complement AI tools and require inclusivity statements in grant proposals, framing this as a critical equity investment rather than a voluntary cost. Hiring, promotion, and grant review frameworks should explicitly recognise local-language publications, policy briefs, and community-engagement outputs as legitimate scholarly contributions. Lastly, to foster reciprocal collaboration, English-speaking researchers working in the non-English speaking Americas must invest time in increasing proficiency in another American language, as is expected of their non-English-speaking colleagues. Will these efforts require financial investment and resource allocation? Yes. Yet maintaining the status quo only reduces short-term costs at the expense of widening long-term inequities.

The Americas are home to abundant linguistic diversity; non-English languages cannot remain peripheral in health research and education. Aligning publishing norms, institutional practices, and funding incentives toward multilingualism will broaden participation, increase policy relevance of research, and democratise access to timely evidence.

Contributors

Kaela Connors conceived the idea, performed the literature review, co-wrote the initial draft, co-created the initial draft of the figure, finalized the draft, and translated the comment into Spanish.

Jonathan Lara-Arevalo conceived the idea, performed the literature review, co-wrote the initial draft, co-created the initial draft of the figure, finalized the draft, and translated the comment into Spanish.

Declaration of interests

None.