When I was three years old, my mother—allured by the idea of the American Dream—decided to immigrate from China to the U.S. The implications of starting a new life in an unfamiliar country was very clear to the rest of our extended family, who wanted to remain in China. So my mother went alone, and I lived with my grandparents for a year, when my mother was financially capable to raise me in the U.S.
Like many immigrants, my mother faced the daunting task of adjusting to life in America. While she was able to find a stable job and a supportive community, she struggled to navigate the complexities of the healthcare system. Specifically, my mother felt unable to clearly communicate her needs with her providers due to her language barrier and the difficulty of learning the necessary health terminology. Sometimes, my mother also took a prolonged time to express her thoughts in English; she would often come back from an appointment with a visible expression of frustration, complaining that she couldn’t find the right words to express her needs, which caused the doctor to become impatient with her. This perpetuated a further stigma towards receiving care, and my mother often felt hesitant to voice her needs even when she felt wronged. During an appointment for an ear-related issue, she felt that the physician was being too rough in his exam to the point where the inside of her ear started bleeding. Not wanting to cause a commotion and believing that the doctor wouldn’t understand anyway, she just remained in a silent grimace for the remainder of the exam. She never went to that doctor again. These experiences pushed my mother to seek care in more familiar places. To this day, she receives her primary care from an all-Mandarin speaking clinic—Mandarin-speaking physicians, nurses, assistants, even the receptionist. Asking her why, she would say, “I feel that they can understand me and I feel more comfortable around them.”
The seeds of The Health Fluency Project lay grounded in these stories—not only from my mother but also from friends and strangers alike. I heard these stories as individual events—at the dinner table, at gatherings with family friends, on the internet—and initially viewed them as such. Combining these stories in a mosaic, however, I began to see that there was a systemic issue—one I hope to address through this project. Many immigrants and non-native English speakers have trouble navigating the healthcare system and communicating with their providers, whether due to the language barrier, low health literacy, or the stigma that stems from previous negative experiences in healthcare. In a country as culturally and linguistically diverse as America, it is crucial for everyone—regardless of language spoken—to effectively utilize such a basic right as healthcare. We hope to achieve this, holding each story in the light.
Beier Nelson
Co-Founder of The Health Fluency Project
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