Migrant health literacy in the European Union: A systematic literature review

Background Refugees have poorer health compared to indigenous populations, which may be explained by lower health literacy, i.e. not being able to access, understand, appraise or apply health information. This study aims to determine levels of functional and comprehensive health literacy, and factors associated with inadequate health literacy, in refugees coming to Sweden. Method A cross-sectional study was performed among 455 adult refugees speaking Arabic, Dari, Somali or English. Participants in 16 strategically selected language schools for immigrants responded to a questionnaire. Health literacy was measured using the Swedish Functional Health Literacy Scale and the HLS-EU-Q16 questionnaire. Uni- and multivariate statistical methods were used to investigate group differences. Results The majority of the participating refugees had inadequate or limited functional health literacy and comprehensive health literacy. About 60% of them had inadequate functional health literacy and 27% had inadequate comprehensive health literacy. Low education and/or being born in Somalia were factors associated with an increased risk of having inadequate functional health literacy. Having inadequate functional health literacy was associated with an increased risk of having inadequate comprehensive health literacy. Conclusions The majority of refugees in the language schools had limited or poor health literacy. Health literacy should be taken into consideration in contexts and in activities addressing migrants. More research is needed to better understand health literacy among refugees and to develop strategies and methods to increase health literacy and make life easier for those with low health literacy. Electronic supplementary material The online version of this article (doi:10.1186/1471-2458-14-1030) contains supplementary material, which is available to authorized users.

Immigrant populations are vulnerable to serious health disparities, with many immigrants experiencing significantly worse health outcomes, such as higher rates of morbidity and mortality, than other segments of society. Immigrants disproportionately suffer from heart attacks, cancer, diabetes, strokes, HIV/AIDS, and many other serious diseases. These health risks demand effective health communication to help immigrants recognize, minimize, and respond effectively to potential health problems. Yet, while the need for effective communication about health risks is particularly acute, it is also tremendously complicated to communicate effectively with these vulnerable populations. A literature review using online databases was performed. Immigrants often have significant language and health literacy difficulties, which are further exacerbated by cultural barriers and economic challenges to accessing and making sense of relevant health information. This paper examined the challenges to communicating relevant information about health risks to vulnerable immigrant populations and suggested specific communication strategies for effectively reaching and influencing these groups of people to reduce health disparities and promote public health. Communication interventions to educate vulnerable populations need to be strategic and evidence-based. It is important for health educators to adopt culturally sensitive communication practices to reach and influence vulnerable populations. Community participative communication interventions are a valuable strategy for integrating consumers' perspectives into health education efforts and building community commitment to health communication interventions.