English Proficiency as a Public Health Determinant: A Theory Adaptation Model of Sustainable Health Practices Among Nigerian Students
Abstract
Abstract English dominates global health information, yet many Nigerian students lack the proficiency to access and apply it. This position paper uses theory adaptation to integrate the Health Belief Model, Social Cognitive Theory, and Functional Health Literacy to explain how English proficiency enables sustainable health practices among Nigerian students. We argue that English proficiency improves Functional Health Literacy, which reduces perceived barriers and increases self-efficacy for preventive behaviours. Self-efficacy enables students to maintain personal hygiene, balanced nutrition, mental wellness, and environmental stewardship. The model specifies a sequential mediation pathway from English proficiency through Functional Health Literacy and self-efficacy to sustained health practices. These relationships are moderated by institutional language policy, cultural context, and scientific vocabulary support. The paper contributes by re-framing English proficiency as a public health determinant rather than a purely academic skill and by providing testable propositions for future empirical work. The paper concludes that without addressing linguistic determinants, health knowledge will remain inaccessible to the students who need it most. Suggestions for policy include embedding simplified English texts, bilingual glossaries, and plain language standards into school health curricula. Teacher training should address code-switching and cultural reconciliation of biomedical concepts so comprehension translates into sustained behaviour.