Healthcare gaps for CALD communities 

Written by Vania Khoury RN CDE NAATI Accredited Interpreter 

In Australia, people living with diabetes from Culturally and Linguistically Diverse (CALD) communities face unique challenges due to cultural and language barriers. These challenges include limited access to healthcare services and translated information that aligns with their cultural needs. People from CALD backgrounds also experience higher rates of diabetes compared to those born in Australia, with diagnoses occurring 5-10 years earlier and often leading to worse health outcomes. These disparities highlight the pressing need for culturally appropriate and linguistically accessible healthcare services.

The differences in diabetes prevalence and risk by birthplace can be attributed to a combination of genetic, biological, behavioural and environmental factors. Additionally, language barriers, low literacy, both in their own language and English, and lack of access to culturally specific information and services all contribute to the health inequality between those born overseas and their Australian-born counterparts. 

Effective self-management of diabetes is significantly dependent on an individual’s access to culturally relevant information and services. In recognition of this critical need, the NDSS (National Diabetes Services Scheme) has actively sought community input through consultations and created an extensive collection of culturally tailored resources. These resources, available in 26 different languages, encompass written materials and audio-visual content, providing invaluable support for individuals living with diabetes who speak languages other than English. Access to these NDSS resources can be found on their Information in your language webpage.

In 2021, nearly a third of Australia’s resident population were born overseas, and this number is expected to continue rising. As a result, it is likely that at least every third client health professionals see will require tailored care to ensure they consistently enjoy a comfortable, person-centred, meaningful, action-oriented, and culturally appropriate healthcare experience. So, what steps can you take to meet your CALD clients’ needs?

Cultural competency training

Obtain training to understand and respect the cultural beliefs and practices of CALD communities. This includes learning from your client by asking respectful questions, acknowledging traditional remedies, understanding cultural views on health and illness, and respecting religious beliefs and practices that may affect health care. 

Build trust

Build trust with your client and their family. Effective communication goes beyond words; body language can transcend culture as well as the spoken word. Greeting them in their own language is a welcoming gesture that can foster a comfortable environment that is conducive to learning. 

Act with humility

As health professionals, we have as much to learn from our clients as they do from us. Approach every interaction with humility and an open mind. 

Consider social determinants

Consider the social determinants of health including factors like income, education and housing, which can greatly impact health.

Use positive language

The words you use to talk about diabetes affect the physical and emotional health of people living with diabetes. They also affect how people in society view people living with diabetes, or those at risk of developing diabetes. Using positive language does not take more time; it can save time. Diabetes Australia’s Our Language Matters serves as a useful guide about the significance of language and its potential impact.

Collaborate

Collaborate with other service providers such as social workers, mental health professionals, and community organisations to provide comprehensive care. 

Stay informed

Stayup-to-date on best practice for providing care to CALD communities. This could include learning about new research, and participating in cultural competency training. 

The NDSS Health Professional Portal or helpline 1800 637 700 can be an effective way to maintain your diabetes information. It is also important to register your clients with NDSS as it allows them to access support and services. It is free to all Australians who have been diagnosed with diabetes and have a Medicare card. 

Tailored care

Remember that each CALD community is unique, and health care should be tailored to meet the specific needs of each individual in each community. This could include offering specific screening programs, providing targeted in-language health education, and adapting treatment plans to suit the cultural and linguistic needs of each client. 

Communicate effectively

When language barriers exist, use a National Accreditation Authority for Translators and Interpreters (NAATI) Accredited Interpreter and remember to: 

• Ensure the interpreter understands medical terminology and procedures. As theyare a bridge between you and your client, their understanding is crucial. 
• Be patient. Allow enough time for your client to process the information. Don’t rush them. 
• Use short sentences and clear, concise and relevant language  
• encourage questions – this will clarify misunderstandings and show you whether they understood your message. 
• Repeat critical information to ensure the client has understood it. 
• Check for understanding by asking the client to repeat the message in their own words. This is known as teach-back which helps ensure that your message was understood. 
• Ask open-ended questions that require more than a one-word answer. This will give you insight into how well your client has understood the information. 
• provide written in-language information that they can take home and review at their leisure. See the NDSS Information in your language page.

Recognising and addressing the unique cultural, linguistic and social needs of CALD clients, establishes a more inclusive, equitable and effective healthcare environment. This, in turn, leads to improved health outcomes and a stronger foundation of trust, understanding and collaboration between healthcare professionals and their CALD clients.