Résumés
Abstract
During the COVID-19 pandemic, refugee women in the United States faced significant challenges to sustain their livelihoods, such as losing jobs and health care, becoming essential workers, and finding oneself again in unprecedented situations of limited mobility. These impacts reflect dynamics in migrant health literacy including language proficiency (skills-based approaches) as well as experiences, identities, and power relations in society (socio-cultural approaches). In this article, I explore these dynamics through a gender perspective with a focus on intra-familial health brokering, empowerment-based health education, and health information mapping by drawing on ethnographic research from Portland, Oregon. This includes interviews with 15 refugee women and representatives of organizations working in the context of migration as well as observations of service-providing community efforts. My interviews and observations demonstrate that disruptions in language learning, socio-cultural barriers, and limited access to health-related information resources have posed significant challenges to refugee women’s livelihoods during the pandemic. I suggest that English as a Second Language (ESL) classes can be imperative in addressing these challenges as the classes provide a space for language learning, intercultural dialogue, and information sharing in gender-responsive ways.
Keywords:
- refugee women,
- health literacy,
- English as a Second Language,
- ESL,
- COVID-19
Résumé
Pendant la pandémie de COVID-19, les femmes réfugiées aux États-Unis ont été confrontées à des défis importants pour maintenir leurs moyens de subsistance, comme la perte d'emplois et de soins de santé, le fait de devenir des travailleurs essentiels et de se retrouver à nouveau dans des situations inédites de mobilité limitée. Ces impacts sont le reflet de dynamiques au niveau de la littératie en matière de santé des migrants telles que la maîtrise de la langue (approches basées sur les compétences) ainsi que les expériences, les identités et les relations de pouvoir dans la société (approches socio-culturelles). Dans cet article, j’explore ces dynamiques à travers une perspective de genre mettant l’accent sur le courtage de santé intra-familial, l’éducation à la santé basée sur l’autonomisation et la cartographie des informations sur la santé en m’appuyant sur une étude ethnographique de Portland, Oregon. Cette étude comprend des entretiens avec 15 femmes réfugiées et représentants d’organisations œuvrant dans le contexte de la migration ainsi que des observations d’efforts communautaires de prestation de services. Mes entretiens et observations démontrent que les interruptions dans l’apprentissage de la langue, les barrières socio-culturelles et l’accès limité aux ressources d'informations liées à la santé ont posé des défis importants au maintien des moyens de subsistance des femmes réfugiées pendant la pandémie. Je suggère que les cours d’anglais langue seconde sont impératifs pour faire face à ces défis puisque ces cours fournissent un espace pour l’apprentissage de la langue, le dialogue interculturel et le partage d’informations de manière sensible au genre.
Parties annexes
Bibliography
- Andrews, M. M., & Boyle, J. S. (2008). Transcultural concepts in nursing care. Wolters Kluwer/Lippincott, Williams & Wilkins.
- Andrulis, D., & Brach, C. (2007). Integrating literacy, culture, and language to improve health care quality for diverse populations. American Journal of Health Behavior, 31(Supp1), S122–S133. https://doi.org/10.5555/ajhb.2007.31.supp.S122
- Banulescu-Bogdan, N. (2020, January). Beyond work: Reducing social isolation for refugee women and other marginalized newcomers. Transatlantic Council on Migration. https://www.migrationpolicy.org/sites/default/files/publications/TCM-Social-Isolation_FINALWEB.pdf
- Barnes, D. M., Harrison, C., & Heneghan, R. (2004). Health risk and promotion behaviors in refugee populations. Journal of Health Care for the Poor and Underserved, 15(3), 347–356. https://doi.org/10.1353/hpu.2004.0034
- Boyd, M., & Pikkov, D. (2005). Gendering migration, livelihood and entitlements: Migrant women in Canada and the United States. UNRISD Occasional Paper No. 6. United Nations Research Institute for Social Development (UNRISD). https://www.econstor.eu/bitstream/10419/148814/1/863099858.pdf
- Bresolin, L. (1999). Health literacy: Report of the Council on Scientific Affairs. JAMA: The Journal of the American Medical Association, 281(6), 552–557. https://doi.org/10.1001/jama.281.6.552
