Cultural Context of Health Literacy


Public health promotion efforts should address the sensitivity or importance of health literacy while dealing with the target populations’ needs or unmet needs or the effectiveness and efficiency of health promotion measures. Perhaps, health promotion efforts will not be effectively delivered to the target audience when the health literacy level is suboptimal and when the programs under investigation are not tailored to the cultural awareness or consciousness or sensitiveness of the target population (Crosby, DiClemente, & Salazar, 2013; Parker, & Thorson, 2009; Resnick, & Siegel, 2013). In fact, health literacy, cultural competency, and linguistic competency are three major factors which are critical in promoting a dynamic health awareness and facilitating dissemination of health information, effectively (U.S. Department of Health and Human Services, n.d.). Therefore, integration of health literacy, cultural competency, and linguistic competency assessments into several stages in the health campaign planning or campaign processes are critical steps needed in health promotion improvement processes. Ultimately, the dynamics and motivations of public health or health promotion efforts are driven effectively toward a positive social change when health literacy, cultural, and linguistic competency are integrated at the upstream, intermediate, and downstream stages of health programs; and continuously evaluated during the program’s lifespan (Crosby, DiClemente, & Salazar, 2013; Parker, & Thorson, 2009; Resnick, & Siegel, 2013).

Cultural Context of Health Literacy

Among many related factors including socio-economic status, race, ethnicity, nation of origin, etc. associated with health literacy and cultural awareness, the level of researcher’s formative research on socio-cultural competence within a target population or community could introduce or eliminate or reduce cultural bias within the proposed health program. Avoiding cultural bias is an essential attribute of an efficient and sustainable community-based health assessment within the community in question (Schneiderman et al., 2010). Although ‘health’ and ‘quality of life’ are universal concepts, public health professionals should understand the formative, summative, and socio-construct or socio-operational integrity of “health” within the target community (Schneiderman et al., 2010). Also, health professionals must understand the cultural values associated with ‘health’ within a specific community.

In a cultural context, the term ‘health’ has different interconnections. Some cultural settings do not view ‘health’ as an individual effort but rather as a communal effort. Hence, in such cultural contents, when a family member is experiencing an unhealthy condition, there is enormous social support advanced to the subjects in question, and in such situations depending on the socio-cultural context, family members, in ‘good faith’, are heavily involved in making the health decisions for their loved ones (Chavez, 2013). In a community or cultural environment where communal efforts are highly valued or expected, efficient application of social support system provides a platform for human interconnectivity by providing social resources for quality health and psychological well-being. For instance, researchers showed that immigrants are strongly affected by acculturation, a phenomenon that deals with a dissociation process of immigrants’ national and cultural origin (Chavez, 2013). The acculturation process among immigrants is linked to a phenomenon called “immigrant health paradox” (Chavez, 2013). The immigrant health paradox in most cases promotes depression, rapid aging, chronic disease, etc. (Chavez, 2013). Hence, the fundamental concept of the ‘immigrant health paradox’ is that the longer the immigrants live in society other than their nation of origin, the individuals will lose their cultural values through the lack of social support or support from similar cultural values (Chavez, 2013). As a result, the person’s health and quality of health, deteriorate (Chavez, 2013). Also, the severity of the ‘immigrant health paradox’ impacts, depends on the level of sensitivity or socio-cultural awareness or health literacy of the community to which the immigrants lives.

Health literacy implicates the level of understanding an individual or group of persons attain regarding the operational construct of health values within a given society. Nonetheless, whatever the construct definition of health is in a particular community, the standard operational health status and quality of life values should be effectively communicated to individuals or group of individuals, communities, health organizations, and health practitioners (Chavez, 2013; USDHHS, n.d.). For instance, in Europe and other continents, health officials are concerned that nutritional habits or types of nutrition are associated with many chronic conditions; hence, they required labeling of nutritional products. Also, others promote labeling of nutritional products to differentiate non-organic products from organic food products, and perhaps, to encourage informed decision-making process or health literacy on nutritional lifestyle among consumers (Séralini, et al., 2012).

