Health Literacy in a migrant portuguese speaking community in Portugal and healthcare use

BACKGROUND: Health Literacy is strongly related with barriers to accessing healthcare services. Migrants may represent a vulnerable population in this matter, usually correlated with the language barrier. We aim to answer the question “Which are the perceptions, behaviors and skills of a migrant Portuguese speaking community using and getting access to health care in Portugal?” METHODS: Descriptive, cross-sectional and exploratory study. The Health Literacy Questionnaire (Osborne et al.,2013) was applied with a sociodemographic and health characterization. Data were collected and processed from a sample of 101 participants from a group of 570 people from a migrant community, all native Portuguese speakers mostly born in African Countries with Portuguese as an Official Language. RESULTS: The sample represented 17,7% of the total population. Thus, a confidence level of 95% and a margin of error of 9% were assumed. In the Health Literacy Questionnaire, the Cronbach's Alpha internal consistency coefficient was calculated as between 0.714 and 0.928. The analysis dimensions were mostly positioned below the average of the scale and were influenced by education, migratory status and age. “Feeling understood and supported by health professionals” had the worst score. There were better results in those who sought primary health care services and who had chronic illnesses. Self-rated health worsened with increasing length of stay in the country. Approximately 31% never attended healthcare in Portugal because they did not feel the need or were unable to access it. CONCLUSIONS: This study demonstrated the association between health literacy with migrants and healthcare use excluding the language factor. This community presented low healthcare services use and low health literacy levels despite the use of the same language. Interaction with primary healthcare services improved migrants health literacy. This study supported a community intervention with public and private stakeholders. KEY MESSAGES: • Migrants places potential constraints on healthcare utilisation in destination countries that are not necessarily related to language barrier. • Health Literacy is crucial to migrants health, health care access and Public Health improvement.