Effects of health literacy and activation on U.S. Bhutanese refugees’ health outcomes

Refugee populations who have sought permanent asylum in the United States are often ill-equipped with necessary tools and precursors for navigating the U.S. healthcare system. For Bhutanese refugees in particular, their relocation experiences are distinguished by violent refugee camps, separation from their families, and severe discrimination. As a consequence of such trauma, many refugees have developed mental illnesses, such as depression and PTSD. These are paired with staggering physical health disparities in nutritional serum levels, chronic health conditions, and women’s health. Barriers in health education, language and communication, and motivation to participate in their own health care are components of Bhutanese refugees’ lower health literacy in the U.S., contributing to their inability to receive culturally competent care. The absence of health literacy interventions is scarcely acknowledged in the medical field. The primary objective of this thesis is to review surveys and interview data collected from existing studies analyzing refugee experiences of barriers in health literacy, that caused disparities in their health outcomes. Preliminary analysis indicates refugees lack the skills and confidence to engage in health care interactions and preventative measures due to a history of discomfort enduring stigmatization of their unique relocation experiences and insensitivity to their low health literacy from U.S. providers. I identify the most successful solutions practiced in small groups from this literature such as the use of help-seeking and social networks and cultural competency education modules for providers, and propose a plan for future research on this method to improve healthcare outcomes for this population.