- Chao, X., & Kang, B. (2020). Health literacy among bhutanese adult refugees in the United States: The sociocultural approach. Adult Education Quarterly, 70(3), 258–276. https://doi.org/10.1177/0741713620904047
- Deacon, Z., & Sullivan, C. (2009). Responding to the complex and gendered needs of refugee women. Journal of Women and Social Work, 24(3), 272–284. https://doi.org/10.1177/0886109909337401
- Flores, G., Abreu, M., Brown, V., & Tomany-Korman, S. C. (2005). How Medicaid and the State Children’s Health Insurance Program can do a better job of insuring uninsured children: The perspectives of parents of uninsured Latino children. Ambulatory Pediatrics, 5(6), 332–340. https://doi.org/10.1367/A04-067R2.1
- Galanti, G.-A. (2008). Caring for patients from other cultures. University of Pennsylvania Press. https://doi.org/10.9783/9780812203479
- Gany, F. M., Herrera, A. P., Avallone, M., & Changrani, J. (2006). Attitudes, knowledge, and health-seeking behaviors of five immigrant minority communities in the prevention and screening of cancer: A focus group approach. Ethnicity and Health, 11(1), 19–39. https://doi.org/10.1080/13557850500391394
- Gelatt, J., Batalova, J., & Capps, R. (2020, November). An early readout of the economic effects of the COVID-19 crisis. Migration Policy Institute. https://www.migrationpolicy.org/sites/default/files/publications/COVID-19-Unemployment-Women-FS-FINAL.pdf
- Gelatt, J., & Capps, R. (2020, May). Barriers to COVID-19 testing and treatment: Immigrants without health coverage in the United States. Migration Policy Institute. https://www.migrationpolicy.org/research/covid-19-testing-treatment-immigrants-health-insurance
- Golesorkhi, L. Z., Fortson, G., Harder, K., & Riedmann, T. (2020). Centering community in COVID-19 responses: Refugee women’s livelihoods in a global pandemic. International Journal of Sociology and Social Policy, 42(3–4), 289–297. https://doi.org/10.1108/IJSSP-07-2020-0332
- Golesorkhi, L. Z., Fortson, G., & Riedmann, T. (2022). Filling the gaps: Policy mismatches, community responses, and refugee livelihoods during a global pandemic. In G. Schweiger (Ed.), Philosophical perspectives on the social consequences of the COVID-19 pandemic (pp. 291-308). Springer.
- Hill, H. (2004). Health literacy is a social justice issue that affects us all. Adult Learning, 15(1–2), 4–6. https://doi.org/10.1177/104515950401500101
- Im, S., & Swan, L. E. T. (2019). Qualitative exploration of critical health literacy among Afghan and Congolese refugees resettled in the USA. Health Education Journal, 78(1), 38–50. https://doi.org/10.1177/0017896918785932
- Ingleby, D. (2012). Acquiring health literacy as a moral task. International Journal of Migration, Health and Social Care, 8(1), 22–31. https://doi.org/10.1108/17479891211231383
- Khuu, B. P., Lee, H. Y., Zhou, A. Q., Shin, J., & Lee, R. M. (2016). Healthcare providers’ perspectives on parental health literacy and child health outcomes among Southeast Asian American immigrants and refugees. Children and Youth Services Review, 67, 220–229. https://doi.org/10.1016/j.childyouth.2016.06.006
- Lloyd, A. (2014). Building information resilience: How do resettling refugees connect with health information in regional landscapes—implications for health literacy. Australian Academic & Research Libraries, 45(1), 48–66. https://doi.org/10.1080/00048623.2014.884916
- Mas, F. S., Cordova, C., Murrietta, A., Jacobson, H. E., Ronquillo, F., & Helitzer, D. (2015). A multisite community-based health literacy intervention for Spanish speakers. Journal of Community Health, 40, 431–438. https://doi.org/10.1007/s10900-014-9953-4
- Mas, F. S., Mein, E., Fuentes, B., Thatcher, B., & Balcázar, H. (2013). Integrating health literacy and ESL: An interdisciplinary curriculum for Hispanic immigrants. Health Promotion Practice, 14(2), 263–273. https://doi.org/10.1177/1524839912452736
- Nelson-Peterman, J. L., Toof, R., Liang, S., & Grigg-Saito, D. C. (2015). Long-term refugee health: Health behaviors and outcomes of Cambodian refugee and immigrant women. Health Education & Behavior, 42(6), 814–823. https://doi.org/10.1177/1090198115590779
- Nutbeam, D. (2000). Health literacy as a public health goal: A challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259–267. https://doi.org/10.1093/heapro/15.3.259
- Orellana, M. F., Dorner, L., & Pulido, L. (2003). Accessing assets: Immigrant youth’s work as family translators or “para-phrasers.” Social Problems, 50(4), 505–524. https://doi.org/10.1525/sp.2003.50.4.505
