Health Literacy &

Vulnerability in
Immigrant/Refugee
Communities
Ihssan Tahir RN, BSN
Jacksonville State University
EM 548
June 12th, 2021
Immigration Stats
• In 2018, 22,491 refugees were admitted to the U.S. (NCSL, 2021).
• Congo- 35%
• Myanmar- 16%
• Ukraine- 12%
• Bhutan- 10%
• Eritrea- 6%

• 26% percent of the U.S. population are immigrants (MPI, 2021).

• 20,455 people were granted asylum (NCSL, 2021).

• 11.3 million unauthorized people in the U.S. (NCSL, 2021).

Issues
• Limited English proficiency
• Cultural barriers
• Inaccessibility to resources
• Distrust of government
• Prior traumas
Language Literacy is the CORE

Language Literacy is focused on reading, writing, and

comprehension skill.(ACTFL, 2020).

reading, writing
This includes: 3 modes of listening
communication speaking
 Literacy is not only limited to reading
and writing.

Culture, politics, economics, religion and

race influence literacy.
Literacy is
Comprehensive Other forms of literacy:
• Functional literacy
• Document literacy
• Computer literacy
• Cultural literacy
• (Thomas, 2013.)
 • Old School Literacy
• Document Literacy- Finding information
Old School and completing form

Vs. New • Prose Literacy- Read and analyze

School information

Literacy • Visual Literacy- Comprehend, interpret

images (Thomas, 2013)
 Literacy is a forever
evolving and changing Old School
concept (Thomas, 2013). vs. New
School
Literacy
New School Literacy
Cultural Literacy- Health Literacy-
Media Literacy-
Understanding Access, understand
Access, analyze and
morals, values and and express health
use different media
traditions matters
 Health
literacy is
as

Health
important
as ever

Better health
outcomes with
Increased
Literacy
migration
accessibility

Demand
to meet
the needs
of diverse
cultural
groups
 Health literacy and
individual intelligence
are NOT related
Impact on EM’s

EM’s are an important First educators in the Proper outreach prior to Communication
piece of the large puzzle community large scale events
 Non-English speaking individuals (e.g.
Immigrants/refugees/undocumented
individuals)
• Hispanic and Asians to triple by 2050.

Vulnerable • Non-Hispanic whites will make up only one-half of the

total population (U.S. Census 2011)

Communities
Culturally sensitive communication
& Needs
Effective outreach
Lack of Services

There are very few existing efforts

in place for this population

Immigration policies & Trump

Admin

Limited health coverage options

 • Health literacy & functional literacy (reading, writing)
closely intertwined.

• WHO links health literacy initiatives to improved global

Health literacy, which is one of the organization’s international
sustainable development goals (Levin, 2017).
Literacy in
• Health literacy emphasis in youth = positive outcomes in
Children & adulthood.
Adolescents
• Centers for Disease Control and Prevention (CDC)
recognizes the need to cultivate health literacy.
(Levin, 2017)
 • Primarily focused on education
(Levin, 2017).
• Existing health issues
Health • Cultural competency and
Literacy in appropriate language.
Adults • Understanding = Comfort
Health Literacy in Families
• Low health literacy means WHOLE family suffers (Levin,
2017).
• Certain Cultures= Collective health decisions.
• Organizations/NGO’s play important role.
• E.g. The HEY! (Healthy Eating for Young Children)
organization
Title: A Novel Approach to Improve Health Literacy in Immigrant Communities
Journal: Health Literacy Research and Practice
(Johnson, 2019)

Subject: Health Literacy Method: Using Peer

Among Immigrant/Refugee Language Navigators (PLN)
Population in Anchorage, as health community
Alaska. ambassadors.

Results: A recent evaluation Conclusions: This research

of the program using ripple provides evidence that
effects mapping showed information sharing among
that the program has community members is
demonstrated wide success. effective.
Meeting the Needs

Shared responsibility
Cultural Awareness of
between Health Involve Community
EM’s = Understanding &
providers, EM’s, society Stake holders
Adherence
and individual

Proper health
Incorporate Community messaging to
leaders vulnerable groups
(outreach/education) • Understanding cultural
perception of emergencies
Stakeholders in Health Literacy

WHO Regional Office for Europe, 2013

EM Strategies &
Recommendations
• Know your communities,
especially the most vulnerable.
• Working in conjunction with
community.
• Develop effective strategies for
outreach.
• Ensure staff is trained to work
with diverse groups of people
(Thomas, 2013).
References
ACTFL. (2020). https://www.actfl.org/resources/guiding-principles-language-
learning/literacy-la

Johnson, R. M., Search for more papers by this author, Shepard, L., Berg, R. V. D., Ward-
Waller, C., Smith, P., Weiss, B. D., & S., C. (2019, April 8). A Novel Approach to Improve
Health Literacy in Immigrant Communities. A Novel Approach to Improve Health Literacy
in Immigrant Communities | HLRP: Health Literacy Research and Practice.
https://journals.healio.com/doi/10.3928/24748307-20190408-01.

MPI. (2021, May 14). Frequently Requested Statistics on Immigrants and Immigration in the
United States. migrationpolicy.org.
https://www.migrationpolicy.org/article/frequently-requested-statistics- immigrants-and-
immigration-united-states-2020.
Thomas, D. S., Phillips, B. D., Lovekamp, W. E., & Fothergill, A.
(2013). Social Vulnerability to Disasters. Boca Raton: Taylor & Francis
Group.https://www.actfl.org/resources/guiding-
principles-language-learning/

Zimmerman, M. S. (2019). Information horizons mapping to assess the

health literacy of refugee and immigrant women. Association for
Information Science & Technology.
https://asistdl.onlinelibrary.wiley.com/doi/abs/10.1002/pra2.2018.14
505501195.