Culture and Language | Health Literacy

Cross-culture communication

Culture can be defined by group membership, such as racial, ethnic, linguistic, or geographical groups, or as a collection of beliefs, values, customs, ways of thinking, communicating, and behaving specific to a group.

Public health officials and health care providers belong to professional cultures with their own language—such as epidemiological and medical terms. These terms are not familiar to the public and hinder the public’s understanding of written and spoken health messages. Understanding can be further hindered when other cultural differences exist.

The National Culturally and Linguistically Appropriate Services (CLAS) Standards can help your organization overcome these cultural and linguistic differences. The National CLAS Standards are a set of 15 action steps intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health and health care organizations to implement culturally and linguistically appropriate services.

Learn how the White Earth Nation, one of 11 tribes in the state of Minnesota, used culturally and linguistically appropriate messaging and other health literacy best practices as part of a multifaceted approach to respond to the COVID-19 pandemic. Their efforts resulted in vaccinating more than 93 percent of the White Earth Nation’s elders. Read Stories from the Field: The White Earth Nation.

Adapt your communication products and strategies to the specific culture and language of your intended audience by consulting CDC’s Health Equity Guiding Principles for Inclusive Communication (HEGP).

If you or your organization works in global public health, consult Global Public Health Equity Guiding Principles for Communication. This resource complements HEGP by adding a global perspective.

Learn to work with faith leaders and faith-based organizations to overcome cultural and linguistic barriers to global health communication. Watch The Importance of Language: Faith Partner Resources for Health Emergencies. In this recording of a World Health Organization webinar, presenters show how faith-based organizations used health literacy best practices in their COVID-19 educational efforts. This included translating materials into many languages (like Honduran Sign Language for people who are deaf) to provide clear information on different health topics to specific populations. It also included working with faith leaders in a participatory design approach.

Review the Find Training section of this website for courses in culture and communication.

Translation and interpretation

Translated materials and interpreter services can help bridge language differences, but translations and interpreter services may not be fully accurate or complete. Not all languages have words for something that exists in other languages and cultures, and not all words and ideas can be easily translated into or explained in another language.

Or, people may have weak literacy and numeracy skills in their native language, and translated materials may be too complex or technical for them.

The context for communication, such as the physical location or people’s shared or different experiences, may also affect the meaning of translated and interpreted words. The intended meaning may be lost, causing confusion even when everyone involved in the communication exchange believes they understand what is said.

To minimize this confusion, match certified translators and interpreters with the primary audience. A good match happens when the translator or interpreter collects information about and adapts to the intended audience’s language preferences, communication expectations, and health literacy skills. The American Translators Association has information on finding and becoming a certified translator.

Language access

According to the U.S. Census Bureau, at least 350 languages are spoken in U.S. homes. Federal agencies and organizations that receive federal funds must create and follow plans to meet the needs of people with limited English proficiency (LEP).

Before creating web content, social media messages, and other digital products for people with LEP, consult the following resources:

• Designing for Translation (Digital.gov Multilingual Community of Practice, May 2021): In this webinar, speakers discuss the following topics:
  • What is designing for translation?
  • Language choice
  • Plain language
  • Layout and imagery

• Practical Tips for Accessible Content and Multilingual Websites (Digital.gov Multilingual Community of Practice, December 2020): In this webinar, two digital accessibility experts discuss accessibility considerations for creating and working with multilingual platforms and content. Fast forward to the 33:36 mark on the video progress bar.
• Lost in Translation (Digital.gov Multilingual Community of Practice, October 2012): Read this article to learn why you should avoid relying on machines or automation as a translation solution. Learn how human translation helps you culturally adapt your material to successfully communicate with your intended audience.

To enhance effective communication between people who provide and receive care in health care facilities, consult the Guide to Providing Effective Communication and Language Assistance Services.

Resources for translated materials