The Health Literacy of U.S. Immigrant Adolescents: A Neglected Research Priority in a Changing World

Abstract

Immigrant adolescents are the fastest-growing sector among U.S. youth, but they receive little attention in health literacy research. Immigrant adolescents are a diverse population tasked with mastering new literacies while also navigating new social systems. Many immigrant adolescents serve as important linguistic and cultural resources in their families and local communities, and yet their contributions (and struggles) as new navigators of our health care system remain invisible. In this commentary article, we argue that health literacy researchers need to devote more attention to immigrant adolescents and the pathways by which they learn new language and literacy skills while also developing their own health habits and behaviors. We contend that the study of immigrant adolescents provides a critical window into health literacy as a socially and historically situated practice, specifically how immigrant adolescents’ transnational experiences shape their learning of new health literacy practices. With a coordinated interdisciplinary research agenda on immigrant adolescents, the health literacy field will expand its empirical base for what becoming “health literate” looks like in today’s globalizing world.

Child and Youth Health Literacy: A Conceptual Analysis and Proposed Target-Group-Centred Definition

“…A nuanced milieu perspective on the children’s family milieu and their social and cultural capital can help to understand how personal health literacy is acquired and practised within the given social structures and mechanisms [13]. With regard to immigrant adolescents’ health literacy, Santos et al [57] have proposed a similar focus, namely to view health literacy as a socially situated practice, using a bike-riding metaphor: Bike-riding requires the coordination of many working parts (gears, brakes, handle bars, and pedals). Each part has a unique purpose, but their contributions have little meaning apart from the whole.…”

“…Similarly, we view an immigrant adolescent’s process of becoming ‘health literate’ as an evolving coordination of many working parts (e.g., reading skills, math skills, form-filling skills, linguistic choices, digital tools, or interactions that involve any of these skills and tools). The significance of these parts cannot be accurately understood when apart from the social, cultural, and historical context in which immigrant children are growing up.([57] page 4)…”

Adolescent Health Literacy in Beijing and Melbourne: A Cross-Cultural Comparison

“…For example, health literacy initiatives such as the OPtimising HEealth LIterAcy (OPHELIA) toolkit can help address socio-cultural differences between health providers and patients (e.g., children and adolescents), thus narrowing the communication gap and improving access to health information and services [58]. Meanwhile, given that little empirical evidence is available from the young generation [10,59], there is also a need to examine the specific role of culture (e.g., ethnicity, race, ancestry) and how it interacts with health literacy and eventually contribute to health outcomes.…”

“…Compared to adult health literacy, adolescent health literacy is under-researched, particularly from a cultural and societal perspective [10]. The seminal health literacy framework proposed by the Institute of Medicine (IOM) highlights three settings (healthcare; education; culture and society) where health literacy can be developed and enhanced at both individual and population levels [11].…”

“…Cultural and social contexts shape an individual's beliefs and languages and, therefore, influence health literacy [11]. The relationship between health literacy and an individual's cultural beliefs and language backgrounds has been well documented, with immigrants and ethnic minority groups having a higher risk of low health literacy [10,15]. In the present study, we focused on the broad cultural and social environment, rather than an individual's cultural beliefs and language backgrounds.…”