1. Physical and Mental Health Literacy and Its Impact on Asian Americans’ Health Outcomes
Young-Me Lee, Kunsook Bernstein, Scarlett Choi, Shinhi Han, Hyeonkyong Lee
DePaul University, Hunter College, Long Island University, Yonsei Uniersity
Background
Methods
Results
Health literacy is defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decision (Lee et al., 2015).
Low health literacy and health inequality are closed related and prevalent among the elderly, the poor, ethnic minorities, and in populations with chronic health conditions.
Asian Americans (AAs) are frequently affected by the negative consequences of low health literacy such as poor physical and mental health outcomes and poor access to healthcare system.
Research Design
An integrative literature review was used.
The review was guided by Whittemore and Knafl’s integrative review methodology.
Problem Identification Stage
AAs experience disproportionate health burdens and
inequities.
A paucity of research on both physical and mental health
literacy of AAs and consequent health outcomes
Importance of identifying cultural uniqueness and psycho-
somatic presentation among AAs
Literature Search Stage
Multiple text combinations used: health literacy, Asian American OR Korean OR Chinese OR Japanese, association OR correlation OR relationship OR relation, and health OR Mental OR Physical
3 database used: CINAHL, PubMed, and PsycInfo
Data Evaluation & Data Analysis
Inclusion Criteria: Peer-reviewed article, published between 2007 and 2017 in English, studies discussing impacts of physical and/or mental health literacy and a relationship between physical and mental health literacy, target population of AAs in the U.S.
Exclusion Criteria: studies done outside North America, subjects consisting of Non-AAs, articles discussing factors leading to low health literacy without mentioning impacts on physical or mental health status & duplicate articles.
A total of 12 articles yielded for in-depth review.
Figure 1. Diagram of Study Selection and Review Process
Three Impacts of Low Mental Health Literacy on General Health
Negative perceptions (distrust) toward mental health care providers
• AAs with low mental health literacy viewed providers as unhelpful and showed a lower level of readability and confidence (Lee, et al, 2015).
• Parents showed lack of understanding of the Western healthcare system.
Lack of awareness of mental health issues
• Mental health commonly viewed as a stigma by Aas.
• Lack of accurate knowledge act as barriers to action to seek for professional help.
• Chinese Americans with Alzheimer’s disease showed greater perceived threats of AD, higher depressive
symptoms and poorer self-rated health (Sun, et al, 2013).
Social Isolation and Low Self-Esteem
• Immigrant AAs more likely to be isolated from dominant culture
• KAs showed improved mental health literacy after the intervention program also demonstrated decreased depressive symptoms and increased self-esteem (Kim, et al, 2015).
A Direct Relationship Between Physical and Mental Health Literacy
Overall, a positive correlation was found between physical and mental health literacies. For example, increased health literacy on both physical and mental health showed positive effects on health outcomes in KA seniors with hypertension (Kim, et al, 2014).
Purpose
Examine the impact of physical and mental health literacy on overall health among AAs.
Identify the relationship between physical and mental health literacy among AAs.
Major Challenges Attributing Impacts
Impacts of Physical Health Literacy
Impacts of Mnetal Health Literacy
Limited English Proficiency
Different Cultural Beliefs
Aculturation
Delayed medical seeking behaviors and treatments
Negative perceptions (Distrust) toward mental health care providers
Inadequate adherence to medication regimen
Lack of awareness of mental health issues
Lack of self-care and illness management
Social Isolation and Low Self-Esteem
Methods
Conclusion
Results
Health literacy greatly impacts both physical and mental health among AAs.
There is a limited synthesis of published data on the impact of physical and mental health literacy on health outcomes among AA.
Culturally-tailored intervention programs for AAs about chronic disorders and mental diseases have shown to significantly promote self-care abilities, adherence to treatment regimen, and decrease depressive symptoms.
Negative perceptions influenced by stigma and cultural beliefs play a key role in preventing AAs from seeking appropriate treatments.
There is a urgent need for development of culturally-sensitive health intervention programs to promote health literacy among AAs, acknowledging the cultural and language barriers and understanding the cultural uniqueness of this population.
Three Impacts of Low Physical Health Literacy on Health
Delayed medical seeking behaviors and treatments
• A low level of physical health literacy is associated with
delayed-treatment seeking behaviors among AAs,
contributing to poorer health outcomes.
Inadequate adherence to medication regimen
• KAs showed difficulty understanding health resources
and following instructions (Lee, et al, 2015).
• Low PHL likely prevent many AAs from adhering to
treatment regimens which ultimately leads to significant
impacts on health status.
Lack of self-care and illness management
• Low health literacy is related to poor dietary habits and
unhealthy lifestyle habits, worsening symptoms of DM
among KAs (Lee, et al, 2015).