Purpose: While social cohesion is important for the promotion of immigrant health, language is a core component through which immigrant groups establish social connections. Since language is a vehicle through which immigrant groups establish social linkages and that English language proficiency has been established as a virtual requirement for full participation in US society, the purpose of this paper is to examine the role of language in establishing social cohesion affecting immigrant health. Design/methodology/approach: Using the 2012 California Health Interview Survey, the authors investigated the role of language efficacy in the relationship between social cohesion and utilization of healthcare among immigrant groups with good and poor health statuses (n=11,134). Mediation analyses were conducted using PROCESS Macro. Findings: The direct effect of social cohesion on healthcare utilization and the effect of English language efficacy on healthcare utilization were significant for both groups. English language efficacy was a significant mediator between social cohesion and healthcare utilization among immigrants with good health statuses. Research limitations/implications: Limitations include generalizability issues across immigrant sub-populations, limited measures in terms of English language efficacy and limitations with measures variables such as length of stay. Social implications: This study highlights that language is the channel that plays a crucial role not only to establish and maintain social cohesion for positive health outcomes, but also the ripple effects of promoting trust, belonging, opportunity of upward mobility and inclusion. Originality/value: The findings of the study add value to other pertinent issues of linguistic diversity, positive social relationships and well-being of diverse communities. © 2018, Emerald Publishing Limited.

Healthcare utilization Immigrant health Social cohesion Language diversity Language efficacy

California major clinical study immigrant social interaction drug efficacy mediator length of stay English (language) Article interview health care utilization human wellbeing human experiment Trust