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The crucial importance and relationship of health literacy to effective communication in a culturally diverse healthcare environment


Health care providers increasingly deliver care to culturally diverse populace some of whom are not native language speakers. To ensure effective health care provision, health care providers are required to improve their health literacy to be able to deliver care to culturally diverse populations. As a result, healthy literacy is recognised as a crucial influencing factor on the quality and safety of health care. Health literacy is about understanding health information correctly and communicating it effectively. It is pertinent at all points along the care scale from health and wellness, disease detection and prevention, diagnosis and decision-making and self-care and treatment. This paper explores the crucial importance and relationship of healthy literacy to effective communication in a culturally diverse healthcare environment. The paper offers a succinct description of healthy literacy and a culturally diverse health environment; highlight the importance and the link between healthy literacy and effective communication and underscore issues linked to health literacy with respect to effective communication in a culturally diverse healthcare environment.

A clear comprehension of health literacy can offer direction to the health systems of community agencies and public health practitioners toward implementing policies amid at resolving incompatibilities amid the demands of health systems and needs of individuals. According to Parnell (2012), health literacy concept was not established into health care literature until the 1990s. The emphasis on self-management health and disease established in early 2000s placed great focus on a person’s heath literacy skills. Health literacy skills are essential in accessing, navigating and understanding the contemporary health care system. Although there is no clear definition of health literacy, Parnell (2012) defines health literacy as the degree to which persons can obtain, process, comprehend and communicate about health-linked information crucial in making informed health decisions. Zarcadoolas, Pleasant and Greer (2012) define healthy care literacy as a broad range of competencies and skills that people develop over their lifetime to seek out, evaluate, comprehend and utilise health concepts and information to make informed choices, increase quality of life and reduce health risks. A health-literate person is in a position to utilise health information and concepts generatively through applying information to novel situations. A health-literate person is also able to communicate effectively in culturally diverse health environment. With regard to a culturally diverse health environment, a nurse cannot offer appropriate cultural care devoid of understanding cultural diversity.

Cultural diversity includes people who are different from one another along the dimensions of first language, religion, ethnicity, race, gender and age to mention but a few. Booyens (2008) asserts that cultural diversity entails acceptance of the distinct norms, behaviour patterns, customs, traditions and worldviews of many groups of people. As a result, a culturally diverse health environment is a setting where people of different social class, educational background, gender, age, ethnicity, religion and race have health needs that require health care practitioners to provide culturally suitable health care that respects and acknowledges the integrity of every person. Culturally appropriate personal and health care is person-centred and promotes individual spiritual, linguistic and cultural needs. A culturally diverse health environment fosters cultural diversity among heath care providers and clients. When operating within healthcare settings, it is important to contemplate about cultural diversity. Sensitivity of cultural diversity informs the associations that health care practitioners have amid each other and with recipients of healthcare. The degree of the associations between healthcare practitioners among themselves and with their clients greatly affects the determination, delivery and improvement of health literacy. All these aspects greatly determine health outcomes.

The call to mull over health literacy within the milieu of culture and language is essential in nursing because of the diversity of the populace that requires healthcare. Health literacy is a powerful strategy that promotes effective communication. Health literacy is not only crucial as a social determinant of health, but also in promoting effective communication in a culturally diverse health environment. Cultural competence and effective communication are essential in managing the complex link amid healthy literacy and cultural diversity. According Bohlman, Panzer & Kindig (2004), cultural competence becomes essential to heath literacy at the point where culture and language support or interfere with effective communication. Although healthy efforts are not restrained to cross-cultural situations and cultural competence efforts are wider than health literacy, initiatives on healthy literacy and cultural competence benefit from their coordination. Communication practices towards culturally diverse population should be aimed at developing relations and maintaining a sense kindness, mutual understanding and respect. Effective communication within culturally diverse health settings is achieved when healthcare providers endorse cultural competency.

Health literacy promotes effective communication. According to Hernandez (2009), effective communication is not just about the rights of patients, but it is crucial to patient care and safety. However, the focus of health literacy came principally through a focus on concerns linked to language and culture and their effect on ethnic and racial health differences. The relationships and communication procedures that subsist amid healthcare recipients and healthcare providers are viewed as essential components of health literacy setting including directing information to individual needs, checking that information is well comprehended and shared-decision making procedures. Healthy literacy promotes effective communication that in turn helps in reducing the health disparities in linguistically and culturally diverse populations. According to Lie, Pokras, Braun and Coleman (2012), health care competencies and health literacy can help in addressing imbalanced access to pooled information understanding amid service recipients and healthcare providers through effective communication. Particularly, health care providers can promote reduction in health disparities through recognising the subsistence of culture and their own biases and assumptions, deploying correct communication skills and using resources to distinguish, diagnose and tackle cultural differences and health literacy.

