[영문]Background. Approximately 3.5 million U.S. schoolchildren are limited in Englishproficiency (LEP). Disparities in children’s health and health care are associated withboth LEP and speaking a language other than English at home, but prior researchhas not examined which of these two measures of language barriers is most usefulin examining health care disparities.Objectives. Our objectives were to compare primary language spoken at home vs.parental LEP and their associations with health status, access to care, and use ofhealth services in children.Methods. We surveyed parents at urban community sites in Boston, asking 74questions on children’s health status, access to health care, and use of healthservices.Results. Some 98% of the 1,100 participating children and families were of nonwhiterace/ethnicity, 72% of parents were LEP, and 13 different primary languageswere spoken at home. “Dose-response” relationships were observed betweenparental English proficiency and several child and parental sociodemographicfeatures, including children’s insurance coverage, parental educational attainment,citizenship and employment, and family income. Similar “dose-response” relationshipswere noted between the primary language spoken at home and many but notall of the same sociodemographic features. In multivariate analyses, LEP parentswere associated with triple the odds of a child having fair/poor health status,double the odds of the child spending at least one day in bed for illness in the pastyear, and significantly greater odds of children not being brought in for neededmedical care for six of nine access barriers to care. None of these findings wereobserved in analyses of the primary language spoken at home. Individual parentalLEP categories were associated with different risks of adverse health status andoutcomes.Conclusions. Parental LEP is superior to the primary language spoken at home as ameasure of the impact of language barriers on children’s health and health care.Individual parental LEP categories are associated with different risks of adverseoutcomes in children’s health and health care. Consistent data collection onparental English proficiency and referral of LEP parents to English classes bypediatric providers have the potential to contribute toward reduction and eliminationof health care disparities for children of LEP parents.