Imagine living in a country where you don’t speak the language and don’t know the culture…and then you or someone close to you in the same situation gets sick. While you might know what to do in your home culture, the new environment creates all kinds of complications, from simple language barriers to more nuanced differences in norms and expectations about health care. Where do you even start in your search for health care services?
A new literature review [PDF] by Tessa Naus confirms what we already know, that migrants have a tougher time navigating health care than locals; but it also points to some health communication interventions that can help them.
According to Naus (2017), when it comes to health care, migrants are expected to know,
“…how to inform themselves about health and disease, how to describe their complaints to health care providers, how to ask those providers the right questions, [and how to] follow-up their appointments” ( p. 1).
This is known as health literacy.
Naus (2017) looked at many different research projects and attempted to summarize and highlight their findings as they relate to migrants and health literacy.
She found that migrants have lower health literacy rates than locals. This matters because it means migrants are potentially exposed to more negative health outcomes as a result. Naus cites two specific examples from the literature she reviewed, but we can assume there are countless more:
“Migrants screen less for breast cancer and have higher maternal mortality rates compared with [the] native-born…” (2017, p. 4).
So what can be done?
Naus’ (2017) review shows that using health educators succeeds in increasing health literacy among migrants.
For example, one German research project [PDF] sent women from the migrants’ cultures to their homes to conduct courses about health to small groups.
Another project cited by Naus [PDF] asserts that bicultural health educators effectively served as bridges between local health professionals and migrants. These bicultural health educators were especially effective in helping both migrants and the local health workers; they helped migrants by navigating them to health services and appointments, managing their expectations, and encouraging greater engagement, and they helped local health professionals by informing them about the specific health-related beliefs and social circumstances that might be influencing the decision-making of their migrant patients (Naus, 2017).
Thus, one of the more successful ways to help people to understand their new health care environment when they move to a new culture, and at the same to help the local health providers understand their new foreign patients, is to train health educators to become expert cultural brokers and serve as mediators between the two parties.