Culture, Diversity and Health in Australia : Towards Culturally Safe Health Care

Cover Half Title Title Page Copyright Page Dedication Table of Contents List of figures List of tables List of boxes List of contributors Acknowledgements List of abbreviations Part I: Understanding culture, diversity and health Chapter 1: An introduction to culture, diversity and health in Australia Learning outcomes Key terms Chapter summary Diversity in Australia Country of birth, ethnicity and ancestry Geography Language Religion Diversifying the term diversity An introduction to social determinants of health What are social constructions, and why do they matter? Health and intersecting identities: Intersectionality Cultural safety, diversity and the health care system Why is cultural safety important? The role of health professionals in promoting cultural safety Culture, diversity and health in Australia: Towards cultural safety Rationale for this textbook Overview of the textbook Cultural safety teaching and learning resources in this book Conclusion References Chapter 2: The social and cultural determinants of health Learning outcomes Key terms Chapter summary Introduction Conceptualising the social determinants of health Cultural determinants of health Understanding culture Explaining the cultural determinants of health: An “invisible” concept History of the social determinants of health Explaining health inequalities The social determinants of health—Critical perspectives Limitations of measurement Unidirectional/causal relationships Socio-political context Conclusion References Chapter 3: Cultural models of health and health care Learning outcomes Key terms Chapter summary Introduction What is health? The biomedical model of health and wellbeing Critiques of the biomedical model Ethnocentrism, Eurocentrism and health The biopsychosocial model of health and wellbeing Critiques of the biopsychosocial model Primary health care models and cultural safety Considering cultural perspectives on health and wellbeing Reflections on the primary health care models and cultural perspectives of health and wellbeing Non-Western models of health and wellbeing Eastern ways of health and wellbeing in practice Critiques of non-Western models of health Conclusion References Part II: Culturally safe health care practice Chapter 4: Principles of cultural safety Learning outcomes Key terms Chapter summary Introduction Principles of cultural safety Why cultural safety? Understanding cultural safety in health care Access to health care Effects of power and authority on health care Whiteness, White privilege, White fragility White privilege White fragility Reverse racism? Racism is not directional Reactions to the launch of the codes Conclusion Notes References Chapter 5: Policy and advocacy in culturally diverse health care Learning outcomes Key terms Chapter summary Introduction Health policy in Australian health care Social determinants of health and policy Policy and standards in Australian health care Health national standards Cultural safety and policy considerations Critiques in policies Policy and cultural safety for health professionals Policies, enablers and limitations towards culturally safe care Institutional discrimination The role of health professionals in health advocacy Scenario 1 Scenario 2 Conclusion References Chapter 6: Culturally safe health care practice Learning outcomes Key terms Chapter summary Introduction Culturally safe practice addresses the impact of health professionals’ cultural realities, attitudes and behaviours on others Culturally safe practice recognises the importance of health care that is driven by the individual, family and community Trust and respect Shared dialogue Collaboration, partnership and power sharing Culturally safe practice acknowledges the factors that impact individual and community health Culturally safe practice is regard ful of culture Conclusion Action plan for enacting cultural safety in professional health practice References Part III: Working with diverse populations Chapter 7: Aboriginal and Torres Strait Islander Australians Learning outcomes Key terms Chapter summary Aboriginal and Torres Strait Islander peoples Aboriginal peoples Torres Strait Islanders The East Coast of Australia: First arrival of the British (including convicts from Ireland, Wales, Scotland and England) in the Sydney Basin 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? Impacts of invasion and the establishment of a penal colony in Australia: Breakdown of societies Government policies Aboriginal and Torres Strait Islander peoples and their health Aboriginal Community Controlled Health Organisations (ACCHOs) and Aboriginal Medical Services (AMS): A wholistic model of primary health care The importance of understanding health Culture is an important determinant of health Changes happening for health professional bodies such as Ahpra Disparities in health Scenario: Torres Strait Story continues Scenario summary Learn more about this topic Conclusion References Chapter 8: Culturally and linguistically diverse Australians Learning outcomes Key terms Chapter summary Introduction Australia’s migration policies—A brief history Contemporary Australia and cultural diversity Who are culturally and linguistically diverse Australians? The relationship between culture and health The “healthy migrant effect” Health disparities Barriers to CALD health care Culturally safe health care with CALD communities Conclusion References Chapter 9: Religious