Health Literacy and Children Language Brokers: How Bilingual Children and Spanish-Speaking Parents Navigate the Medical Setting

Significance: Patients’ health literacy, or ability to comprehend and understand health information, influences their health status, knowledge about medical care and conditions, and hospitalization and adherence rate (Andrus, & Roth, 2002). Low- English proficiency patients are especially at risk, given they must overcome English and health literacy barriers. Background: Oftentimes, children of patients with limited English language skills will language broker, or translate cultural and linguistic information for their parents (Morales & Hanson, 2005). This paper 1) analyzed health literacy levels of children who language broker and 2) sought to understand how parents and children combine their knowledge, as the skills of one may compensate for the skills of the other. Methods: Survey data was collected from 100 parent-child dyads of low-income, predominantly Mexican heritage households from the Chicago area to measure health literacy levels among parents and children using the Test of Functional Health Literacy Assessment (TOFHLA). Results: Results revealed that 25% of language brokers had inadequate health literacy (i.e., below an 8th grade level); 75% had adequate health literacy. Child health literacy levels correlated with parent self-efficacy (r = -.28**), parent foreign language anxiety (r = .29**), and parent ability to read English (r = .23*). Conclusions: Many children brokers have functional health literacy. While parents may help their children increase health literacy in low-pressure situations (e.g., reading English documents), during a medical conversation, parents who are anxious and lack self-efficacy have children who compensate with increased health literacy for the parent’s lack of social skills