Chakraverty, Digo ORCID: 0000-0002-8952-8092 (2023). Gender- specific aspects of health literacy in persons with a migration background. PhD thesis, Universität zu Köln.
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Abstract
Background: Gender is one of the major factors that shape our social lives. As men and women have been found to handle information differently, gender may also influence the ability to access, understand, appraise, and apply health-related information. This ability is called health literacy. Persons with a migration background consistently report lower health literacy than the general population. Low health literacy, however, is connected to worse health outcomes. Moreover, migration, which continues to take place on a high level worldwide, causes persons to move between different cultures with different understandings of gender and gender roles that may affect their health literacy. Therefore, the aim of this dissertation is to explore how gender influences the health literacy of persons with a migration background. Methods: This dissertation applies a multi-method approach. It entails three studies. Study I, a systematic review and meta-analysis, was conducted to find out whether gender differences of health literacy exist in persons with a migration background, assessed with standardized instruments. For Studies II and III, two different qualitative content analyses of the same focus group discussions with German healthcare professionals were conducted to explore their views on a) how gender as a personal determinant of health literacy affects interactions with migrant patients (Study II) and b) how societal and environmental determinants, situational conditions, and personal factors influence health literacy in transcultural treatment settings (Study III). Results: In Study I, twenty-two studies were meta-analyzed, finding a small, but significant difference in favor of female migrants’ health literacy and a clear shortage of studies on the health literacy of male migrants. Study II found gender aspects such as severe language issues in women of the first Turkish immigrant generation, or husbands restricting their wives to receive treatment by male healthcare professionals, to hinder the effective exchange of health information. Study III revealed general issues, e.g., systemic lack of time, cost pressure and a high workload as especially detrimental to the communication between healthcare professionals and migrant patients. Healthcare professionals reported to need more time and funding for translators and cultural mediators. Discussion Five main findings were derived from the joint examination of the three studies: 1) Health literacy seems higher in female than in male migrants, 2) health literacy is gender-specific, with men and women facing different challenges and especially women providing gender-specific solutions to these challenges, 3) the genders’ health literacies are interdependent, as men’s and women’s health literacy can limit (husbands restricting access of their wife) or enhance (women as pioneers for the acceptance psychotherapy also by men) each other, 4) there is little known about men’s health literacy, and 5) health literacy issues concerning the general population can be seen in persons with a migration background as if under a magnifying glass. More gender-sensitive, participative research on health literacy in migrants is necessary to explore the particular advantages of females and males and shortcomings in this realm. This allows to investigate the concrete interactions of the genders’ health literacies, to shed light on the neglected health literacy of male migrants, and to learn about health literacy-related challenges and solutions that concern the whole population but may be seen clearer and earlier in migrants.
Item Type: | Thesis (PhD thesis) | |||||||||
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URN: | urn:nbn:de:hbz:38-646468 | |||||||||
Date: | 12 January 2023 | |||||||||
Place of Publication: | Köln | |||||||||
Language: | English | |||||||||
Faculty: | Faculty of Human Sciences | |||||||||
Divisions: | Faculty of Human Sciences > Department Psychologie | |||||||||
Subjects: | Psychology Social sciences Medical sciences Medicine |
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Date of oral exam: | 15 December 2022 | |||||||||
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Health & Social Care in the Community, 26(2), e191-e206. https://doi.org/10.1111/hsc.12368 | |||||||||
Refereed: | Yes | |||||||||
URI: | http://kups.ub.uni-koeln.de/id/eprint/64646 |
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