UNDERSTANDING HEALTH LITERACY REGARDING THE CANADIAN HEALTH CARE SYSTEM UPON SETTLEMENT OF ISMAILI MUSLIM CANADIANS: A NARRATIVE STUDY

Health literacy is an individual\u27s ability to read, understand, and use health care information to make informed health decisions for treatment (Kwan, Frankish, & Rootman, 2006). Health literacy studies worldwide have increased dramatically within the past decade in response to concerns about the populations that are at risk and the need to target effective interventions for them. Canadian censuses have utilized the International Adult Literacy and Life Skills Survey (IALLS) to examine Canadian health literacy rates and found that the most high-risk populations are older adults, immigrants, and the chronically unemployed. However, when researching the topic of health literacy, there was little information from the high-risk population themselves, few longitudinal studies, little research about possible interventions, nor was there consistent use of a single definition of health literacy. Being an Ismaili Muslim and understanding their history of migration, I wanted to ground my study through my family\u27s experiences of having to move from East Africa to Canada in 1972. My goal was to gain a better understanding of the post-immigration experiences of the Canadian health care system in comparison to the pre-immigration expectations among older Ismaili Muslim adults, to discover how health literacy affected health seeking behaviours during immigrant settlement in Canada for this group, and to explore the effects of cultural capital, or the non-financial resources that assist in social and economic means, to determine how it assisted or hindered the successful settlement process of Ismaili Muslims within Canada. The research was a narrative inquiry using in-depth, semi-structured interviews to get thick descriptions of the experiences of four Ismaili Muslim older adults who moved to Canada in 1972, their experiences of using the Canadian health care system for the first time, and their thoughts on the topic of health literacy. Their experiences and suggestions, detailed in their stories to live by, expanded the knowledge on the topic of health literacy by explaining possible interventions that have yet to be mentioned in research. iii As a result of the study, four key considerations emerged: communication strategies applied in health literacy are not successfully targeting the immigrant population; there was confusion about the Canadian health care system, especially relating to the tiers of health care and the limits of OHIP coverage; the Ismaili population utilized the resource of cultural capital to assist in their settlement experiences and stressed the importance of comfort, trust, and sensitivity when taking advice from individuals about the health care system; and knowledge exchange about health literacy is vital for health professionals and patients, as well as other groups, to understand the importance of this topic. The key considerations from the study have important implications for newly arrived immigrants and the Canadian health care system. The study suggests supplementing the typical quantitative surveys with rich, qualitative literature and targeting interventions particularly to the groups that require immediate attention. This study displays the importance of providing the immigrant population with a voice and an opportunity to describe their experiences about the health care system and the topic of health literacy