Health and legal literacy for migrants: twinned strands woven in the cloth of social justice and the human right to health care

Abstract

BackgroundBased on an analysis of published literature, this paper provides an over-view of the challenges associated with delivering on the right to access quality health care for international migrants to industrialized countries, and asks which group of professionals is best equipped to provide services that increase health and legal literacy. Both rights and challenges are approached from a social justice perspective with the aim of identifying opportunities to promote greater health equity. That is, to go beyond the legal dictates enshrined in principles of equality, and target as an ethical imperative a situation where all migrants receive the particular assistance they need to overcome the barriers that inhibit their equitable access to health care. This assistance is especially important for migrant groups that are further disadvantaged by differing cultural constructions of gender. Viewing the topic from this perspective makes evident a gap in both research literature and policy. The review has found that while health literacy is debated and enshrined as a policy objective, and consideration is given to improving legal literacy as a means of challenging social injustice in developing nations, however, no discussion has been identified that considers assisting migrants to gain legal literacy as a step toward achieving not only health literacy and improved health outcomes, but critical participation as members of their adoptive society.ConclusionIncreasing migrant health literacy, amalgamated with legal literacy, aids migrants to better access their human right to appropriate care, which in turn demonstrably assists in increasing social engagement, citizenship and productivity. However what is not evident in the literature, is which bureaucratic or societal group holds responsibility for assisting migrants to develop critical citizenship literacy skills. This paper proposes that a debate is required to determine both who is best placed to provide services that increase health and legal literacy, and how they should be resourced, trained and equipped.

Language interpretation conditions and boundaries in multilingual and multicultural emergency healthcare

“…Thus, an asymmetrical power relation might need to be accepted temporarily to help the individual retain or regain health. Communication is central for caring, but in such situations it might not be fully possible to provide transcultural care where the individual’s needs and cultural beliefs are taken into account [ 16 ] and person-centered, safe, and equal care can be delivered in accordance with Swedish law [ 35 , 36 ] and human rights [ 26 ] including the legal and health literacy [ 28 ]. Health professionals in this study described how they selected certain situations for interpreting, in contrast to care for people who speak the official language of the country.…”

“…Communication can be described as a multifaceted phenomenon which makes a person’s identity visible and shows how the other person is perceived on the individual and the social level [ 27 ]. It also makes it possible for the individual to participate in society [ 17 ], where the individuals have legal and health literacy including a certain ability to understand, assess, access and communicate selected information about the care obtained, confronting social injustice either for themselves or their families in order to achieve health and well-being [ 28 ]. Increasing migrant health literacy enables migrants to have better access to appropriate health care, which in turn promotes social justice by increasing migrants’ social engagement, inclusion and full citizenship.…”

Organizing Language Interpreting Services in Elderly and Emergency Healthcare

“…In relation to interpreting practices, it is important to be aware of how professionals discuss and reason about language interpretation in the workplace and how care recipients can participate in communication situations to exert influence and to reach the goal of equal healthcare (Lill 2007). Society's responsibility to assist migrants to gain legal and health literacy to manage health care visits is also of great importance for achieving social justice (Vissandjée et al 2017).…”

“…The way healthcare professionals discuss and reason about language interpretation and the way care recipients can participate in communication situations in healthcare institutions contributes to the field of ethnicity on the societal level (Lill 2007). To participate in society and health situations, individuals also need legal and health literacy including a certain ability to understand, assess, access and communicate selected information about the care obtained, confronting social injustice in order to achieve health and well-being (Vissandjée et al 2017).…”

Attitudes to Ethical Approach to Migration

“…Desirability and challenges of delivering Universal Health Care is predicated on a belief enshrined in international human rights agreements that it is morally fair that all individuals have "rights to health and to a standard of living adequate for health" (Braveman et all. 2011; Vissandjée et al 2017). …”