Does acculturation narrow the health literacy gap between immigrants and non-immigrants—An explorative study

Sarah Mantwill, Peter J. Schulz

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Objectives To compare functional health literacy (HL) levels in three immigrant groups to those of the German- and Italian-speaking non-immigrant population in Switzerland. Moreover, to investigate whether language-independent, respectively language-dependent, functional HL and variables of acculturation were associated with self-reported health status among immigrants. Methods Language-independent HL was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) in the respective native languages. Language-dependent HL was measured using Brief Health Literacy Screeners (BHLS) asking about participants’ confidence in understanding medical information in the language of the host country. Measures of acculturation included length of stay and age when taking residency in Switzerland. Results In particular Albanian- and Portuguese-speaking immigrants had lower levels of functional HL. In unadjusted analysis “age when taking residency in Switzerland” was associated with the BHLS. Adjusted analysis showed that the BHLS were significantly associated with self-reported health among all immigrant groups (p ≤ 0.01). Conclusions Functional HL that is dependent on understanding of medical information in the language of the new host country is a better predictor for self-reported health status among immigrants than language-independent HL. Practice implications In the clinical setting limited functional HL might be a significant obstacle to successful disease treatment and prevention in immigrants.

Original languageEnglish
Pages (from-to)760-767
Number of pages8
JournalPatient Education and Counseling
Issue number4
StatePublished - 1 Apr 2017

Bibliographical note

Publisher Copyright:
© 2016 Elsevier Ireland Ltd


  • Acculturation
  • Health literacy
  • Immigrant health
  • Immigrants
  • Switzerland


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