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No one left out: Breaking down cultural barriers to support healthy aging

The Bottom Line

  • Health promotion and education programs can save lives and help prevent serious illness.
  • Language and other cultural barriers can make it difficult for people to access and participate in health promotion programs.
  • Culturally adapted health promotion materials and approaches – such as translation and support from peers – can help improve people’s ability and motivation to respond to health promotion programs.
  • Speak up, get involved and advocate for healthy aging activities and approaches that work for you.

Taking responsibility for your own health isn’t just about going to the doctor when you’re hurt or ill. It’s also about being proactive: going for check-ups, taking part in screening programs that can detect certain diseases in the early stages and learning how to prevent or better manage chronic conditions. These actions can help save lives and prevent more invasive medical procedures (1;2). But what if you don’t know about such programs, have no way to get to them, are confused about their purpose or don’t understand what you’re being told?


That’s the case for many people, including those in underserved communities who don’t access these vital health programs due to location, language and/or other barriers (3). Being sensitive to cultural values, beliefs and concerns is a starting point to help reduce unequal access to health information and programs. But what specific actions can we take?


A recent systematic review on cancer screening measured whether culturally adapted health education helps to improve cancer screening rates (4). Participants were included in peer-led information sessions about cancer screening and given culturally customized materials (pamphlets, brochures, videos, etc.), individualized reminders and guidance, and – in some cases – free materials or reimbursement of costs related to screening.


What the research tells us

Communication and training that reflects an individual’s language and culture improves people’s ability and motivation to respond to health promotion programs (4;5). Culturally adapted materials resulted in higher cancer screening participation rates (4).


We often feel more comfortable and receptive when we can relate to the person giving advice, and this review found that programs were particularly successful when delivered by “peer providers” with the same ethnic background or similar cultural values (4;5). Many of the included studies found that these targeted approaches also helped improve people’s knowledge, awareness and attitudes about screening, suggesting they are more likely to continue participating in the programs in the future.


And this is just one example. Culturally customized health education can have benefits beyond cancer screening: another systematic review found that culturally adapted training for diabetes self-care improves symptoms and helps people cope better with the disease (6).


Translation of information and interpretation by peers helps to ensure health messages are meaningfully understood… but we know it takes more than this. Dr. Esha Ray Chaudhuri, a social scientist and member of McMaster Optimal Aging Portal's Citizen Advisory Council, points out that a message is only useful if people “actually relate to its value,” and are able to put the advice into practice. For example, translated materials can help people understand the importance of cancer screening or improving their diet. But if these recommendations differ from their personal or cultural values, or they are dependent on a family member or public transportation to take them to appointments or shopping, they may not be able to actually do these things.


Dr. Ray Chaudhuri also cautions that some approaches could back-fire “if based on a limited understanding of a different culture.” Making assumptions about the needs and uniformity of cultural communities could actually turn people off and impede the success of health programs, she says.


What can you do?

One way to ensure that healthy aging education, programs and services fit your needs is to get involved: advocate for activities and approaches that work for you! Dr. Ray Chaudhuri encourages all of us to recognize and share our individual needs and preferences as a “whole” person – including language and cultural/personal values – as a way to help more people access and follow through on recommendations to improve health. Speak up at appointments with your health providers and contact your local health centre to find out how you can get involved.


Cultural attitudes and values are central to how people view their own health and wellbeing. Incorporating these values into health communication and promotion strategies can help ensure that no one "falls through the cracks" when it comes to preventing or managing serious diseases.


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References

  1. Torre LA, Bray F, Siegel RL et al. Global cancer statistics, 2012; CA Cancer J Clin. 2015; 65(2):87-108. doi: 10.3322/caac.21262.
  2. Curry SJ, Byers T, Hewitt M. Fulfilling the potential of cancer prevention and early detection. Washington, DC: The National Academies Press; 2003.
  3. Ahmed S, Shahid RK. Disparity in cancer care: A Canadian perspective. Curr Oncol. 2012; 19(6):e376–e382. doi: 10.3747/co.19.1177.
  4. Escriba-Aguir V, Rodriguez-Gomez M, Ruiz-Perez I. Effectiveness of patient-targeted interventions to promote cancer screening among ethnic minorities: A systematic review. Cancer Epidemiol. 2016; 44:22-39. doi: 10.1016/j.canep.2016.07.009.
  5. Henderson S, Kendall E, See L. The effectiveness of culturally appropriate interventions to manage or prevent chronic disease in culturally and linguistically diverse communities: A systematic literature review. Health Soc Care Community. 2011; 19(3):225-249. doi: 10.1111/j.1365-2524.2010.00972.x.
  6. Zeh P, Sandhu HK, Cannaby AM, et al. The impact of culturally competent diabetes care interventions for improving diabetes-related outcomes in ethnic minority groups: A systematic review. Diabet Med. 2012; 29(10):1237-1252. doi: 10.1111/j.1464-5491.2012.03701.x.

DISCLAIMER: The blogs are provided for informational purposes only. They are not a substitute for advice from your own healthcare professionals.

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