Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service deliverySaras Henderson A C and Elizabeth Kendall B
A School of Nursing and Midwifery, Griffith Health Institute, Gold Coast Campus, Griffith University, Qld 4222, Australia.
B Griffith Health Institute and Research Centre for Population and Community Health and Centre for National Research on Disability and Rehabilitation Research, Griffith University, Logan Campus, Meadowbrook, Qld 4131, Australia.
C Corresponding author. Email: email@example.com
Australian Journal of Primary Health 17(2) 195-201 http://dx.doi.org/10.1071/PY10065
Submitted: 10 September 2010 Accepted: 7 March 2011 Published: 7 June 2011
With 28% of Australia’s population having a culturally and linguistically diverse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage.
Additional keywords: community-based navigators, culturally appropriate health service delivery, culture, ethnicity, focus groups.
ReferencesAriotti L (1999) Social construction of Anangu disability. The Australian Journal of Rural Health 7, 216–222.
| Social construction of Anangu disability.CrossRef | 1:STN:280:DC%2BD3c7pslSlsA%3D%3D&md5=88627609a6d8f5548642c73f997f3bddCAS | 10732511PubMed |
Australian Bureau of Statistics (1996) ‘Aspects of Literacy: Assessed Skill Levels.’ Catalogue no. 4228.0 (ABS: Canberra)
Bates MS, Edwards WT (1992) Ethnic variations in chronic pain experience. Ethnicity & Disease 2, 63–83.
Bates MS, Rankin-Hill L, Sanchez-Ayendez M, Mendez-Bryan R (1995) A cross cultural comparison of adaptation to chronic pain among Anglo-American and native Puerto Ricans. Medical Anthropology 16, 141–173.
| A cross cultural comparison of adaptation to chronic pain among Anglo-American and native Puerto Ricans.CrossRef | 1:STN:280:DyaK2M3jtFamtQ%3D%3D&md5=30e0840c98193b9c67622624db710049CAS | 7715417PubMed |
Berger JT (1998) Culture and ethnicity in clinical care. Archives of Internal Medicine 158, 2085–2090.
| Culture and ethnicity in clinical care.CrossRef | 1:STN:280:DyaK1M%2FhsFOqsQ%3D%3D&md5=a8946f55d6ce92aab9a13d1ae1b6b360CAS | 9801174PubMed |
Bishop C, Earp JA, Eng E, Lynch KS (2002) Implementing a natural helper lay health advisor program: Lessons learned from unplanned events. Health Promotion Practice 3, 233–244.
| Implementing a natural helper lay health advisor program: Lessons learned from unplanned events.CrossRef |
Bloor M, Frankland J, Thomas M, Robson K (2001) ‘Focus groups in social research.’ (Sage Publications: London)
Brach C, Fraser I (2000) Can cultural competency reduce racial and ethnic disparities? A review and conceptual model. Medical Care Research and Review 57, 181–217.
Culley L, Hudson N, Rapport F (2007) Using focus groups with minority ethnic communities: Researching infertility in British South Asian communities. Qualitative Health Research 17, 102–112.
| Using focus groups with minority ethnic communities: Researching infertility in British South Asian communities.CrossRef | 17170248PubMed |
Eckermann A, Dowd T, Chong E, Nixon L, Gray R (1992) ‘Binangoonj: Bridging cultures in aboriginal health.’ (UNE Press: Armidale)
Eng E, Smith J (1995) Natural helping functions of lay health advisors in breast cancer. Breast Cancer Research and Treatment 35, 23–29.
| Natural helping functions of lay health advisors in breast cancer.CrossRef | 1:STN:280:DyaK2Mzjsleqsw%3D%3D&md5=8d3b01773a1a1115f758853ad677cfd6CAS | 7612900PubMed |
Halcomb EJ, Gholizadeh L, DiGiacomo M, Phillips J, Davidson P (2007) Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups. Journal of Clinical Nursing 16, 1000–1011.
| Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups.CrossRef | 17518876PubMed |
Jenkins CNH, Le T, Mcphee SJ, Stewart S, Ha NT (1996) Health care access and preventive care among Vietnamese immigrants: Do traditional beliefs and practices pose barriers? Social Science & Medicine 43, 1049–1056.
| Health care access and preventive care among Vietnamese immigrants: Do traditional beliefs and practices pose barriers?CrossRef | 1:STN:280:DyaK2s%2FksFemsg%3D%3D&md5=a511ac0eb07ca87218905bb467873cf4CAS |
Kelaher M, Williams G, Manderson L (1999) Towards evidence-based health promotion and service provision for new migrants to Australia. Ethnicity & Health 4, 305–313.
| Towards evidence-based health promotion and service provision for new migrants to Australia.CrossRef | 1:STN:280:DC%2BD3c7mvFOntg%3D%3D&md5=0391bc3bb16a605f16399bbf9ee23d37CAS | 10705566PubMed |
Kleinman A, Eisenberg L, Good B (1978) Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine 88, 251
Knodel J (1995) Focus groups as a qualitative method for cross-cultural research in social gerontology. Journal of Cross-Cultural Gerontology 10, 7–20.
| Focus groups as a qualitative method for cross-cultural research in social gerontology.CrossRef |
Lewin S, Babigumira SM, Bosch-Capblanch X, Aja G, van Wyk B, Glenton C, Scheel I, Zwarenstern M, Daniels K (2007) ‘Lay health workers in primary and community health care: a systematic review.’ Available at http://www.cochran.org/reviews/en/ab004015.html
Maher P (1999) A review of traditional Aboriginal health beliefs. The Australian Journal of Rural Health 7, 229–236.
| A review of traditional Aboriginal health beliefs.CrossRef | 1:STN:280:DC%2BD3c7pslSltg%3D%3D&md5=0ad33bb1fc35786b18fa84897386017fCAS | 10732513PubMed |
Manderson L, Allotey P (2003) Storytelling, marginality, and community in Australia: How immigrants position their difference in health care settings. Medical Anthropology 22, 1–21.
| Storytelling, marginality, and community in Australia: How immigrants position their difference in health care settings.CrossRef | 12641294PubMed |
Mayeno L, Hirota SM (1994) Access to health care. In ‘Confronting critical health issues of Asian and Pacific Islander Americans.’ (Eds NWS Zane, DT Takeuchi, KNJ Young) pp. 347–375. (Sage Publications: Thousand Oaks)
Morgan DL, Slade MD, Morgan CM (1997) Aboriginal philosophy and its impact on health care outcomes. Australian and New Zealand Journal of Public Health 21, 597–601.
| Aboriginal philosophy and its impact on health care outcomes.CrossRef | 1:STN:280:DyaK1c7jtFSnsw%3D%3D&md5=a6ff84921697590441f91cf22e2b1cbeCAS | 9470265PubMed |
Payer L (1998) ‘Medicine and culture.’ (Penguin New: York)
Ramsden I (1990) Cultural safety. The New Zealand Nursing Journal. Kai Tiaki 83, 18–19.
Smith LT (1999) ‘Decolonising methodologies: Research and indigenous peoples.’ (University of Otago Press: Dunedin)
Walker C, Weeks BA, McAvoy B, Demetriou E (2005) Exploring the role of self-management programmes in caring for people from culturally and linguistically diverse backgrounds in Melbourne, Australia. Health Expectations 8, 315–323.
| Exploring the role of self-management programmes in caring for people from culturally and linguistically diverse backgrounds in Melbourne, Australia.CrossRef | 16266419PubMed |
Watt IS, Howel D, Lo L (1993) The health care experience and health behaviour of the Chinese: A survey based in Hull. Journal of Public Health Medicine 15, 129–136.