Better Health Through Better Understanding for Hispanics/Latinos: Health Literacy, Barriers to Healthcare, and Improving Language Access and Health Outcomes 2023 Reading List
This brief bibliography contains various resources focused on Hispanic/Latino health, health literacy, and limited English proficiency (LEP). The list contains three sections:
- Factsheets and resources for consumers.
- Reports for health providers, and other professionals.
- Peer-reviewed journal articles.
All the resources in this list are available to read and download for free. For more resources on the health of racial and ethnic minority populations, contact the OMH Knowledge Center or browse the online catalog.
Health Status
Hispanics/Latinos are the largest racial and ethnic minority population in the United States (U.S.), representing 18.8 percent of the total U.S. population in 2021. This group includes any person of Cuban, Mexican, Puerto Rican, South or Central American descent, or another Spanish- speaking culture or origin, regardless of race. The 2019 American Community Survey data show that the proportion of Hispanics who speak a language other than English at home are as follows: Spanish (93.8 percent), French and Cajun (2.5 percent), and German and other West Germanic languages (1.8 percent). Limited English proficiency (LEP) and limited English fluency are barriers in healthcare, limiting effective patient-provider communication and therefore impacting health care access and health outcomes.
- According to the Centers for Disease Control and Prevention (CDC), compared to other racial and ethnic groups, Hispanics have higher rates of illness and death for certain chronic health conditions including heart disease and diabetes. Hispanic adults are more than 50 percent likely to develop type 2 diabetes in their lifetime and are likely to develop it at a younger age. This population is also burdened with higher rates of diabetes-related conditions such as kidney failure, vision loss, and blindness, and are 30 percent more likely to die from diabetes. Additionally, Hispanics are impacted by infectious diseases including hepatitis C and HIV.
- The Hispanic population has the highest uninsured rate of any racial or ethnic group within the U.S. According to the 2021 U.S. Census Bureau report, the uninsured rate for Hispanic individuals was 18.3 percent, compared to 5.2 percent for non-Hispanic whites.
Health Literacy and LEP
In addition to the high burden of disease and high uninsured rate, Hispanics have the lowest health literacy levels compared to other racial and ethnic groups, largely due to language barriers, which contribute to health disparities. According to the CDC, and reinforced in the Healthy People 2030 initiative, health literacy includes both personal and organizational elements.
- Personal health literacy entails an individual’s ability to find, understand, and use information and services to inform health-related decisions and take deliberate actions for themselves and others.
- Organizational health literacy focuses on an organization enabling individuals to find, understand, and use information and services to inform health-related decisions and take informed actions for themselves and others.
- Racial and ethnic minority groups have the lowest health literacy levels (National Center for Education Statistics), and these groups also experience a disproportionate burden of disease. Therefore, it is important to find ways to improve their access, understanding, and use of health information to achieve better health outcomes.
- The CDC further explains that health disparities are inequitable and are related to unequal distribution of social, political, economic, and environmental resources, and that disparities can be reduced by addressing the nonmedical factors that influence health outcomes, known as social determinants of health (e.g. education, income, occupation, neighborhood, healthcare access, language and literacy skills).
Building capacity to improve language access for LEP individuals is pivotal for promoting health literacy among Hispanics/Latinos.
- LEP individuals are defined as “the population 5 years or older who self-identify as speaking English less than ‘very well’ according to the U.S. Census 2008-2012 American Community Survey 5-Year Estimate data.” Recent Census data show that over 64 million individuals residing in the U.S. speak a language other than English in their homes, and of these people, nearly 26 million are considered LEP.
- LEP individuals have poorer health outcomes than individuals who speak English proficiently in healthcare settings. LEP individuals tend to use health resources less often, including preventative services and prescription medications. They are more likely to receive incomplete aftercare or discharge instructions from providers and are less likely to provide full, documented consent that they understand the risks and benefits of a medical procedure.
- When providers fail to provide language access services (i.e., professional translators), LEP individuals often depend on translations from family members or other medical staff who are not trained in medical interpretation.
While the current literature shows that LEP is a significant barrier to adequate healthcare for millions of individuals in the U.S., including Hispanics, it also shows that there are countless opportunities, as well as enthusiasm, to improve language access services. Culturally tailored interventions and culturally and linguistically appropriate services have been shown to be effective in improving health outcomes.
Resources
These resources are intended for Hispanics/Latinos, health providers, and other professionals to learn more about issues that affect the Hispanic/Latino community. Please click on the title to learn more about each topic. Additional related resources in the online catalog may be accessed here.
2020 Profile of Hispanic Americans Age 65 and Older. Administration of Community Living, acl.gov, 2021.
2022 Heart Disease & Stroke Statistical Update Fact Sheet: Hispanic/Latino Race & Cardiovascular Diseases. American Heart Association, heart.org, 2022.
