Culture, Diversity and Health in Australia: Towards Culturally Safe Health Care PDF
Preview Culture, Diversity and Health in Australia: Towards Culturally Safe Health Care
Culture, Diversity and Health in Australia Australia is increasingly recognised as a multicultural and diverse society. Nationally, all accrediting bod- ies for allied health, nursing, midwifery and medical professions require tertiary educated students to be culturally safe with regards to cultural and social diversity. This text, drawing on experts from a range of disciplines, including public health, nursing and sociology, shows how the theory and practice of cultural safety can inform effective health care practices with all kinds of diverse populations. Part 1 explores key themes and concepts, including social determinants of health and cultural models of health and health care. There is a particular focus on how different models of health, including the bio- medical and Indigenous perspectives, intersect in Australia today. Part 2 looks at culturally safe health care practice focusing on principles and practice as well as policy and advocacy. The authors consider the prac- tices that can be most effective, including meaningful communication skills and cultural responsiveness. Part 3 examines the practice issues in working with diverse populations, including Indigenous Australians, Culturally and Linguistically Diverse Australians, Australians with disabilities, Australians of diverse sexual orientation and gender identity, and ageing Australians. Part 4 combines all learnings from Parts 1–3 into practical learning activities, assessments and feedback for learners engaging with this textbook. Culture, Diversity and Health in Australia is a sensitive, richly nuanced and comprehensive guide to effective health practice in Australia today and is a key reference text for either undergraduate or postgraduate students studying health care. It will also be of interest to professional health care practitioners and policy administrators. Tinashe Dune is a multi-award-winning Senior Lecturer in the areas of health sociology and public health and is also a clinical psychology registrar. At Western Sydney University Dr Dune teaches in the Interprofessional Health Science program. Her research and teaching focuses on marginalised popula- tions. This includes the experiences of culturally and linguistically diverse people, those living with dis- ability, ageing populations, LGBTIQ-identifying people and Indigenous populations. Dr Dune utilises mixed-methods approaches and interdisciplinary perspectives, which support multidimensional under- standings of the lived experience, health outcomes and empowered ways to improve wellbeing. Kim McLeod is Senior Lecturer in the School of Social Sciences at the University of Tasmania. Kim is known for her expertise in philosophically informed and arts-based health research. Much of Kim’s work explores the social change that contributes to health equity and population-level wellbeing. Kim’s approach to understanding health as ongoing processes of change is presented in her single authored book, Wellbeing Machine: How Health Emerges from the Assemblages of Everyday Life. Kim brings a multidis- ciplinary approach to her research practice. She commonly collaborates with researchers from the Health Sciences, Humanities and Social Sciences on health-related research projects. Kim’s teaching expertise is introducing health profession students to cultural safety and the social context of health. She leads col- laborative research projects to explore best teaching practice in this area. Robyn Williams has nursing and education qualifications and has over 37 years of experience of work- ing with Indigenous peoples, primarily in the Northern Territory but also all over Australia. Her fields of expertise include cultural safety, effective communication, curriculum development and program imple- mentation, evaluation of community-based programs, and qualitative research in Indigenous and rural and remote health issues and culturally safe practitioners. Culture, Diversity and Health in Australia Towards Culturally Safe Health Care Edited by Tinashe Dune, Kim McLeod and Robyn Williams First published 2021 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 605 Third Avenue, New York, NY 10158 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2021 selection and editorial matter, Tinashe Dune, Kim McLeod and Robyn Williams individual chapters, the contributors The right of Tinashe Dune, Kim McLeod and Robyn Williams to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record has been requested for this book ISBN: 978-0-367-68676-5 (hbk) ISBN: 978-1-760-52738-9 (pbk) ISBN: 978-1-003-13855-6 (ebk) Typeset in Bembo by SPi Global, India I dedicate this book to my children, Naya, Yarran and Burnum Lawson—so the world will be ready for you. Love Tinashe I dedicate this book to my partner Joanne, and Biscuit, our Golden Retriever. Your companionship sustains me every day. This book is also for all the students who are