The newest census figures show Chinese languages and Punjabi are the dominant immigrant languages spoken in Metro Vancouver homes.
Of the 712,000 people who reported speaking an immigrant language most often at home, nearly 18 per cent reported speaking Punjabi.
But the combined number of people who spoke either Cantonese, Mandarin or an unspecified Chinese language accounted for 40 per cent of the population who spoke an immigrant language as their main language at home.
In Greater Vancouver, the number of people whose mother tongue is something other than French or English is now nearly one million people.
Jas Cheema with the Fraser Health Authority says the changing demographics point to the growing need for interpreter services.
"It's crucial, it could be a matter of life and death — if a health professional can't understand a symptom of the patient that they're serving, it could be detrimental," she said.
"There's lots of research out there that we can even reduce wait times or stay times in the hospitals if we have access to interpreters."
The census figures show Punjabi and the Chinese groups accounted for more than half — 57.7 per cent — of the overall population speaking an immigrant language most often at home in the Metro Vancouver census area.
The census also found the proportion of the population that reported speaking only English at home continued to decline, from 65 per cent in 2001 to 58 per cent in 2011 — 1,328,780 people.
But the census also found a sizable increase in the number of people who reported speaking both English and an 'other' language at home, from 18 per cent in 2001 to 24 per cent in 2011 — 549,950 people.
In Greater Vancouver, the number of people who only speak something other than French or English at home has remained roughly the same since 2001, and is now about 16 per cent — 369,350 people.
The total number of people who speak some English at home, with or without another language, is now about 83 per cent, dropping only about one per cent since 2001.
Across the country, the biggest increase is those from the Philippines who speak Tagalog. Nearly 279,000 people now speak it as their main language at home.