title: Healthcare Communication Barriers and Self-Rated Health in Older Chinese American Immigrants.
abstract: Older Chinese immigrants are a growing population in the United States who experience multiple healthcare communication barriers such as limited English proficiency and low health literacy. Each of these obstacles has been associated with poor health outcomes but less is known about their effects in combination. This study examined the association between healthcare communication barriers and self-rated health among older Chinese immigrants. Cross-sectional survey data were obtained from 705 Chinese American immigrants ages 50-75 living in San Francisco, California. Communication barriers examined included spoken English proficiency, medical interpreter needs, and health literacy in written health information. The study sample (81 % females, mean age = 62) included 67 % who spoke English poorly or not at all, 34 % who reported needing a medical interpreter, and 37 % who reported "often" or "always" needing assistance to read health information. Two-thirds reported poor self-rated health; many reported having access to racial-concordant (74 %) and language-concordant (86 %) healthcare services. Both poor spoken English proficiency and low health literacy were associated with poor self-rated health, independent of other significant correlates (unemployment, chronic health conditions, and having a primary doctor who was ethnic Chinese). Results revealed that spoken English proficiency and print health literacy are independent communication barriers that are directly associated with health status among elderly Chinese American immigrants. Access to racial- or language-concordant health care services did not appear to resolve these barriers. These findings underscore the importance of addressing both spoken and written healthcare communication needs among older Chinese American immigrants.
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave (TRC-0984), San Francisco, CA, 94143, USA. janice.tsoh@ucsf.edu.|Asian American Research Center for Health (ARCH), San Francisco, CA, USA. janice.tsoh@ucsf.edu.
authors.forename: Janice Y
authors.initials: JY
authors.lastname: Tsoh
authors.affiliation: Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA.
authors.forename: Tetine
authors.initials: T
authors.lastname: Sentell
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA.
authors.forename: Ginny
authors.initials: G
authors.lastname: Gildengorin
authors.affiliation: Asian American Research Center for Health (ARCH), San Francisco, CA, USA.|Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA.
authors.forename: Gem M
authors.initials: GM
authors.lastname: Le
authors.affiliation: Department of Psychiatry, University of California, San Francisco, 401 Parnassus Ave (TRC-0984), San Francisco, CA, 94143, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Chan
authors.affiliation: Health Education Department, Chinatown Public Health Center, San Francisco, CA, USA.
authors.forename: Lei-Chun
authors.initials: LC
authors.lastname: Fung
authors.affiliation: Asian American Research Center for Health (ARCH), San Francisco, CA, USA.|University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
authors.forename: Rena J
authors.initials: RJ
authors.lastname: Pasick
authors.affiliation: Division of Biostatistics, University of California, Davis, CA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Stewart
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA.
authors.forename: Ching
authors.initials: C
authors.lastname: Wong
authors.affiliation: NICOS Chinese Health Coalition, San Francisco, CA, USA.
authors.forename: Kent
authors.initials: K
authors.lastname: Woo
authors.affiliation: Asian American Research Center for Health (ARCH), San Francisco, CA, USA.|Health Education/Holistic Health Studies, San Francisco State University, San Francisco, CA, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Burke
authors.affiliation: Asian American Research Center for Health (ARCH), San Francisco, CA, USA.|Academy of Chinese Culture and Health Sciences, Oakland, CA, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: McPhee
authors.affiliation: Asian American Research Center for Health (ARCH), San Francisco, CA, USA.|Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA.
authors.forename: Tung T
authors.initials: TT
authors.lastname: Nguyen
mesh_terms: D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D057220:Health Literacy; D006304:Health Status; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology
keywords: Communication barriers; Health literacy; Health status; Immigrant health; Limited English proficiency