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Yet the nursing literature offers minimal help in integrating cultural and linguistic considerations into nursing efforts to address patient health literacy.Nurses are in an ideal position to facilitate the interconnections between patient culture, language, and health literacy in order to improve health outcomes for culturally diverse patients.As authors we use the broadly accepted definition of health literacy developed by Ratzan and Parker (2000) and used in the 2004 Institute of Medicine (IOM) report, titled Health Literacy: A Prescription to End Confusion.In this report, health literacy was defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (IOM, 2004, p. This definition expands upon earlier conceptual understandings of health literacy, which focused chiefly on the written word and native speakers of English.In this article the authors begin by describing key terms that serve as background for the ensuing discussion explaining how culture and language need to be considered in any interaction designed to address health literacy for culturally diverse patients.The authors then discuss the interrelationships between health literacy, culture, and language. Vol14No03Man04 Keywords: health literacy, culture, cultural competence, interpretation, limited English proficiency (LEP), linguistic competence, transcultural nursing, communication, racial and ethnic health disparities Low health literacy, cultural barriers, and limited English proficiency have been coined the “triple threat” to effective health communication by The Joint Commission (Schyve, 2007).Next we will discuss the interrelationships between health literacy, culture, and language.

Because health literacy is an emerging field, examination of culture and language as determinants of patient health literacy has been limited (Andrulis & Brach, 2007; Chang & Kelly, 2007; Nguyen & Bowman, 2007; Zanchetta & Poureslami, 2006).

This will be followed by a description of how literacy skills are affected by culture and language, a note about culturally diverse, native-born patients, and a presentation of case examples illustrating how culture and language barriers are seen in patients’ healthcare experiences.

We will conclude by offering recommendations for promoting health literacy in the presence of cultural and language barriers and noting the need for nursing interventions that fully integrate health literacy, culture, and language.

The second aim is to demonstrate the need for nursing interventions that fully integrate health literacy, language, and culture.

First we will describe key terms that serve as background for the ensuing discussion explaining how culture and language need to be considered in any interaction designed to address health literacy for culturally diverse patients.

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