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How Effective Healthcare Communication Contributes to Health Equity

“I take one of that and one of the other.” “In the morning?” “In the morning.” “Like this.” “Okay.” (Narrator) Effective healthcare communication policies and practices, including provider health literacy contribute to improving the quality of services for culturally and linguistically diverse populations as well as people with limited health literacy skills. At HRSA, we view healthcare communication as a synergy of three factors: health literacy, cultural competency, and linguistic competency. It is important to emphasize a dynamic view of healthcare communication. These three factors interplay with each other in dynamic ways. “What?” “This is a generic drug from Walgreen’s.” (Narrator) For example, a person’s health literacy may be influenced by socio-cultural factors including education, income, country of origin level of assimilation to the host culture, to name a few. Cultural factors not only include language, gender socio-economic status, sexual orientation, and gender identity but also physical and mental capacity, age, religion, housing status and regional differences. Culture also includes diversity within specific cultural and ethnic groups, even the culture of western medicine. All of the factors that I have mentioned are very dynamic and highly interdependent. They are difficult to isolate and they tend to interact and influence each other. It is important to note that low health literacy is not language dependent. Additionally culture seems to be a prime mediator among these various factors. The U.S. is becoming ever more linguistically and culturally diverse. The number of people who spoke a language other than English at home has more than doubled in the last three decades and at a pace four times greater than the nation’s population growth. In that time frame the percentage of non-English language speakers grew by one hundred and forty percent while the nation’s overall population grew by thirty-four percent. “So, she says in this moment she’s feeling better; yesterday she felt a little bit of pain but she’s feeling much better today.” “And her chest?” “In your chest was the pain, correct?” (Narrator) The rise in our nations non- English speakers calls for rapid and innovative responses on the part of health care systems to ensure that trained healthcare interpreters are immediately available when required. Health equity is the attainment of the highest level of health for all people. A disparity is a particular type of health difference that is closely linked with social or economic disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social and economic obstacles to health. HRSA views effective cross-cultural communication as health disparity, quality, safety and civil rights issues. Health literacy must be viewed within a cultural context. HRSA has a web-based health communication training tool designed to improve interaction between healthcare providers and their patients. This interactive training course “Effective Communications Tools for Healthcare Professionals” aims to raise the quality of provider-patient interactions by teaching providers and their staff how to gauge and respond to their patient’s health literacy, cultural background and language skills. The course’s five modules take five hours to complete. Modules one through four provide an introduction to health communication, health literacy, cultural competency and limited English proficiency. In module five, participants can apply information learned in previous modules to test their ability to communicate effectively with patients. This year we are working to expand this course to include more ethno-cultural specific information: tools and resources on particular ethnic and racial groups, including LGBT patients, with clinical aids related to the cultural diversity of LGBT patients within ethnic and racial groups. Here is the front screen of this course. It is important to note that a number of accrediting bodies, including the American Academy of Family Physicians, the American Diabetes Educators Association, the American Academy of Physician Assistants, the American Association of Health Education and the National Association of Social Workers award up to five free credits for completing this course. The HRSA mission statement is the framework that supports a healthcare system that assures access to comprehensive, culturally competent quality care. In order to fully integrate cultural and linguistic competence and health literacy factors in into HRSA funding opportunity announcements, new suggestive guidelines have been developed to improve the effectiveness of healthcare communication between providers and their patients. Programs are encouraged to apply these principles whenever appropriate in their policies and practices. Please remember that these are guidelines and suggestions for preparing responsive applications. They are not directives. Please feel free to contact the name listed in the funding opportunity announcement at any time for further clarification regarding this effective healthcare communication policy. Also available on these web pages are links to other public resources and tools of cultural competence, linguistic competence and health literacy that we have found for you to use. We encourage you use these links to assist in the preparation of your application. (Music)

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