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Ethnic populations continue to rise in Australia with 1 in every 4 Australians in 2001 born outside Australia and rising annually. It has been acknowledged and documented that there are disparities in health outcomes for people from CALD backgrounds, and the way that they access and use the health system. There is also a policy background which underpins our commitment to equality in healthcare. For example the charter of Human Right and Responsibilities Act, various state frameworks eg. The Cultural Competency in health guidelines (Commonwealth – 2005), The Cultural Responsiveness Framework in Victoria (2009), as well as the Australian Safety and Quality in health Care Commission’s Standards.
Julia Puebla Fortier, Director, DiversityRx – Resources for Cross Cultural Health Care, who’ll be speaking on global initiatives on health for multicultural populations at one of IIR Australia’s health conferences, Culturally Responsive Health Services this August, has given us her time to answer a few questions on this very topic.
Please explain the importance of addressing inequalities for culturally and linguistically diverse groups within the healthcare system?
The goal of most health care organizations is to provide high quality care that leads to the best possible outcomes, both for individuals and for communities. When people feel that their needs or individual circumstances are not understood by providers, they tend not to seek care. When care is delayed until it is unavoidable, outcomes tend to be worse. Clearly the individual impact of delayed care can be tragic. But the multiplier effect of poor health status and outcomes for whole segments of the population is a problem for health systems too. More advanced disease generally costs more, and families and communities are put at risk when preventable or treatable illnesses are unaddressed. It may take extra efforts to adapt health systems to respond to cultural and linguistic needs, but there will certainly be gains in more appropriate utilization of services and adherence to treatment.
What are some of the main challenges to achieving health equity?
Lack of awareness — both about the barriers to care experienced by diverse populations and the strategies that providers can use to break through those barriers. The education process should start in the pre-professional training period, and continuing education would ideally target all the players in the system, from front-line staff staff to CEOs and boards of directors. It is often a challenge to change provider attitudes about the need for adapting health services for the particular needs of CALD populations — this is why it’s so critical to have high-level organizational leadership that prioritizes the issue through words, actions and resources.
What are some of the most interesting research or technological developments in this field at the moment?
It has been exciting to see a steady stream of research that looks at the relationship between cultural and linguistic competence interventions and outcomes, many published in mainstream medical journals. We have done a good job of documenting the problem — now we need to focus on what works from both the clinical and process perspectives.
The role of technology — internet based tools, apps, smartphones, video interface, health IT — is transforming how health care is delivered. While the essence of cross cultural health care is a highly engaged and empathetic personal encounter, there is a powerful role for technology in supporting both clinicians and patients by making tools, data and educational information readily available and interactive format.
