WORKING WITH CULTURALLY AND LINGUISTICALLY DIVERSE (CALD) BACKGROUND POPULTIONS

1. WORKING WITH CULTURALLY AND LINGUISTICALLY DIVERSE (CALD) BACKGROUND POPULTIONS CALD Chronic Disease Program Ethnic Communities Council of Queensland

2. In this presentation • Who are CALD background people? • CALD health statistics • Challenges we face • Population health planning

3. Multicultural Australia • In all since 1945, seven million people migrated to Australia • Today 1 in 4 of Australia’s 22 million people were born overseas • 4 million speak a language other than English at home • We speak over 260 languages and • Identified with more then 270 ancestries • ‘Multiculturalism is all about all Australians and for all Australians’ , The People of Australia – Australia’s Multicultural Policy, 2011

4. Multicultural Queensland (Census 2006) • 33% of Queenslanders were born overseas or have a parent who were born overseas • Almost 8% of Queenslanders speak other language than English at home • Or 1.2 % percent of the population are either to speak English well, or not at all

5. CALD Health Statistics • Very limited understanding of the health status of Australian CALD populations • No systematic collection and reporting of data on CALD health across Australian jurisdictions • Recent literature review reported that only 2.2 percent of the total articles published in the past 12 years in the three major Australian healthcare journals were preliminary on CALD health issues • Further conclusion highlighted that apart from some refugees, asylum seekers and Vietnamese immigrants health issues of other CALD populations remained under researched and unrepresented in Australian research

6. Who are CALD background people? • Since 1996, Commonwealth agencies have agreed to replace NESB with the term ‘Culturally and Linguistically Diverse’. • The Australian Bureau of Statistics (ABS) defines CALD by three variables: 1. Country of birth 2. Language other than English spoken at home, and 3. English language proficiency • In the Australian context, individuals from a CALD background are those who identify as having specific cultural or linguistic affiliation by virtue of their place of birth, ancestry, ethnic origin, religion, preferred language, or language spoken at home, or because of their parents identification on a similar basis

7. Challengers we face National Health and Medical Research Council (2006) Observation on evidence in multicultural health: “…individuals and groups from CALD backgrounds are being systematically excluded in the research due to the challenges and additional investments required to ensure participations. Research frequently excludes consideration of people from CALD backgrounds and their health issues.” Some of the reasons: • Costs • Inappropriate exclusion criteria • Attitudes • Socio-cultural barriers

8. Challengers we face con. • Most data reported in major Australian surveys and reports is only on country of birth commonly aggregated into regions (United Kingdom, Other North-West European, Southern and Eastern European, North Africa and Middle East, South East Asia and All other countries) • Data appear accurate • ‘ misclassification bias’ (Bhopal, 2009b) • Response can not be developed

9. Population health planning • Acknowledge that the quality of Australian data to inform policy makers, program developers and service development is poor • By not being including CALD populations in the clinical trials we are missing vital evidence to inform clinical practice improvement concerning this particular populations • It is difficult to advocate for the investment if the evidence is not there to support it Recommendations: • Review Standards for Statistics on Cultural and Language Diversity • Mandatory inclusion of CALD populations in research • Funded national multicultural health research • Training for researchers and grant assessors

10. Questions?????