diversity in Australia Learning outcomes Key terms Chapter summary Introduction What is religion? Religion and the Australian census Catholics and abortion The rise of nonreligion Religion in Australia Religion and migration Culturally safe health care practice for patients’ religious and spiritual needs Respect and methodological agnosticism “Cults” and “dangerous” religions Religion and suffering Religious diversity and self-confidence Respect: Living well with religious diversity Conclusion Useful website resources References Chapter 10: Australians with disabilities Learning outcomes Key terms Chapter summary Introduction Understanding disability Australian context Overlap between disability and health issues The medical model and the social model in health care Social determinants of health and why these matter to people with disability Systemic and systematic disability discrimination Barriers and facilitators to developing culturally safe health care Barriers to respectful communication Poor quality of information and documentation as a barrier Limited time and heavy caseloads as a barrier Facilitator to respectful communication Flexible and non-judgemental communication as a facilitator Supportive decision making as a facilitator Collaboration as a facilitator Streamlining information using technology as a facilitator Liaison and specialist team models as facilitators Barriers to accessing services Universal design as a facilitator when planning accessible health care Conclusion Commitment to education and professional development References Chapter 11: Gender and health Learning outcomes Key terms Chapter summary Introduction Social constructions of gender Constructions of masculinity Constructions of femininity The relationship between gender constructions and health outcomes Limitations of existing research Australian health policies and systems Gender-based health programs and cultural safety Men’s Sheds African Women Australia Inc. The role of the health professional Conclusion References Chapter 12: Australians of diverse sexual orientations and gender identities Learning outcomes Key terms Chapter summary Introduction Relevant terms Gender Intersex Sexuality Gender and sexuality diversity Heteronormativity Minority stress Introduction to stigma and discrimination Social determinants of health Stigma Discrimination Barriers and facilitators to culturally safe health care for gender and sexuality diverse Australians Creating inclusive health settings Digital health interventions Cultural safety: Addressing stigma and discrimination in health care Case studies Acknowledgements Notes References Chapter 13: Ageing Australians Learning outcomes Key terms Chapter summary Introduction Ageing in Australia Ageing, health and wellbeing Age-associated health complications Impacts on societal participation Chronic conditions Mental health of older Australians Social dynamics of ageing Ageism and social exclusion Elder abuse Loneliness Caregiver burden Health literacy in older adults Ageing and the health system Health care costs for older adults Increased health care demand and use with age Diversity in health care needs and access for older adults Towards a health care system to support Australia’s ageing population Conclusion Useful website resources References Part IV: Culturally safe teaching and learning Chapter 14: The future of culture, diversity and health in Australia: Culturally safe teaching and learning Learning outcomes Key terms Chapter summary A model for cultural safety teaching and learning in Australia Principle 1: Consistent self-awareness and self-reflection Learning activity Learning assessment Feedback Principle 2: Reflecting on social constructions, social determinants and intersectionality Learning activity Learning assessment Feedback Principle 3: Exploring diversity and difference in experiences and expectations of health and wellbeing Learning activity Learning assessment Feedback Principle 4: Becoming familiar with the principles of cultural safety Learning activity Learning assessment Feedback Principle 5: Understanding the importance of cultural safety and its relevance to health policy and advocacy Learning activity Learning assessment Feedback Principle 6: Engaging in culturally safe health care practice Learning activity Learning assessment Feedback Principle 7: Applying principles for cultural safety with diverse populations Learning assessment Feedback Principle 8: Evaluating the impact of cultural safety in practice Conclusion References Glossary Index "Australia is increasingly recognised as a multicultural and diverse society. Nationally, all accrediting bodies 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 healthcare. There is a particular focus on how different models of health including the biomedical and Indigenous perspectives intersect in Australia today. Part 2 looks at culturally safe healthcare practice focusing on principles and practice as well as policy and advocacy. The authors consider the practices 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 healthcare. It will also be of interest to professional healthcare practitioners and policy administrators"-- Provided by publisher Australia is increasingly recognised as a multicultural and diverse society. Nationally, all accrediting bodies 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 biomedical 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 practices 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.