embarking on a journey in relation to culturally safe health care. Thank you for the contribution you will make towards more equitable health for us all. All the best Kim I dedicate this book to my partner Mick for your years of patience with my wind- mill tilting, and my two adult sons Stephen and Joseph—you give me hope for a future that has caring, compassionate and critical thinkers. I also dedicate this book to the students past, present, and future that have, do and will embrace the challenge of negotiating culturally safe practice. Robyn Contents List of figures xiii List of tables xiv List of boxes xv List of contributors xix Acknowledgements xxvi List of abbreviations xxviii PART I Understanding culture, diversity and health 1 1 An introduction to culture, diversity and health in Australia 3 TINASHE DUNE, KIM McLEOD AND ROBYN WILLIAMS Diversity in Australia 4 An introduction to social determinants of health 5 What are social constructions, and why do they matter? 6 Health and intersecting identities: Intersectionality 8 Cultural safety, diversity and the health care system 9 Culture, diversity and health in Australia: Towards cultural safety 11 Conclusion 13 References 13 2 The social and cultural determinants of health 15 REBECCA E. OLSON, ALLYSON MUTCH, LISA FITZGERALD AND SOPHIE HICKEY Introduction 17 Conceptualising the social determinants of health 18 Cultural determinants of health 20 Understanding culture 20 Explaining the cultural determinants of health: An “invisible” concept 22 History of the social determinants of health 23 Explaining health inequalities 24 The social determinants of health—Critical perspectives 27 Conclusion 31 References 31 viii Contents 3 Cultural models of health and health care 36 ALEXANDER WORKMAN, SYEDA ZAKIA HOSSAIN, PRANEE LIAMPUTTONG, ANGELICA OJINNAKA AND ELIAS MPOFU Introduction 37 What is health? 39 The biomedical model of health and wellbeing 39 Ethnocentrism, Eurocentrism and health 41 The biopsychosocial model of health and wellbeing 42 Primary health care models and cultural safety 43 Non-Western models of health and wellbeing 47 Conclusion 48 References 49 PART II Culturally safe health care practice 53 4 Principles of cultural safety 55 ROBYN WILLIAMS, TINASHE DUNE AND KIM McLEOD Introduction 56 Principles of cultural safety 56 Why cultural safety? 57 Understanding cultural safety in health care 58 Access to health care 60 Effects of power and authority on health care 60 Whiteness, White privilege, White fragility 62 White privilege 64 White fragility 65 Reverse racism? 66 Reactions to the launch of the codes 67 Conclusion 68 Notes 69 References 69 5 Policy and advocacy in culturally diverse health care 73 KEERA LACCOS-BARRETT AND ANGELA BROWN Introduction 74 Health policy in Australian health care 74 Social determinants of health and policy 75 Policy and standards in Australian health care 76 Health national standards 77 Cultural safety and policy considerations 79 Critiques in policies 80 Policy and cultural safety for health professionals 81 Policies, enablers and limitations towards culturally safe care 83 Contents ix Institutional discrimination 84 The role of health professionals in health advocacy 86 Scenario 1 87 Scenario 2 88 Conclusion 89 References 89 6 Culturally safe health care practice 92 KIM McLEOD, ROBYN WILLIAMS AND TINASHE DUNE Introduction 93 Culturally safe practice addresses the impact of health professionals’ cultural realities, attitudes and behaviours on others 95 Culturally safe practice recognises the importance of health care that is driven by the individual, family and community 98 Culturally safe practice acknowledges the factors that impact individual and community health 101 Culturally safe practice is regardful of culture 103 Conclusion 106 Action plan for enacting cultural safety in professional health practice 106 References 108 PART III Working with diverse populations 113 7 Aboriginal and Torres Strait Islander Australians 115 LIESA CLAGUE, JANELLE TREES AND ROB ATKINSON Aboriginal and Torres Strait Islander peoples 117 The East Coast of Australia: First arrival of the British (including convicts from Ireland, Wales, Scotland and England) in the Sydney Basin 119 What do we know about Aboriginal peoples from the Sydney Basin before the penal colony was established and invasion of land, resources, culture and society of Aboriginal peoples? 120 Impacts of invasion and the establishment of a penal colony in Australia: Breakdown of societies 122 Government policies 124 Aboriginal and Torres Strait Islander peoples and their health 127 Aboriginal Community Controlled Health Organisations (ACCHOs) and Aboriginal Medical Services (AMS): A wholistic model of primary health care 128 The importance of understanding health 128 Culture is an important determinant of health 129 Changes happening for health professional bodies such as Ahpra 131 Disparities in health 133 Scenario: Torres Strait 133 Scenario summary 137 Learn more about this topic 138 Conclusion 138 References 140
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