Alcohol and the Hispanic Community. National Institute on Alcohol Abuse and Alcoholism, niaaa.nih.gov, 2019.
Cancer Facts & Figures for Hispanic/Latino People 2021-2023. American Cancer Society, cancer.org, 2021. English Version | Spanish Version
COVID-19 and the Latinx Community: Skills to Reduce Stress, Stigma, and Substance Use. Addiction Technology Transfer Center Network, attcnetwork.org, 2021.
Health of Hispanic or Latino Population. National Center for Health Statistics, Centers for Disease Control and Prevention, cdc.gov, 2023.
Hispanic and Asian Subgroups Are at Higher Risk for Diabetes. Centers for Disease Control and Prevention, cdc.gov, 2019
Hispanics/Latinx and Hepatitis: An Overlooked Health Disparity. Latino Commission on AIDS, hispanichepatitisday.org, 2018.
Medicare & You 2023: The Official U.S. Government Medicare Handbook. Centers for Medicare & Medicaid Services, medicare.gov, 2022.
Mental Health Disparities: Hispanics and Latinos. American Psychiatric Association, psychiatry.org, 2017.
National Healthcare Quality and Disparities Report: Chartbook on Health Care for Hispanics. Agency for Healthcare Research and Quality, ahrq.gov, 2015.
Social Determinants of Health among the Rural Hispanic Population. Rural and Minority Health Research Center, sc.edu, 2019.
Understanding the Health Needs of Diverse Groups of Hispanic Medicare Beneficiaries. Office of Minority Health, Centers for Medicare & Medicaid Services, cms.gov, 2018.
Best Practice Highlights: Latino/as and Hispanics. American Psychiatric Association, psychiatry.org, 2017.
Contact Tracing and the Challenges of Health Equity in Vulnerable Latino and Native American Communities: Proceedings of a Workshop--In Brief. National Academies of Sciences, Engineering, and Medicine, nap.nationalacademies.org, 2021.
Depression and Anxiety Among Latinos: Urgent Call for Mental Health Services. Latino Center for Health, latinocenterforhealth.org, 2021.
Health Insurance Coverage in the United States: 2021. U.S. Census Bureau, census.gov, 2022.
Latino Views on COVID-19 Vaccinations: Understanding Hesitancy. Latino Center for Health, latinocenterforhealth.org, 2021.
Latinos, COVID-19, and Social Belonging: Voices from the Community. UnidosUS, unidosus.org, 2021.
The Health Literacy of America's Adults Results From the 2003 National Assessment of Adult Literacy. National Center for Education Statistics, eric.ed.gov, 2006.
A Psychometric and Relative Importance Evaluation of Health Literacy and Health Consciousness on COVID-19 Preventative Behaviors Among Hispanic Adults. Health Education & Behavior, v. 50, #2 (April), p. 161-171, 2023.
Addressing Health Disparities in Hispanic Communities Through an Innovative Team-Based Medical Spanish Program at the Medical School Level: A Single-Institution Study. BMC Medical Education, v. 22 (February 14): Art. 98, 2022.
Alzheimer’s Disease in Bilingual Latinos: Clinical Decisions for Diagnosis and Treatment Planning.Journal of Health Service Psychology, v. 14, #4 (October 12), p. 171-179, 2021.
Assessment of Spanish Translation of Websites at Top-Ranked US Hospitals. JAMA: Journal of the American Medical Association, v. 4, #2 (February): Art. e2037196, 2021.
Association between Health Literacy and Medication Adherence among Hispanics with Hypertension. Journal of Racial and Ethnic Health Disparities, v. 6, #3 (June), p. 517–524, 2019.
Associations of Acculturation with English- and Spanish-Language Health Literacy Among Bilingual Latino Adults. Health Literacy Research and Practice (HLRP), v. 3, #2 (April 10), p. e81-e89, 2019.
Barriers in Healthcare for Latinx Patients with Limited English Proficiency—a Narrative Review. Journal of General Internal Medicine, v. 38, #5 (April), p. 1264-1271, 2023.
Birthing Experiences of Spanish Speakers during the COVID-19 Pandemic in NYC. Journal of Immigrant and Minority Health, v. 24, #4 (August), p. 1013-1019, 2022.
Collaborating with Culturally Competent Prenatal Education among Hispanic Communities. Kansas Journal of Medicine, v. 15 (January 11), p. 1-7, 2022.
Colorectal Cancer Screening: Understanding the Health Literacy Needs of Hispanic Rural Residents.AIMS Public Health, v. 6, #2 (April 1), p. 107-120, 2019.
Cost and Healthcare Utilization Analysis of Culturally Sensitive, Shared Medical Appointment Model for Latino Children with Type 1 Diabetes. Pediatric Diabetes, v. 22, #5 (August), p. 816-822, 2021.
