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      International Perspective on Health Literacy and Health Equity: Factors That Influence the Former Soviet Union Immigrants

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          Abstract

          Among the world’s 272 million international migrants, more than 25 million are from the former Soviet Union (FSU), yet there is a paucity of literature available about FSU immigrants’ health literacy. Besides linguistic and cultural differences, FSU immigrants often come from a distinct healthcare system affecting their ability to find, evaluate, process, and use health information in the host countries. In this scoping review and commentary, we describe the health literacy issues of FSU immigrants and provide an overview of FSU immigrants’ health literacy based on the integrated health literacy model. We purposefully consider the three most common locations where FSU immigrants have settled: the USA, Germany, and Israel. For context, we describe the healthcare systems of the three host countries and the two post-Soviet countries to illustrate the contribution of system-level factors on FSU immigrants’ health literacy. We identify research gaps and set a future research agenda to help understand FSU immigrants’ health literacy across countries. Amidst the ongoing global population changes related to international migration, this article contributes to a broad-scope understanding of health literacy among FSU immigrants related to the system-level factors that may also apply to other immigrants, migrants, and refugees.

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          Most cited references112

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          Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California.

          This study estimated health status by low health literacy and limited English proficiency alone and in combination for Latino, Chinese, Korean, Vietnamese, and White respondents in a population-based sample: 48,427 adults from the 2007 California Health Interview Survey, including 3,715 with limited English proficiency. Multivariate logistic models examined self-reported health by health literacy and English proficiency in the full sample and in racial/ethnic subgroups. Overall, 44.9% with limited English proficiency reported low health literacy, versus 13.8% of English speakers. Among the limited English proficient, Chinese respondents had the highest prevalence of low health literacy (68.3%), followed by Latinos (45.3%), Koreans (35.6%), Vietnamese (29.7%), and Whites (18.8%). In the full sample, respondents with both limited English proficiency/low health literacy reported the highest prevalence of poor health (45.1%), followed by limited English proficiency-only (41.1%), low health literacy-only (22.2%), and neither (13.8%), a hierarchy that remained significant in multivariate models. However, subanalyses revealed that limited English proficient Latinos, Vietnamese, and Whites had equal or greater odds of poor health compared with low health literate/limited English proficient respondents. Individuals with both limited English proficiency and low health literacy are at high risk for poor health. Limited English proficiency may carry greater health risk than low health literacy, though important racial/ethnic variations exist.
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            Health Education as Social Policy

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              Achieving Health Equity: Closing The Gaps In Health Care Disparities, Interventions, And Research.

              In the United States, racial/ethnic minority, rural, and low-income populations continue to experience suboptimal access to and quality of health care despite decades of recognition of health disparities and policy mandates to eliminate them. Many health care interventions that were designed to achieve health equity fall short because of gaps in knowledge and translation. We discuss these gaps and highlight innovative interventions that help address them, focusing on cardiovascular disease and cancer. We also provide recommendations for advancing the field of health equity and informing the implementation and evaluation of policies that target health disparities through improved access to care and quality of care.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                24 March 2020
                March 2020
                : 17
                : 6
                : 2155
                Affiliations
                [1 ]School of Nursing and Dental Hygiene, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA; cherylal@ 123456hawaii.edu
                [2 ]Interdisciplinary Center for Health Literacy Research, Bielefeld University, 33699 Bielefeld, Germany; eva-maria.berens@ 123456uni-bielefeld.de
                [3 ]Department of Health Education and Promotion, Clalit Health Services, School of Public Health, University of Haifa, Haifa 31000, Israel; diamos@ 123456zahav.net.il
                [4 ]Kazakhstan School of Public Health, Medical University, Almaty 050000, Kazakhstan; altyn.aringazina@ 123456gmail.com
                [5 ]National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of the Russian Federation, 101000 Moscow, Russia; MLopatina@ 123456gnicpm.ru
                [6 ]Chamberlain College of Nursing, Chamberlain University, Downers Grove, 60515 IL, USA; LIvanov@ 123456chamberlain.edu
                [7 ]Office of Public Health Studies, University of Hawai’i at Mānoa, Honolulu, HI 96822, USA; tsentell@ 123456hawaii.edu
                Author notes
                [* ]Correspondence: uliana@ 123456hawaii.edu
                Author information
                https://orcid.org/0000-0002-0032-6815
                Article
                ijerph-17-02155
                10.3390/ijerph17062155
                7142703
                32213891
                2c127171-9d89-4138-acef-be53e882393e
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 January 2020
                : 16 March 2020
                Categories
                Review

                Public health
                immigrant,migrant,refugee,soviet,russian-speaking,access to care,healthcare system
                Public health
                immigrant, migrant, refugee, soviet, russian-speaking, access to care, healthcare system

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