Letter to the Editor by Epstein on Understanding Cultural and Linguistic Barriers to Health Literacy

Promoting Health Literacy: Strategies for Healthcare Providers

July 21, 2010

Response by Leonard G. Epstein to Uderstanding Cultural and Linguistic Barriers to Health Literacy by Kate Singleton and Elizabeth M. S. Krause (September 30, 2009).

Dear Editor:

We at the Health Resources and Services Administration (HRSA) are pleased to see the recent article by Singleton and Krause (September, 2009) on the vital importance of viewing health literacy within a cultural and linguistic context. Too often, it has been our experience that these issues are placed in artificial silos that are potentially harmful to the patients we are dedicated to serve. The authors correctly argue that health literacy needs to be fully integrated with an understanding of a patient's culture and language orientation in order to practice a unified health communication approach that potentially offers a deeper understanding of patient perspectives, communication styles, potential adherence to treatment and prevention protocols in order to achieve improved health outcomes for the growing diversity of patients that we all serve. HRSA uses its $7.48 billion annual budget (FY 2010) to fill in the healthcare gaps for people who live outside the economic and medical mainstream. In FY 2009 HRSA received an additional $2.5 billion under the American Reinvestment and Recovery Act to expand the Health Center program and strengthen the nation's health professions workforce.

One vital resource that readers should know about is a fairly recent web course released by the Health Resources and Services Administration. The Unified Health Communication (UHC) Course is a free, online interactive training course designed to help healthcare providers improve patient communication skills and increase their awareness and knowledge of health literacy, cultural competency and limited English proficiency. The course includes five self-paced modules: Module 1 provides an introduction to integrated health communication; Modules 2-4 address health literacy, cultural competency and limited English proficiency; and Module 5 enables users to apply what they have learned in the previous modules in a capstone activity. Self-paced instruction allows users to complete one or more modules at a time. The total time required to complete the course is five hours, and technical assistance is available.

The National Committee on Quality Assurance (NCQA) awards up to five free credits for nurses and physicians successfully completing this course. Because the NCQA is American Nurses Credentialing Center (ANCC) accredited as a provider of Continuing Nursing Education (CNE), nurses can earn up to 5.0 contact hours of CNE credit. The course is also certified by the American Board of Family Medicine. Register at www.hrsa.gov/publichealth/healthliteracy/

Leonard G. Epstein, MSW
Senior Advisor, Clinical Quality & Culture
Health Resources & Services Administration (HRSA)
Office of Health Equity
Rockville, MD