Enhancing cultural competency and health literacy: a critical component to quality care and empowerment

Health literacy concerns the knowledge and competences of individuals to meet the complex demands of health in modern society. Although its importance is increasingly recognized, there are no good studies of health literacy assessment, monitoring, and evaluation over time to give a sense of the effectiveness of public health and clinical interventions to empower the public and patients to improve health [1].

As a result of the 7th Global Conference on Health Promotion held in 2009. WHO encouraged member states to focus on the public health development based on the concept of health literacy, which refers to cognitive and social skills of individuals to access, understand, and use information to promote and maintain a healthy life [2].

The study by Intarakamhang and Kwanchuen in the present issue attempts to develop and apply the ABCDE-health literacy scale for Thai adults in a first attempt to use standard tools for health literacy assessment [3]. Standard tools would allow comparability of the level of health literacy over time if a good monitoring system is developed by authorities concerned. Monitoring is essential to assess the effectiveness of public health interventions, and enhance the development of more effective health literacy improvement strategies.

Sociocultural factors, race, ethnicity, and limited language proficiency within and between countries also influence the effectiveness of clinical preventive services and clinical care. Sociocultural background influences a patient’s perspectives, values, beliefs, and behaviors regarding health and wellbeing. Health literacy is, therefore, increasingly important in the delivery of quality health care [4, 5]. Various cultures, ethnicity, and language proficiency determines whether patients recognize their symptoms and their thresholds for seeking care. Sociocultural factors also influence the patients’ comprehension of management strategies, expectations of, and adherence to preventive measures and medications.

Cultural competency standards were developed to bridge the cultural sensitivity in the hospital environment [6]. The design, measurement, and evaluation of clinician–patient communication is a key to quality care [7]. A tool is available to assess, monitor, and evaluate the provider’s cultural competencies on patient satisfaction [8]. This may eventually lead to development of more effective strategies to communicate with and thus empower patients to have greater contribution to their health and clinical outcomes because it may overcome the clinician’s failure to recognize and understand the sociocultural differences between their patients and themselves [9].