Health literacy is a critical need for all segments of society. According the Journal of the American Medical Association, 46% of American adults lack the functional literacy to navigate the healthcare system in the US and health literacy levels are even lower among non-native English speakers.
Literacy levels directly affect patients’ ability to understand disease processes, to engage in disease prevention and early detection, and to comply with therapeutic routines. In order to successfully manage chronic diseases such as hypertension and diabetes, patients must be active participants in their care, making lifestyle modifications and taking medication consistently.
Immigrant elders learning English through SHINE acknowledge that their participation improves access to healthcare. Effective, culturally appropriate health education materials, geared to the language and literacy abilities of immigrant elders, are essential for elders to acquire health literacy and to access healthcare resources.
Our investigation into the health literacy needs of older immigrants in Philadelphia, PA and San Jose, CA has confirmed that tremendous confusion and uncertainty exists among immigrant elders regarding their eligibility for health benefits and services, their ability to understand medical instructions, communicate with their doctors and other health professionals, and maintain their health and well-being. In the first year, ten focus group and seventeen in-depth individual interviews were conducted with elderly immigrants as part of the needs assessment in Philadelphia and San Jose.
Information about immigrant and refugee elders’ views toward the health care system and their health literacy needs was solicited from 101 individuals representing seven major language groups: Cambodian, Chinese, South Asian (Hindi, Gujarati and Marathi), Korean, Russian, Spanish, and Vietnamese. In order to better understand the complexity of issues faced by this population, additional insights were collected from professionals in the fields of health care, senior services, immigration and English as a Second Language. Temple University nursing students and San Jose State University’s gerontology students assisted in the needs assessment. Students from these universities, with guidance from supervising faculty members, investigated demographic and health statistics of immigrant communities and conducted community needs analyses.
Although elders expressed a strong desire to improve their language skills in order to communicate more effectively in medical settings, they recognized that effective communication is a shared responsibility. Recommendations from this needs assessment include training in intercultural communication for health professionals and interdisciplinary collaboration in the development and implementation of advocacy-oriented health literacy curricula. Curricula should include information about the healthcare system and patients’ rights as well as strategies for developing language, literacy and communication skills in healthcare settings. The report summarizing the findings from this needs assessment is currently being edited for publication and will be disseminated to ESL, immigration, health care and senior service providers through professional associations, state offices on aging, refugee and immigrant organizations and other appropriate venues. Preliminary findings of focus groups and interviews with immigrant elders are currently available.
The SHINE-MetLife Foundation Health Literacy Initiative began in 2003, with a generous grant from MetLife Foundation.
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