Language Barriers, Health Literacy, and Discharge

Language barriers are a reality of the Canadian health care system, particularly in large urban centres such as Toronto, where over 60% use a mother tongue other than English or French at home, and 5% of respective residents report having no knowledge of either of Canada’s official languages. Individuals with language barriers face significant challenges in navigating the health care system, leading to poor self-reported health¹, increased medical errors², poor compliance with therapy and follow-up³ and increased costs⁴. Defined as “the degree to which individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions⁵,” an estimated 55% of Canadians between the ages of 16 and 65 have low health literacy, and only 12% of those above 65 have adequate health literacy skills. Poor health literacy leads to poor outcomes, especially among the elderly, those with limited education, chronic health diseases, and immigrants with added language barriers.

The period following discharge from a hospital is a vulnerable time for patients. The transition of care responsibilities from the hospital to the primary care provider or from the hospital to the patient frequently results in adverse events, particularly medication errors. Imagine how much worse this can be for patients with language or health literacy barriers. Share your thoughts with us!

If you have been admitted to the hospital in the last year, or have a close family member who was, please consider contacting us and getting involved in the PODS project. Contact Shoshana Hahn-Goldberg at shoshana.hahn-goldberg@uhn.ca

[1] Canadian Institute for Health Information. All-Cause Readmission to Acute Care and Return to the Emergency Department. 2012 June 14. Downloaded May 10 2013 from https://secure.cihi.ca/free_products/Readmission_to_acutecare_en.pdf

[2] Dowse R, Ehlers M. Medicine labels incorporating pictograms: do they influence understanding and adherence? Patient Educ Couns. 2005; 58:63-70.

[3] Mansoor LE, Dowse R. Effect of pictograms on readability of patient information materials. Ann Pharmacother. 2003; 37:1003-9.

[4] Morrow DG, Hier CM, Menard WE et al. Icons improve older and younger adults’ comprehension of medication information. J Gerontol B Psychol Sci Soc Sci. 1998; 53B:P240-54.

[5]. Patel V, Eisemon T, Arocha J. Comprehending instructions for using pharmaceutical products in rural Kenya. Instr Sci.1990; 19:71-84.