Although health literacy and effective health communication are viewed as linked, but different concepts, health literacy is a crucial element of effective communication. Berkman, Davis and McCormack (2010) confirm that health literacy is major element of effective health communication while effective communication is a mediator within the relationship-between healthcare recipients and healthcare providers as well as between health outcomes and health literacy. Because effective health care information is delivered orally, communication skills that include ability to negotiate, speak and listen are crucial health literacy dimensions that contribute to development of health literacy skills. Notwithstanding the link amid effective communication and health literacy, some people can demonstrate effective communication skills without being health literate. However, health literacy is crucial as it promote effective health communication in a culturally diverse health environment. To promote good health outcomes both effective communication and healthy literal must be measured, assessed and addressed.

With regard to communication in a culturally diverse health environment, cultural competence is one of the factors that affect health literacy. According to Wright, Sparks and O’Hair (2012), cultural competence is one of the major indicators of being health literate. The concept of cultural competence holds implications on the field of gealth literacy. According to Mayer and Villaire (2007), health literacy efforts are undeniably supported by a comprehension of cultural competence. The failure of healthcare providers to pay attention to cultural disparities in their clients lead to misdiagnosis, poor use of health care resources by patients, patient alienation and lack of patient cooperation (Parnell, 2014). Cultural competence is crucial as it provides healthcare practitioners with a blueprint for establishing and assessing approaches to patient care. Talbot and Verrinder (2014) asserts that the concept of cultural competence calls for the aptitude to offer culturally suitable healthcare where culturally suitable health care entails the acknowledgement and response to individual requirements linked to service recipients’ diversity in behaviours, attitudes and beliefs. Being culturally competent requires a constant process that includes identifying one’s cultural identity and determining the differences of one cultural identity to other cultures. Cultural competence requires healthcare practitioners and clients to self-reflect upon cultural disparities and similarities within and amid different groups. In this view, constant cultural competency adaptation procedure helps in improving effective communication and health literacy in a culturally diverse health environment.

Language affects health literacy with regard to effective communication in a culturally diverse healthcare environment is language. Language is identified as a major social determinant of health. Language is essential in promoting one’s ability to comprehend and response to health information. For instance, lack of skills in the overriding language may instigate group or personal disadvantages triggered by miscommunication (Parnell, 2014). Differences in languages as well as differences in educational level may instigate miscommunication. As a result, obstacles linked to languages affect health upshots because they limit one’s ability to communicate and gain health literacy. However, to address language barriers, the services of interpreters can be used. In addition, miscommunication caused by language barriers can be addressed through adapting productive and culturally suitable communication skills aimed at promoting health literacy. Increased health literacy skills help healthcare recipients to assess the benefits and risks linked to medical interventions and products making them to be able to make informed decisions and attain improved health outcomes.

Power relationships affect health literacy. According to Lambert et al. (2014), the relationship between healthcare recipients and health care providers functions at power position. Because of a feeling of power, health care practitioners fail to communicate effectively health information from their stance as experts by ignoring the personal conditions of the recipients. The difference of power link between recipients, particularly amid indigenous Australians, and health care providers affects adoption of health literacy skills. The power relationships difference is a major change towards attainment of health literacy among scores of indigenous Australians. Other factors that affect attainment of health literacy include discrepancy in staff, and resource and time constraints. Low health literacy hinders strong comprehension of health issues and making of informed health decisions. In addition, low heath literacy negatively affects the effectiveness, quality and safety of healthcare besides holding negative effects on healthcare outcomes and access to health services. Low health literacy also affects the trust of health care recipients towards health care practitioners.


Health literacy entails as a broad range of competencies and skills that people develop over their lifetime to seek out, evaluate, comprehend and utilise health concepts and information to make informed choices. Health literacy affects effective communication in a culturally diverse health setting. As a result, there are is a powerful relationship between health literacy and effective health communication. Health literacy with regard effective communication is affected by cultural competence. Language is a major factor that affects improvement of health literacy and cultural competence. Obstacles to language subsist within populations that are culturally diverse thereby negatively affecting their communication aptitude. The language barriers affect the relationship between healthcare recipients and health care providers subsequently affecting attainment of health literacy skills. To address the challenges affecting healthy literacy and effective health communication in culturally diverse settings, health care practitioners must demonstrate cultural competence aimed at establishing health relationships and fostering improvement of healthy literacy. Health care practitioners must understand that cultural diversity informs and enriches health literacy determination. Healthcare practitioners must address power relationships in health care provision because power perception can promote or hinder positive health outcomes. Understanding the effects of power relationships helps in enhancing life quality and wellness, besides lowering health inequalities.


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