Culturally and linguistically diverse

Meeting the palliative care needs of people from diverse cultural backgrounds

The Australian population includes many people that were born overseas or have a parent born overseas or speak a variety of languages. The term used to describe these communities with diverse background and cultural traditions is ‘culturally and linguistically diverse’ (CALD). Within the Australian population, there are over 300 languages spoken. Almost half of all Australians were born overseas or have parents who were born overseas. This cultural and language diversity can impact on access to and the experience of care.

Why palliative care matters

Members of the CALD community are very diverse and generalisations are not appropriate. However:

• new arrivals tend to have less chronic conditions and lower mortality rates but after 10 years in Australia this effect disappears for some groups and conditions
• language and cultural barriers may prevent timely access to palliative care
• for many refugees and those fleeing conflict, post-traumatic stress and mental health issues are more common
• some members of the CALD community have a higher incidence of life-limiting conditions that are less common within the general population. For example, hepatitis B related liver cancer is more common among Aboriginal and Torres Strait Islander people and residents born in China and Vietnam.
  
  

Common barriers and outcomes

Migrants from non-English speaking countries and people born here but with a non-English first language are more likely to experience barriers to accessing health services. This is due to communication challenges, cultural norms and religious beliefs that can influence patient and health care providers views of end-of-life. For 15 in 100 Australians, English is not their first language, and two in ten Australians speak a non-English language at home. Mistrust of the health system together with communication and health literacy barriers can mean less than optimal treatment adherence and appointment attendance by members of the CALD community.

Overcoming the barriers

Providing care that meets the cultural preferences of a person can be supported by developing a greater cultural understanding. Here are some suggestions for overcoming this barrier:

• language is often a barrier to accessing services and can result in poor health literacy. By providing interpreter and translation services, as well as health information in different languages, people may recognise signs of deterioration earlier.
• not having cultural needs met is a barrier to accessing care for CALD people. For example, some cultures tell diagnosis and prognosis to family members and not the patient, and some cultures prefer active treatment while others prefer conservative treatment. Accessing cultural competency training and utilising culture specific resources can increase knowledge of different cultural beliefs.
  
  

Learn more

To learn more about our culturally and linguistically diverse population visit the ELDAC website and Australian Government Department of Health Exploratory Analysis of Barriers to Palliative Care Issues Report on People from Culturally and Linguistically Divers Backgrounds.