title: Strategies for health education in North American immigrant populations.
abstract: OBJECTIVE
  This article is intended to stimulate critical thinking about barriers and strategies related to health education for immigrant populations. Its rationale is to promote an understanding and appreciation for the individuality and diversity of immigrant beliefs, values and culture, and how these contribute to health education through nursing practice, research and theory.
  
  
  BACKGROUND
  Since 2005, over 1,250,000 immigrants annually have obtained legal permanent residence in North America [over 1 million annually in the United States of America (USA) and over 250,000 annually in Canada].
  
  
  OBJECTIVE
  While a broad immigration policy leads to population growth, cultural change and ethnic diversity, migration impacts immigrants' health status. In North America, the 'healthy immigrant effect', whereby immigrants generally tend to be healthier than individuals born in host countries, steadily declines after immigration.
  
  
  METHODS
  Immigration statistics and reports on literacy and learning were sourced from official websites in Canada and the USA. These were reviewed and discussed in the context of scholarly published literature on health literacy, health education and health promotion.
  
  
  METHODS
  Promoting health in immigrant populations is difficult due to cultural, linguistic, health literacy and socio-economic barriers. Cultural sensitivity, careful inquiry and comprehensive knowledge of immigrants' social circumstances are essential to every health education programme.
  
  
  CONCLUSIONS
  Strategies for immigrant health education must be technologically diverse, involve partnerships with multidisciplinary professionals, elicit active community participation, and facilitate language transfer and interpretation. Future research must continue to explore these barriers and strategies, using both qualitative and quantitative methodologies.
authors.affiliation: Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada. ping.zou@utoronto.ca
authors.forename: P
authors.initials: P
authors.lastname: Zou
authors.forename: M
authors.initials: M
authors.lastname: Parry
mesh_terms: D002170:Canada; D018864:Cultural Diversity; D054242:Emigrants and Immigrants; D006266:Health Education / Q000379:methods*; D057220:Health Literacy; D007802:Language; D012923:Social Class; D014481:United States