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Data Vignettes – The Gonzales Family

Impact on the Family Caring for a Child with Special Health Care Needs

Gonzalez FamilySilvia and Juan Gonzalez moved to the United States in search of work. Because they did not speak English, they were limited in the jobs they could find. Juan works for a landscaping firm during the spring, summer and fall and then tries to pick up work with a painting company he knows in the winter. Silvia has been able to find work with a company that cleans offices at night and works full-time, receiving health care benefits. While they both have learned some English, their long hours at work and the fact that all of their fellow-workers speak Spanish have limited their progress.

Juan and Silvia had little experience with the health care system in the United States. In their home country, people only went to the doctor when they were very sick. Then they could go to the clinic for little or no fee. They had not used the health care system in the United States for themselves, since they were young and healthy. Once, when Juan cut his hand on a pruning shear, he went to the emergency room of the local hospital, but that was all.

All of that changed when Silvia became pregnant with their first child—their daughter Rosa. People kept telling her that she needed to see the doctor as soon as possible to make sure she and the baby were healthy. During an ultrasound exam at 24 weeks of pregnancy, the doctor noticed a problem—the baby seemed to have a neural tube defect—spina bifida. Working with a trained medical interpreter, the doctor tried to explain the problem to the Gonzalez family. The doctor talked about a “high lesion” and looked very worried. Silvia and Juan were not sure what their doctor meant, but were very frightened. The nurse gave them some pamphlets about spina bifida at the end of the appointment. Even though the pamphlets were in Spanish, all the medical terms and descriptions were confusing to the young couple.


Working with Linguistically Diverse Populations: Tips for working with interpreters

Health Literacy (2008), by Penny Glassman, Technology Coordinator, National Network of Libraries of Medicine. This resource includes a definition of health literacy, information about the component skills, statistics populations vulnerable to health literacy issues, and research findings about the impact of health literacy on specific courses of treatment. Retrieved May 28, 2009 from

Health Literacy Improvement (2008), Compiled by the US Department of Health and Human Services, this resource frames health literacy improvement in terms of recommendations from the Healthy People 2010 national health objectives. This site includes guides to health literacy for specific demographic groups, government resources, and research reports. Retrieved May 28, 2009 from


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