- Papen, U. (2009). Literacy, learning and health: A social practices view of health literacy. Literacy & Numeracy Studies, 16(2), 19–34. https://doi.org/10.5130/lns.v0i0.1275
- Parker, R., & Ratzan S. C. (2010). Health literacy: A second decade of distinction for Americans. Journal of Health Communication, 15(S2), 20–33. https://doi.org/10.1080/10810730.2010.501094
- Perry, K. H. (2009). Genres, contexts, and literacy practices: Literacy brokering among Sudanese refugee families. Reading Research Quarterly, 44(3), 256–276. http://www.jstor.org/stable/25655455
- Pignone, M., DeWalt, D. A., Sheridan, S., Berkman, N., & Lohr, K. N. (2005). Interventions to improve health outcomes for patients with low literacy. A systematic review. Journal of General Internal Medicine, 20(2), 185–192. https://doi.org/10.1111/j.1525-1497.2005.40208.x
- Potocky-Tripodi, M. (2003). Refugee economic adaptation: Theory, evidence, and implications for policy and practice. Journal of Social Service Research, 30(1), 63–91. https://doi.org/10.1300/J079v30n01_04
- Poureslami, I., Rootman, I., Doyle-Waters, M. M., Nimmon, L., & FitzGerald, J. M. (2011). Health literacy, language, and ethnicity-related factors in newcomer asthma patients to Canada: A qualitative study. Journal of Immigrant and Minority Health, 13(2), 315–322. https://doi.org/10.1007/s10903-010-9405-x
- Purnell, L., & Paulanka, B. (2008). Transcultural health care: A culturally competent approach. F. A. Davis. https://www.fadavis.com/product/transcultural-health-care-competent-purnell
- Rudd, R., Kirsch, I., & Yamamoto, K. (2004, April). Literacy and health in America: Policy information report. Educational Testing Service. https://www.ets.org/Media/Research/pdf/PICHEATH.pdf
- Salant, T., & Lauderdale, D. S. (2003). Measuring culture: A critical review of acculturation and health in Asian immigrant populations. Social Science and Medicine, 57(1), 71–90. https://doi.org/10.1016/s0277-9536(02)00300-3
- Santos, G., Gorukanti, A. L., Jurkunas, L .M., & Handley, M. A. (2018). The health literacy of US immigrant adolescents: A neglected research priority in a changing world. International Journal of Environmental Research and Public Health, 15(10), Article 2108. https://doi.org/10.3390/ijerph15102108
- Selden, C. R., Zorn, M., Ratzan, S. C., & Parker, R. M. (Eds.). (2000). National Library of Medicine current bibliographies in medicine: Health literacy. National Institutes of Health, US Department of Health and Human Services. https://www.researchgate.net/publication/230877250_National_Library_of_Medicine_Current_Bibliographies_in_Medicine_Health_Literacy
- Shaw, S. J., Huebner, C., Armin, J., Orzech, K., & Vivian, J. (2008). The role of culture in health literacy and chronic disease screening and management. Journal of Immigrant and Minority Health, 11(6), 460–467. https://doi.org/10.1007/s10903-008-9135-5
- Singleton, K. (2002, February). Health literacy and adult English learner. National Center for ESL Literacy Education. https://www.govinfo.gov/content/pkg/ERIC-ED465309/pdf/ERIC-ED465309.pdf
- Singleton, K., & Krause, E. (2009). Understanding cultural and linguistic barriers to health literacy. OJIN: The Online Journal of Issues in Nursing, 14(3), Article 4. https://doi.org/10.3912/OJIN.Vol14No03Man04
- Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., Brand, H., & (HLS-EU) Consortium Health Literacy Project European. (2012). Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 12, Article 80. https://doi.org/10.1186/1471-2458-12-80
- Virginia Adult Learning Resource Center. (2012). VAKRC health literacy toolkit. https://valrc.org/resource/valrc-health-literacy-toolkit/
- Zanchetta, M., & Poureslami, I. (2006). Health literacy within the reality of immigrants’ culture and language. Canadian Journal of Public Health, 97(S2), S26–S30. https://pubmed.ncbi.nlm.nih.gov/16805158/
- Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2005). Understanding health literacy: An expanded model. Health Promotion International, 20(2), 195–203. https://doi.org/10.1093/heapro/dah609
- Zarcadoolas, C., Pleasant, A., & Greer, D. S. (2006). Advancing health literacy: A framework for understanding and action. Jossey-Bass. https://psycnet.apa.org/record/2006-13004-000
- Zimmermann, M. S. (2019). Information horizons mapping to assess the health literacy of refugee and immigrant women. Proceedings of the Association for Information Science and Technology, 55(1), 963–964. https://doi.org/10.1002/pra2.2018.14505501195