The author spends 7 chapters talking about knowing the audience. I think in any field of literacy, the “reader” is always the most important subject. Considering the 500 words limit, I decide to stick to my four-chapter-one article strategy. Here are the four “audience”:


In clinical settings, what is more complex about pediatric Health Literacy (HL) is that it must be considered in both parents’, caregivers’ and children’s HL. I think this is not only because, as the author states, that if you let children actively participate they would be more cooperative in treatment and be more honest about their health related behavior. But more importantly, as my past job in a hospital in Taiwan trained me, it is more “ethical” to let the patient himself/herself involves in the whole process. However it’s harder than adults, since children are usually ill and need to have unpleasant medical procedures. Using humor and real-life examples in hospitals might help the communication. For health children, provide age-appropriate education in school such as teaching them to read the nutrition labels is also an important HL skill training.

Culture and Language (the author has such great points so I decide to quote her saying directly)

As the author argues in the beginning of this chapter, “accessing, using, and understanding the U.S. healthcare system is difficult for almost everyone. But for people who speak limited English or come from other cultures, these tasks might seem impossible”. And, “as the U.S. population grows increasingly diverse, situation like these are becoming more common”.

US now has more Spanish speakers than Spain – only Mexico has more

Furthermore, even these people might be able to “talk about the food or weather”, but to discuss health condition? Not so well.

In addition, culture “impacts how people understand and make sense of health information”. The author gives two examples. First for some regions, health resource are scary, therefore they may not understand why blood pressure checks are routinely recommended. And second, in some cultures, patients are not the ones to make health decisions, so the “decision maker” must be included when discussing.

Emotions and Cognition

Since the author (and me) have talked several times about the influence of emotions in HL in my past articles, I would focus on the cognition part.

Cognitive problems, such as memory loss, dementia and mental illness, most of time will affect concentration, memory and communication, which are all important to literacy. The author provides some strategies to better communicate with these patients. One that relates to reading and writing is that to assist them writing a summary of what was discussed to help them memorizing and understanding.

Hearing Loss

For these patients, “literacy” could have a totally different meaning. Sign language such as American Sign Language (ASL); reading lips; or writing are some of the communicating systems. One thing to notice is that people usually think written information benefits all the hearing loss patients, “but this is not necessarily so—particularly for those who have been Deaf (with the capital D for distinguish)” since birth”, because they have never “heard” of those “words” like hearing people have to learn.

Question for thinking:

Cultural diversity—multicultural society seems to be the future trend of the States. How should both the education and health system “develop” for this change? (Big question, I know!)
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