Australia’s population is diverse. Many people in Australia were born overseas, have a parent who was born overseas, and speak languages other than English. In 2021, 28% of Australia’s resident population were born overseas and 22% of people living in Australia who were Australian born have one or both parents born overseas.[37][38]
Additionally, in 2021, 22% of the population spoke a language other than English at home. Among people who arrived to live in Australia, 8% indicated they do not speak English well, and a further 2% do not speak English at all.[37]
People identifying as belonging to diverse populations may identify across multiple priority population groups. This intersectionality can result in compounding impacts of social, cultural, commercial and environmental determinants of health on cancer experiences and outcomes.
National health data on populations of people from diverse backgrounds is sparse.[39] Current data captured are not comprehensive and do not accurately represent the diverse and multicultural landscape in Australia.
The data that are available indicate that people from diverse backgrounds experience greater adversity in accessing culturally responsive care and information due to communication barriers, poorer health literacy, and cultural variations.[40][41][42][43]
Factors which further impact people in diverse communities accessing the care they need include the ability to navigate the health system, adequacy of interpretation, and cost to access services.[44]
People from diverse backgrounds may experience stigma due to their culture and beliefs and may find it difficult to involve their families in decisions regarding treatment options. Evidence suggests that people from diverse backgrounds experience difficulty in engaging with health professionals because of unfamiliarity with the health system and their experiences with health providers who may have a limited understanding of appropriate cultural and communication practices.[41][42][44] Additionally, people from diverse backgrounds tend to be underrepresented in clinical trials, which may lead to inequitable access to innovative cancer treatments.[45]
The Australian Cancer Plan aims to improve health equity for people from diverse backgrounds.
This includes improving communication between healthcare providers and people from diverse backgrounds through training the workforce in cultural competency, effective use of interpreter services, improving data collection and linkages to enable better identification of specific cultural demographics, and increasing health literacy through targeted cancer care information and resources, as well as access to interpreters and language-appropriate digital platforms to liaise with patients.
Year: 2018
Author: National Disability Insurance Agency, Australian Government
The Cultural and Linguistic Diversity Strategy 2018–22 is the National Disability Insurance Agency’s public statement of commitment to working alongside people with disability from diverse backgrounds to achieve access to, and outcomes from, their National Disability Insurance Scheme Plan.
Year: 2022
Author: Queensland Government
The Queensland Multicultural Action Plan 2022–23 to 2023–24 provides a framework to build the economy and community, provide better access to interpreters, and improve cultural diversity data to enhance service delivery, to improve social and economic outcomes for people from culturally and linguistically diverse backgrounds.
Year: 2020
Author: Government of Western Australia
The WA Multicultural Policy Framework sets out measurable strategies for the public sector to ensure operations, services, and programs are inclusive and accessible for people from culturally and linguistically diverse backgrounds.
Year: 2019
Author: NSW Health
The NSW Plan for Healthy Culturally and Linguistically Diverse Communities: 2019–2023 aims to ensure people of culturally and linguistically diverse backgrounds have equitable access to health care services that are culturally responsive, safe, and high quality.
Year: 2009
Author: Victorian Department of Health
The Cultural Responsiveness Framework outlines a strategic and whole-of-organisation approach for health services to strive for equal access to, and the provision of, quality health care for the whole population. The framework is designed to be aligned with health services' strategic planning processes.
Year: In development
Author: Australian Centre for the Prevention of Cervical Cancer
The National Strategy for the Elimination of Cervical Cancer will aim to eliminate cervical cancer for all people with a cervix across the diverse communities in Australia.
Year: 2018
Author: National Disability Insurance Agency, Australian Government
The Cultural and Linguistic Diversity Strategy 2018–22 is the National Disability Insurance Agency’s public statement of commitment to working alongside people with disability from diverse backgrounds to achieve access to, and outcomes from, their National Disability Insurance Scheme Plan.
Year: 2022
Author: Queensland Government
The Queensland Multicultural Action Plan 2022–23 to 2023–24 provides a framework to build the economy and community, provide better access to interpreters, and improve cultural diversity data to enhance service delivery, to improve social and economic outcomes for people from culturally and linguistically diverse backgrounds.
Year: 2020
Author: Government of Western Australia
The WA Multicultural Policy Framework sets out measurable strategies for the public sector to ensure operations, services, and programs are inclusive and accessible for people from culturally and linguistically diverse backgrounds.
Year: 2019
Author: NSW Health
The NSW Plan for Healthy Culturally and Linguistically Diverse Communities: 2019–2023 aims to ensure people of culturally and linguistically diverse backgrounds have equitable access to health care services that are culturally responsive, safe, and high quality.
Year: 2009
Author: Victorian Department of Health
The Cultural Responsiveness Framework outlines a strategic and whole-of-organisation approach for health services to strive for equal access to, and the provision of, quality health care for the whole population. The framework is designed to be aligned with health services' strategic planning processes.
Year: In development
Author: Australian Centre for the Prevention of Cervical Cancer
The National Strategy for the Elimination of Cervical Cancer will aim to eliminate cervical cancer for all people with a cervix across the diverse communities in Australia.
Improved communication about cancer prevention with individuals from diverse backgrounds was identified. This included ensuring accessible and culturally appropriate communication about the role of cancer screening in preventing cancers and identifying cancers early.
Training health workers in cultural safety and communication will support engagement with people from diverse backgrounds in cancer screening programs and promote understanding of cancer prevention and early detection.
Improved communication about cancer prevention with individuals from diverse backgrounds was identified. This included ensuring accessible and culturally appropriate communication about the role of cancer screening in preventing cancers and identifying cancers early.
Training health workers in cultural safety and communication will support engagement with people from diverse backgrounds in cancer screening programs and promote understanding of cancer prevention and early detection.
Stakeholders noted that people from diverse backgrounds experience difficulties in accessing culturally responsive supportive care and information. Language barriers impact on communication with health providers, making it difficult for individuals to understand and adhere to treatments.
The importance of culture, spiritual needs and family in health care decisions was often misunderstood or dismissed. Limited availability of tailored information, and insufficient understanding of health services were also raised as factors impacting on optimal cancer care experiences and outcomes.
People from diverse backgrounds do not always receive culturally responsive, sensitive or tailored care due to a lack of understanding of cultural needs and reliance on non-professional interpreters, such as relatives.
People from diverse backgrounds can be underrepresented in clinical trials, which may lead to members of this priority population group not being able to access the latest cutting-edge treatment. The importance of increasing engagement and participation of people from diverse communities in research and clinical trials was identified.
Stakeholders also expressed the need to improve data collection and linkage to better identify people from diverse communities that are at greatest risk of poorer cancer outcomes.
Stakeholders indicated that the cancer care workforce should reflect the cultural diversity of the cancer patient population. A culturally diverse cancer care workforce would allow for the delivery of culturally appropriate cancer care and the ability to improve communication with people with diverse backgrounds.
There are opportunities to partner with community-based organisations to train the workforce in cross-cultural communication and cultural safety. Such training would ensure that the cancer care workforce delivers culturally appropriate cancer care to patients with diverse backgrounds.
The Australian Cancer Plan considers an intersectional and health equity approach for Aboriginal and Torres Strait Islander people. This is more than recognising the multiple backgrounds, experiences, and ways Aboriginal and Torres Strait Islander people identify. This approach addresses the way membership of multiple groups may impact people's health and wellbeing needs and ability to access care.
Implementation of each action should consider the compounding impacts of intersectionality across other priority population groups.