COVID-19–Related Care for Hispanic Elderly Adults with Limited English Proficiency. Annals of Internal Medicine, v. 175, #1 (January), p. 143-145, 2022.
Culturally Adapted Depression Education and Engagement in Treatment among Hispanics in Primary Care: Outcomes from a Pilot Feasibility Study. BMC Family Practice, v. 20 (October 21): Art. 140, 2019.
Culturally Tailored Interventions for Ethnic Minorities: A Scoping Review. Nursing Open, v. 8, #5 (September), p. 2078-2090, 2021.
Current Approaches to Cancer Genetic Counseling Services for Spanish-Speaking Patients. Journal of Immigrant and Minority Health, v. 21, #2 (April), p. 434–437, 2019.
Development of a Computerized Intervention to Improve Health Literacy in Older Hispanics with Type 2 Diabetes Using a Pharmacist Supervised Comprehensive Medication Management. PLoS One, v. 17, #2 (February 9): Art. e0263264, 2022.
Does Healthcare Provider Counseling for Weight Management Behaviors among Hispanic Adults Who Are Overweight/Obese Vary by Acculturation Level? International Journal of Environmental Research and Public Health, v. 20, #4 (February): Art. 2778, 2023.
Engaging a Predominantly Latino Community in HIV Prevention: Laying the Groundwork for Pre-Exposure Prophylaxis and HIV Sexual Health Programs. Journal of the Association of Nurses in AIDS Care, v. 31, #1 (January-February), p. 92-97, 2020.
Engaging Latino Families about COVID-19 Vaccines: A Qualitative Study Conducted in Oregon, USA. Health Education & Behavior, v. 48, #6 (December), p. 747-757, 2021.
Evaluation of a Spanish Health Topics Course for Undergraduate Pre-Health Latino Students. Cureus, v. 11, #10 (October 2): Art. e5825, 2019.
Experiences of Advanced Breast Cancer among Latina Immigrants: A Qualitative Pilot Study. Journal of Immigrant and Minority Health, v. 22, #6 (December), p. 1287-1294, 2020.
Exploring Cancer Care Needs for Latinx Adults: A Qualitative Evaluation. Supportive Care in Cancer, v. 31, #1 (January): Art. 76, 2023.
From Theory to Application: A Description of Transnationalism in Culturally-Appropriate HIV Interventions of Outreach, Access, and Retention among Latino/a Populations. Journal of Immigrant and Minority Health, v. 21, #2 (April), p. 332–345, 2019.
A Psychometric and Relative Importance Evaluation of Health Literacy and Health Consciousness on COVID-19 Preventative Hispanic English Language Learner Families and Food Insecurity during COVID-19: Risk Factors and Systems of Food Support. Families, Systems, & Health, v. 40, #1 (March), p. 105-110, 2022.
Improving Latino Health Equity through Spanish Language Interpreter Advocacy in Kansas. Hispanic Health Care International, v. 17, #1 (March), p. 18-22, 2019.
Interrelationships of Economic Stressors, Mental Health Problems, Substance Use, and Intimate Partner Violence among Hispanic Emergency Department Patients: The Role of Language-Based Acculturation. International Journal of Environmental Research and Public Health, v. 18, #22 (November): Art. 12230, 2021.
"It's About Being Healthy"; a Novel Approach to the Socio-Ecological Model Using Family Perspectives within the Latinx Community. BMC Public Health, v. 23 (January 11): Art. 86, 2023.
Juntos: A Model for Language Congruent Care to Better Serve Spanish-Speaking Patients with COVID-19. Health Equity, v. 5, #1 (January-December), p. 826-833, 2021.
Linguistic Isolation and Mortality in Older Mexican Americans: Findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly. Health Equity, v. 5, #1 (January-December), p. 375- 381, 2021.
Long-Term Effect of a Nonrandomized Psychosocial Mindfulness-Based Intervention in Hispanic/Latina Breast Cancer Survivors. Integrative Cancer Therapies, v. 19, #1 (January-December): Art.
1534735419890682, 2020.
Mujeres Fuertes y Corazones Saludables, a Culturally Tailored Physical Activity and Nutrition Program for Rural Latinas: Findings from a Pilot Study. International Journal of Environmental Research and Public Health, v. 16, #4 (February), Art. 630, 2019.
Participant Satisfaction and Acceptability of a Culturally Adapted Brief Intervention to Reduce Unhealthy Alcohol Use among Lation Immigrant Men. American Journal of Men's Health, v. 14, #3 (May-June): Art. 1557988320925652, 2020.
Patient-Centered Measure Development and Spanish Validation Exemplar. Health Literacy Research and Practice (HLRP), v. 3, #4 (November), p. e243-e249, 2019.