“Health Information Accessibility and Availability and Its Impact on the Health Literacy of Hispanics”
by Jennifer Stone | Xchanges 7.1
Discussion
After surveying five healthcare provider locations in a mid-sized Midwestern city and their corresponding websites, several trends were noted. The first trend was the lack of actual printed materials available. Only a few years ago, health pamphlets were a very common commodity that could be found at a variety of locations, especially at healthcare provider locations. However, after speaking to several employees at pharmacies and hospitals, the general feeling was that one of the reasons for a lack of printed health information had mainly to do with the constant changes and discoveries in this type of information. The economy also appears to play a part. Many employees cited the cost to print and re-print materials when changes were needed and the manpower needed to distribute and update them. Rather than having printed health information materials available, healthcare provider locations have moved their materials mostly online, an act which could be causing many people to be unable to access health information.
Another trend noted was the lack of resources available in Spanish. Every healthcare provider and website visited had much less and less varied information available in Spanish. At the physical provider locations, the only information found was about diabetes and smoking cessation — a very limited view of the possible health questions and problems that a Hispanic person could face. This type of information about lifestyle problems carries certain cultural assumptions that could be both damaging and offensive. The Spanish-language information available online was greater and more varied, but was often not accessible to Hispanic people due to the way the websites were designed and their use of English. Of the four health provider websites visited, only one, the UW Hospital’s website, had health information available in Spanish — yet even that was largely inaccessible to Spanish-monolingual Hispanic people.
While it originally seemed that the lack of availability of Spanish-language resources would be the main contributor to poor health literacy among Hispanics, several other interesting trends were discovered, including the lack of easily accessible health information and the shift from printed to online materials. The entire process of trying to find health information appears to be an endless, frustrating sequence of visiting locations without success and talking to multiple people unable to direct anyone to a definite source. This process is overwhelming even to an English-speaking, college-educated researcher with very high health literacy. Imagine how confusing and challenging this would be for a person who spoke little to no English, did not know what she was looking for, or was assumed to have very low health literacy.
A study looking at the Health Information National Trends Survey from 2005 demonstrated that 80% of Spanish-speaking Hispanics had never looked for cancer information, and compared to English-speaking people, Spanish-speaking Hispanics found their information search took a lot of effort, was hard to understand, and was frustrating (Vanderpool et al, 2009). The observed shift of health information from printed materials to online materials has created yet another challenge. Studies have found that between 32 and 55 percent of Hispanic people use the internet (Schroeder et al, 2003), leaving many Hispanic people unable to obtain written health information without going through the confusing process of accessing it at a healthcare provider location. Studies also found that fewer Hispanics (28.9%) use the internet to search for health information compared to non-Hispanic whites (35.6%) (Peña-Purcell, 2008). Furthermore, only 15 percent of those with below basic levels of health literacy used the internet for health information, whereas 62 percent of those with proficient levels of health literacy used the internet for health information (America’s Health Literacy, 2008).
These facts combined with the small area surveyed indicate that more studies should be done to better understand the impact of written health information on the health literacy of Hispanics. Locations with higher concentrations of Hispanics should also be studied in the future. Further studies should also take into account popular health information websites such as WebMD and the Mayo Clinic to better understand how these popular resources and their presentations of health information affect the health literacy of Hispanics.