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'Health Literacy is a Two-Way Street'

'Health Literacy is a Two-Way Street'

Picture of Jessica Ogilvie

For journalists, the topic of health care disparities - particularly in Los Angeles - is a familiar concept. Exploring the discrepencies in care between various socioeconimic and ethnic groups often leads down a road of dismal statistics and frustrating realities. 

But what happens if we refocus our gaze away from the patients and onto the providers?

The phrase "health literacy" is generally taken to mean how well a patient understands their medical care. But Rishi Manchanda, MD, MPH who introduced today's first panel, Barriers to Health Literacy, challenged panelists and attendees to consider the possibility that as a provider, "maybe it's not about them not understanding me, it's about me not understanding them."

Panelist Lark Galloway-Gilliam, MPA, commented on the "arrogance of western medicine," adding that providers look at health literacy as, "it is the patient who is illiterate, and what I've learned is that it is often the provider who is illiterate in the broader sense."

The founding director of the Edward R. Roybal Institute on Aging, Jorge J. Lambrinos, MA, began the discussion by bringing up ways in which the Latino and Hispanic community in particular -- which makes up nearly 50% of the population in L.A. -- may encounter difficulties in communicating with their providers -- and it's not int he way you might think.

In a study Lambrinos did with Latinas over the age of 50, for instance, he found that there was a misconception that breast cancer is caused by injury to the breast.

"That's why they didn't want to go and get a mammogram," said Lambrinos of the study participants. "You go in with beautiful breasts and come out with flat breasts."

Lambrinos added that many Latino and Hispanic patients have certain expectations for their providers. They expect that elders will be treated with respect, for instance, such as being addressed with the formal second person - "usted" - rather than "tu," that the establishment of a personal relationship with a provider translates into a high level of trust, and that many patients expect their families to be heavily involved in their health care.

Building on the message given by Lambrinos, Galloway-Gilliam encouraged providers not to just tell patients what to do, but to understand what may be standing in the way of their adherence to care. By providing more specific suggestions and taking the time to have in-depth conversations, providers can empower patients to take control of their health and their lives.

"You can teach people about eating well, but do we ever ask, 'where do you get your food?,'" she said.

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