The Language Game: Connecting Patients and Providers to Health Information

HCEA 2013 Conference

Dana Abbey, MLSHealth Information Literacy Coordinator

National Network of Libraries of Medicine, MidContinental Region

Objectives

Identify and evaluate online resources which provide quality health information in multiple languages.

Understand the importance of culture in health care.

Compare resources for pinpointing language trends in the communities you serve.

Low Health Information Literacy in Our Communities

• More than 66% of U.S. adults age 60 and over have either inadequate or marginal literacy skills.

• One out of five American adults reads at the 5th grade level or below, and the average American reads at the 8th to 9th grade level, yet most health care materials are written above the 10th grade level.

• Literacy skills are a stronger predictor of an individual’s health status than age, income, employment status, education level, or racial/ethnic group.

• For people who don’t have strong reading skills, easy-to-read health care materials are essential.

Impact of Low Health Literacy

• Annual health care costs for individuals with low literacy skills are 4 times higher than those with higher literacy skills.

• Only about 50% of all patients take medications as directed.

• Patients with low literacy skills were observed to have a 50% increased risk of hospitalization, compared with patients who had adequate literacy skills.

• Patients with low health literacy and chronic diseases, such as diabetes, asthma, or hypertension, have less knowledge of their disease and its treatment and fewer correct self-management skills than literate patients.

Language and Patient Health Accuracy of health history and ability to describe

symptoms. Patient trust level with provider. Ability to engage in treatment decision-making. Understanding a medical diagnosis or treatment. Lower use or misuse of medications. Underuse of primary care and preventative care. Less likely to receive counseling in diet, exercise

and smoking cessation.

Language Resources Consumer Health Information in Many Languages – start here for a wealth of

multi-language patient education resources @ http://nnlm.gov/outreach/consumer/multi.html.

DeafMD – disease and illnesses information from the CDC and NIH translated into American Sign Language @ http://www.deafmd.org/.

Health Information Translations – 19 languages, including American Sign Language. Formats include print, audio and video @ https://www.healthinfotranslations.org/.

Health Translations Online Directory -92 languages, customize the popular “I Speak” poster @ http://www.healthtranslations.vic.gov.au/.

Healthy Roads Media – 21 languages. Formats include handouts, audio, multimedia, web-video, iPod video @ http://www.healthyroadsmedia.org/.

“I Speak” Language Identification Card - short phrases written in over 30 languages that a user can check to indicate the language they speak @ http://www.lep.gov/ISpeakCards2004.pdf.

Lab Tests Online – Peer-reviewed site for understanding clinical lab tests in 17 languages @ http://labtestsonline.org.

Language Resources

LeLeche League – Breastfeeding information in 12 languages @ http://www.llli.org/.

MedlinePlus – Spanish and 48 additional languages. Formats include video, tutorials, patient handouts, current news @ www.medlineplus.gov.

New Americans Health Information Portal – 20 languages. Formats include audio, multimedia, podcast, video @ http://palantir.lib.uic.edu/nahip/.

New South Wales Multicultural Health Communications Service – 50 languages. Audio, video, print, signage @ http://www.mhcs.health.nsw.gov.au/

RHIN (Refugee Health Information Network) – 89 languages. Formats include print, audio and video @ http://rhin.org/.

Refugee Health Technical Assistance Center – provides tools, resources and support for health providers @ http://www.refugeehealthta.org/.

SPIRAL: Selected Patient Information Resources in Asian Languages - 7 languages @ http://www.library.tufts.edu/hsl/spiral/.

Cultural and Patient Health

Health-related beliefs and cultural values(the socioeconomic perspective).

Disease prevalence (the epidemiological perspective).

Treatment efficacy (the outcome perspective).

Cultural Resources

EthnoMed – 10 languages. Strong in Southeast Asian and East African languages. Primarily print @ http://ethnomed.org/patient-education.– Medical and cultural information about immigrant and refugee

populations– Designed as a quick reference tool and resource for patient education– Contains calendar with significant religious holidays

Provider’s Guide to Quality and Culture - http://erc.msh.org/.– Great resource for possible CE activity– Helps providers put culture in context to health care– Discusses in depth the health disparities we touched on earlier

regarding language and health outcomes

The Language Game

There are 7,105 know spoken languages in the world – 420 determined to be first language in the U.S.

50 million U.S. adults have limited English proficiency.

Minorities comprise 26% of the population, and nearly 20% of Americans speak a language other than English at home.

Only 23% of U.S. teaching hospitals provide any language training, and those that do make it optional.

Language Trends

MLA Language Map Data Center - number, ages, and percentage of speakers of each language in a particular geographic region @ http://www.mla.org/map_data.

County Health Rankings – select “Additional Measures” tab for LEP information @ http://www.countyhealthrankings.org/.

National Center for Education Statistics – percentage of adults with low literacy by state and county @ http://nces.ed.gov/naal/estimates/StateEstimates.aspx.

Linguistic Resources

Language Services Resource Guide for Health Care Providers - interpreter and translator associations and agencies, training programs, assessment tools @ http://www.healthlaw.org/images/pubs/ResourceGuideFinal.pdf.

American Translators Association @ http://www.atanet.org/. National Council on Interpreting in Health Care @ http://

www.ncihc.org. International Medical Interpreters Association @

http://www.imiaweb.org/corporate/find.asp. Registry of Interpreters for the Deaf @ www.rid.org. Video Interpreting @ http://www.imiaweb.org/basic/

videointerpreting.asp.

Questions?

Contact

Dana Abbey, MLSHealth Information Literacy CoordinatorNational Network of Libraries of Medicine, MidContinental RegionUniversity of Colorado – Health Sciences LibraryAnschutz Medical Campus12950 E. Montview Blvd., A003Aurora, CO 80045

303-724-2110Dana.abbey@ucdenver.edu