More importantly, promotion of health literacy is a multidirectional process involving pioneer companies, health professionals/governmental health agencies, and consumers’ participation in the process. It is the obligation of the pioneer companies introducing a product in the marketplace to ensure that the product’s risks and benefits are clearly communicated to health professionals and the public. Also, it is the obligation of health professionals/health agencies to disseminate information regarding the risks and benefits of any product to consumers in a clear and unambiguous language or manner (Resnick, & Siegel, 2013). Consumers on the receiving end should understand the implications and applications of a given health program/intervention, and how it is associated with their health condition or meant as a prophylaxis or an intervention for their health condition to achieve the intended health promotion goals (Resnick, & Siegel, 2013). For instance, inappropriate use of child-car-seat restraints could result in devastating health consequences. The lack of efficient knowledge transfer that child restraints are 71% effective in reducing children risk of death in vehicle crashes could cause devastating health consequences in preventative measures implicating car crashes (Resnick, & Siegel, 2013). In 1996, four state studies showed that 80% of participants made at least one significant error in installation of child restraint, and 72% did not use a locking clip or used it incorrectly while 17% used the vehicle seat belt incorrectly (Resnick, & Siegel, 2013). Hence, lack of appropriate knowledge transfer of effective health measures contributes to the avoidable consequences of health literacy disparity associated with loss of life or poor quality of life (Resnick, & Siegel, 2013).

Cultural awareness, on the other hand, is the ability to exercise cultural competency through a formative research. Cultural awareness is a tool needed for health professional to communicate effectively with individuals or communities in meeting their unmet needs. More so, cultural awareness creates a sense of inclusiveness and bridges the gaps of exclusiveness between the consumers and health professionals or the society in question (Resnick, & Siegel, 2013; USDHHS, n.d.). Therefore, for a health promotion program to be a successful continuum process, an effective cultural awareness campaign should be integrated into the evaluation processes of the health programs.

Ultimately the goal of public health efforts or health promotion measures is to maintain, support, and establish a healthy community. Therefore, health practitioners apply several research means including formative, normative, and summative evaluations of health promotion efforts within the community to achieve a well-grounded intervention approach. Thus, social support networks focus on the emotional and mental support, instrumental or physical support, informational (personal connections and links or access to information), and appraisal support in dealing with the populations’ level of satisfaction with the health intervention, under investigation (Chavez, 2013). These health-related support systems are integral in the level of health literacy and cultural awareness evaluation processes within the community and target population. The social network provides support that averts alienation, isolation, de-identification, depression, psychological trauma, etc. which are destructive factors to individual well-being or the population quality of life (Chavez, 2013). However, even when social support systems are necessary for promoting health literacy and cultural awareness, lack of individual’s effort and understanding of their needs may derail the health promotion efforts. Hence, individual’s motivation, opportunity, and ability are critical support systems to health education, health policies, and health marketing tools, and should be provided fairly and proportionately to everyone (Resnick, & Siegel, 2013).


Chavez, V. (2013). Social support networks. [Waldenu video file]. Retrieved from

Crosby, R., DiClemente, R., & Salazar, L. (2013). Research methods in health promotion (Laureate Education, Inc., custom ed.). San Francisco: Jossey-Bass

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Resnick, E., & Siegel, M. (2013). Marketing Public Health: Strategies to Promote Social Change, Third Edition. Burlington, MA: Jones & Bartlett Learning.

Schneiderman, N., Speers, M. A., Silva, J.M., Tomes, H & Gentry, J.H.( 2010). Integrating behavioral and social sciences with public health. American Psychological Association, Washington DC

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U.S. Department of Health and Human Services. (n.d.). Culture, language and health literacy. Retrieved February 13, 2014, from