health disparities
Health disparity is “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage.
Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their
- religion
- socioeconomic status
- gender
- age
- mental health
- cognitive, sensory, physical disability
- sexual orientation or gender identity;
- geographic location;
- other characteristics historically linked to discrimination or exclusion.
Health disparities are preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.
Healthy People 2030
Health equity is the “attainment of the highest level of health for all people."
It requires valuing everyone equally with focused and ongoing societal efforts to address
•avoidable inequalities,
•historical and contemporary injustices,
•and the elimination of health and health care disparities.
Healthy People 2030
Offering alternative methods of communication to English and/or Spanish low literacy Hispanics, African Americans and any at risk population will address the Healthy People 2030 overarching goal of eliminating health disparities. One of the leading health indicators is Access to Health Care. Too see everything included in Healthy People 2030, click on bottom at the bottom of the page.
Find out about Health Equity in Healthy People 2030
Barriers
For minorities, financial, structural, and personal barriers prevent access. This project addresses the latter two barriers.
A structural barrier includes the lack of service providers to meet the needs of clients.
- The American-Speech-Language and Hearing Association (ASHA) has identified the lack of professionals as a problem, particularly with respect to limited English proficient speaking clients. Only 2.5% of Speech-Language Pathologists and 1.8% of Audiologists identify their ethnicity as Hispanic, and not all Hispanic professionals are Spanish proficient Furthermore, the time demands of service providers, and particularly of those servicing bilingual populations preclude them from entirely meeting all of their clients’ individual needs.
Personal barriers include, among others, language barriers and lack of knowledge about health procedures.
- Two language barriers are of interest to this project. First, language barriers caused by low literacy rates in immigrant Hispanics and African Americans because of inadequate education attainment in their native Spanish and/or English. Second, language barriers faced by Hispanics because of insufficient oral English proficiencies in the clients or insufficient Spanish proficiencies in service providers.
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health literacy
Reading Abilities
The Center for Health Care Strategies has estimated that minorities and immigrants have disproportionate literacy problems (50% Hispanics and 40% Blacks) which increase their health risks.
Many Hispanics served do not have English literacy competencies necessary to successfully navigate English literature. Furthermore, because they come from poor rural sectors, Spanish language literacy skills are also low. Filling out simple clinical case history and insurance forms in either language requires individual attention from clinical staff.
This experience runs in concert with reports and studies that state that one-third of English-speaking patients at two public hospitals were unable to read basic health materials. Also, Medicare finds that one-third of the English speaking and half of the Spanish speaking patients had inadequate or marginal health literacy.
Problems with Written Materials
The Institute for Healthcare Advancement summarized from research that written health materials usually appear at the 10th grade level or higher (above average abilities), that they include too much information and no explanation of uncommon words, and that treatments are accompanied by complex instructions. They recommend that appropriate materials be developed.
Martinez gauged the English readability levels of patient communication disorders materials distributed by three the American Speech, Language and Hearing, the National Institutes for Health, and the American Academy of Audiology. The average reading level was found to be at the upper eighth grade level, with the most common reading level at the nineth grade. In conclusion these materials were found too difficult for most to understand because they include too much information and did not provide for explanations of uncommon words.
photonovelas/fotonovelas
The Challenges
Persons who have low academic or health literacy skills have problems understanding the messages contained in materials that are above their reading level. Therefore, strategies have been developed to address these challenges.
- One strategy is the development and use of Photonovela/Fotonovelas.
- Photonovelas are stories formatted with drawings or photographs to convey stories similar to comic books containing dialogues and descriptors either in bubbles or narrations that are suitable for populations with low reading skills.
Photonovelas/Fotonovelas
- Using Photonovelas/Fotonovelas as a strategy follows the recommendation of adult education literacy programs which advocate for using narratives with imaging for education.
- Originating in Italy and Spain, and then used in Latin America and the United States, the photonovela was very popular for telling romance stories, offering simple versions of famous novels, or presenting movie shots in the form of stories.
- Because of its popularity, this strategy has been successfully used by health professionals to educate populations in underdeveloped countries and the United States about a diversity of issues, such as birth control, arthritis, immunization, and nutrition. Also, because of the story-based format, it responds to the strong oral traditions of groups such as Hispanics and African-based cultures.
Talking Photonovelas/Fotonovelas
- Talking Photonovelas/Fotonovelas, different from previous models, use voiceovers, facilitating even better understanding to those with lower reading skills.