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J Community Health. 2016 Aug;41(4):741-52. doi: 10.1007/s10900-015-0148-4.

Healthcare Communication Barriers and Self-Rated Health in Older Chinese American Immigrants.

Author information

1
Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave (TRC-0984), San Francisco, CA, 94143, USA. janice.tsoh@ucsf.edu.
2
Asian American Research Center for Health (ARCH), San Francisco, CA, USA. janice.tsoh@ucsf.edu.
3
Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA.
4
Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA.
5
Asian American Research Center for Health (ARCH), San Francisco, CA, USA.
6
Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave (TRC-0984), San Francisco, CA, 94143, USA.
7
Health Education Department, Chinatown Public Health Center, San Francisco, CA, USA.
8
University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
9
Division of Biostatistics, University of California, Davis, CA, USA.
10
NICOS Chinese Health Coalition, San Francisco, CA, USA.
11
Health Education/Holistic Health Studies, San Francisco State University, San Francisco, CA, USA.
12
Academy of Chinese Culture and Health Sciences, Oakland, CA, USA.

Abstract

Older Chinese immigrants are a growing population in the United States who experience multiple healthcare communication barriers such as limited English proficiency and low health literacy. Each of these obstacles has been associated with poor health outcomes but less is known about their effects in combination. This study examined the association between healthcare communication barriers and self-rated health among older Chinese immigrants. Cross-sectional survey data were obtained from 705 Chinese American immigrants ages 50-75 living in San Francisco, California. Communication barriers examined included spoken English proficiency, medical interpreter needs, and health literacy in written health information. The study sample (81 % females, mean age = 62) included 67 % who spoke English poorly or not at all, 34 % who reported needing a medical interpreter, and 37 % who reported "often" or "always" needing assistance to read health information. Two-thirds reported poor self-rated health; many reported having access to racial-concordant (74 %) and language-concordant (86 %) healthcare services. Both poor spoken English proficiency and low health literacy were associated with poor self-rated health, independent of other significant correlates (unemployment, chronic health conditions, and having a primary doctor who was ethnic Chinese). Results revealed that spoken English proficiency and print health literacy are independent communication barriers that are directly associated with health status among elderly Chinese American immigrants. Access to racial- or language-concordant health care services did not appear to resolve these barriers. These findings underscore the importance of addressing both spoken and written healthcare communication needs among older Chinese American immigrants.

KEYWORDS:

Communication barriers; Health literacy; Health status; Immigrant health; Limited English proficiency

PMID:
26746205
PMCID:
PMC4930414
DOI:
10.1007/s10900-015-0148-4
[Indexed for MEDLINE]
Free PMC Article

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