Journal of Immigrant and Minority Health

, Volume 21, Issue 3, pp 451–460 | Cite as

Relationships Between English Language Proficiency, Health Literacy, and Health Outcomes in Somali Refugees

  • Jessica E. MurphyEmail author
  • Laura Smock
  • Jo Hunter-Adams
  • Ziming Xuan
  • Jennifer Cochran
  • Michael K. Paasche-Orlow
  • Paul L. Geltman
Original Paper


Little is known about the impacts of health literacy and English proficiency on the health status of Somali refugees. Data came from interviews in 2009–2011 of 411 adult Somali refugees recently resettled in Massachusetts. English proficiency, health literacy, and physical and mental health were measured using the Basic English Skills Test Plus, the Short Test of Health Literacy in Adults, and the Physical and Mental Component Summaries of the Short Form-12. Associations were analyzed using multiple linear regression. In adjusted analyses, higher English proficiency was associated with worse mental health in males. English proficiency was not associated with physical health. Health literacy was associated with neither physical nor mental health. Language proficiency may adversely affect the mental health of male Somali refugees, contrary to findings in other immigrant groups. Research on underlying mechanisms and opportunities to understand this relationship are needed.


Refugees Health literacy English proficiency Mental health Physical health 



This research was funded by the National Institute of Dental and Craniofacial Research (Grant 1R01DE017716-01A2, Geltman, PI). Dr. Murphy was funded by a training grant through the Health Resources and Services Administration (Grant D33HP25766).

Compliance with Ethical Standards

Conflict of interest

The authors declared that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Jessica E. Murphy
    • 1
    Email author
  • Laura Smock
    • 2
  • Jo Hunter-Adams
    • 3
  • Ziming Xuan
    • 4
  • Jennifer Cochran
    • 2
  • Michael K. Paasche-Orlow
    • 5
  • Paul L. Geltman
    • 6
  1. 1.Division of General Internal MedicineWarren Alpert Medical School of Brown UniversityProvidenceUSA
  2. 2.Division of Global Populations and Infectious Disease PreventionMassachusetts Department of Public HealthBostonUSA
  3. 3.Health Economics UnitSchool of Public Health and Family Medicine at the University of Cape TownCape TownSouth Africa
  4. 4.Department of Community Health SciencesBoston University School of Public HealthBostonUSA
  5. 5.Division of General Internal MedicineBoston University School of MedicineBostonUSA
  6. 6.Division of Global Populations and Refugee and Immigrant HealthMassachusetts Department of Public HealthBostonUSA

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