Leveraging Digital Strategies to Address Health Disparities Part 4: Speak the Right Language

Lygeia RicciardiThis post is the fourth in a five-part series on disparities and digital health, including Measure What You Want to Manage, Navigate the Digital Divide, and Design for Your Population’s Needs.


Did you know that there are 337 languages spoken in the US? According to the US Census, Spanish is the second-most common language after English, with 35 million speakers. While it may not be practical to translate into every relevant language spoken by members of the particular population you’re addressing, it makes sense to try and cover a few of the most popular.

Languages Spoken in the US

Source: Wikimedia Commons

Health Literacy

Health literacy is the capacity to find, process, and understand basic health information needed to make appropriate health decisions. Poor health literacy can pose an even greater challenge than language barriers, since nearly 90% of adults have difficulty using the information routinely available in health care facilities, retail outlets, and communities, according to the Federal Office of Disease Prevention and Health Promotion.

Wow—speaking for myself I often ignore those text-dense inserts packaged with medications because I find them hard to digest. Not surprisingly, people over 65, with lower education levels, and with lower income levels are the most likely to face health literacy challenges. It is estimated that 40% of African Americans and 58% of Hispanics are health illiterate. Individuals with low literacy are hospitalized 50%–69% more often than those with a higher level of health literacy, at an annual cost of $17 billion  in legal and operational expenses in the US. This federal guide provides basic pointers for presenting health information clearly in a digital context.

Cultural Sensitivity

In the Peace Corps my husband regularly washed his clothes in a laundry detergent called “Barf,” which probably wouldn’t sell so well in the predominantly English-speaking world. In Farsi “barf” translates roughly into “snow.” Let’s just say it’s important to be aware of any double meanings or cultural associations the population you’re trying to reach may have with the words and images you use in reaching them. Make sure to pre-test, even with an informal focus group.


Source: The Uncornered Market blog

Spotlight: One organization that is successfully addressing language and communication barriers for underserved (and other) populations is Kaiser Permanente. At their facilities in downtown Washington DC I’ve had a chance to try their multi-language medical interpreting service, through which a phone in the examining room connects patients to one of many offsite individuals who can live translate between them and the clinical team.

Spotlight: Research by Professor Sheila Murphy and her colleagues at the University of Southern California’s Annenberg School of Communication and Journalism shows empirically that videos with narrative stories are more effective at spreading cancer knowledge and encouraging people to get cancer screenings than non-narrative videos. The story format works particularly effectively when characters are “transported” by an engrossing story and when they can relate to characters of the same ethnic group. 

Your Input

How have you adjusted language, literacy, and cultural context to communicate with particular underserved populations about health? Please share your thoughts and experience through the HIMSS Linked In Group! And stay tuned for the next installment in this series, Leveraging Digital Strategies to Address Health Disparities: Engage the Community.

HIMSS Resources: