Healthcare Communication Barriers and Self-Rated Health in Older Chinese American Immigrants
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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.
KeywordsCommunication barriers Health literacy Limited English proficiency Health status Immigrant health
The authors wish to express their gratitude to Corina Liew, Christina Nip, Ying Wang, and Hy Lam; the Sức Khỏe Là Vàng!—UCSF Vietnamese Community Health Promotion Project; and the Asian American Network for Cancer Awareness, Research and Training-San Francisco (SF-ANNCART) for their valuable contributions in data collection and study implementation.
This research was supported by the National Cancer Institute (5R01CA138778, PI: Nguyen, T). Additional support was provided by the National Cancer Institute’s Center to Reduce Cancer Health Disparities through Grant 1U54153499 to the Asian American Network for Cancer Awareness, Research, and Training. The content is solely the responsibility of the authors and does not reflect the official views of the funders.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
The Institutional Review Boards of the University of California San Francisco and San Francisco State University approved all study procedures.
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