Health literacy, culture and Pacific peoples in Aotearoa, New Zealand: A review

Abstract

The social and cultural determinants of health among Pacific people must be addressed to understand the underlying factors related to poor health outcomes. Such factors may include (but are not be limited to) culture, religion, education, socioeconomic status and health literacy. One study, using the lens of Pacific culture, found that almost 90% of Pacific males and females aged 15 years and over have low health literacy. Individuals with low health literacy are less likely to manage ill health, seek professional medical assistance or interpret nutrition related information.  It is possible that the high rates of non-communicable diseases (NCDs) as a significant issue in the Pacific population, including amongst Pacific mothers, are in some part associated with low levels of health literacy, which in turn link to cultural determinants of health. Findings from this review show that inadequate health literacy was consistent among adult females, particularly older adults of low socioeconomic status, lower level of education, non-English speakers and adults with compromised health status. Further, culture may play a role in attainment of adequate health literacy. These individuals were more likely to report worse chronic physical conditions, such as diabetes, including lack of knowledge of their condition such as the inability to identify normal blood sugar levels, the range of a normal blood pressure or how to self-manage hypoglycaemia. Public health practitioners should apply effective communication using a culturally and ethnically tailored approach to support Pacific peoples to understand health messages, improve health behaviours and health status. The author reviewed 33 papers on the issue of health literacy definitions, measurement and determinants; Pacific peoples and NCDs; and discussed it in the light of a cultural determinants’ approach.