Introduction by Croakey: As in previous years, Croakey is publishing a series of essays from the 2024 National Public Health Student Think Tank Competition, in which students addressed the question:
Considering the need for an inclusive public health system in Australia, propose an innovative strategy to amplify marginalised voices to address the public health challenges of today.
We launch our 2024 Think Tank series with an article advocating for senior health leadership to provide funding and support to bolster health interpreter services.
“If done right, this can assist in overcoming language barriers that many culturally and linguistically diverse communities experience when accessing healthcare,” writes Dr Claudia Rose, who is a Master of Public Health candidate.
Claudia Rouse writes:
To enable better access to healthcare for people from culturally and linguistically diverse backgrounds, support for professionally trained bilingual health workers and interpreters may be required to bolster healthcare networks through co-design and up-skilling strategies.
These strategies need financing and senior leadership support in recognising the many benefits of in-person professional health interpreters.
If done right, this can assist in overcoming language barriers that many culturally and linguistically diverse communities experience when accessing healthcare.
Health outcomes
Culturally and linguistically diverse individuals in Australia represent a large population with unique social determinants of health.
Given migration reflects climate pressures and geopolitics, migration trends are likely to increase and therefore culturally and linguistically diverse populations will become an even more significant priority for the Australian health system.
Although the experience of culturally and linguistically diverse individuals is heterogenous, health outcomes for individuals with low English proficiency are poorer, with a higher prevalence of long-term health conditions compared to those with high proficiency, according to the Australian Institute of Health and Welfare.
Compounding health outcomes are barriers to healthcare access and preventative measures such as vaccination and screening. For example, older people who speak a language other than English at home are between five and fifteen percent less likely to be up to date with vaccine schedules.
This demonstrates an urgent need to listen to communities and ensure the health system responds to their needs.
Interpreter services
Although meeting the needs of culturally and linguistically diverse individuals is multi-faceted, language barriers are a key contributor to poor health outcomes particularly in the context of insufficient access to culturally competent in-person interpreter services at healthcare interfaces.
In-person interpreters in health have demonstrated a myriad of benefits to quality care and patient satisfaction, ultimately targeting health outcomes and equity for diverse populations.
In-person interpreters have been shown to be the preferred interpreter type, enabling rapport building and targeting the social and cultural determinants of health.
Despite the benefits, current barriers to accessing interpreter services in healthcare include insufficient numbers of in-person interpreters, long wait times for services, unavailable target languages and inflexible booking processes. This reduces access and healthcare engagement for culturally and linguistically diverse individuals in Australia.
Current systems therefore need to create and support service structures that engage diverse communities and encourage self-determination to empower communities and enhancing their voice.
Existing initiatives
Independent bi-cultural work programs and bilingual workers have been developed throughout Australia and internationally.
Additionally, a new Multicultural Health Consumer and Carer Network has also been announced in Australia, informed by 16 consumers and carers. This initiative reports seeking recognition of lived experience.
It is acknowledged that a myriad of supports and interventions are needed to strengthen the health and wellbeing of culturally and linguistically diverse individuals.
One consideration to improve outcomes includes improvement in availability and readiness of professional interpreters in the Australian health workforce.
Support for existing health workers who are bilingual to undertake structured cultural/linguistic training and competency-based assessment to become certified as a proficient and evidence-based interpreter could address short-term challenges.
Such training would meet the Australian health interpreting certification standards to provide high quality healthcare in tandem with traditional interpreter pathways. This interim measure could support the workforce in the clinician’s place of current practice in periods of population influx and high service demand.
The priority for consumer safety is paramount, so the safety of linguistic services could be prioritised with baseline language proficiency assessments and further interpreter training for existing professionals to meet accreditation standards.
Trained bilingual clinicians can serve to provide high quality healthcare, improving patient safety and meeting organisational priorities.
Engaging communities
A co-design approach for community members to undertake structured education to become bilingual/bicultural workers and health interpreters could also seek to strengthen interpretation access through a broadened workforce. Building on existing strategies, recent reviews call upon the need for central financing, recognition and training.
It must be acknowledged that engaging and empowering culturally and linguistically diverse individuals in Australia goes far beyond comprehensive interpretation services and must involve community participation.
Effective consumer engagement frameworks and true co-design must be enacted to truly facilitate engagement and contemporary strategies to overcome systemic barriers.
Partnership with culturally and linguistically diverse communities and a broad range of stakeholders harnesses diversity of voice, targets social determinants and supports effective implementation strategies and aligns with internationally recognised approaches.
• Bookmark this link to follow the 2024 Think Tank series. The competition is run by Students and Young Professionals in Public Health (SYPPH) committee of the Public Health Association of Australia to enable students to showcase their innovation and enthusiasm for the field of public health.
About the author
Dr Claudia Rouse is a junior doctor and Master of Public Health candidate, focused on addressing systemic barriers to healthcare access. Rouse is a passionate healthcare professional with a deep commitment to advancing health equity and improving public health outcomes.
See Croakey’s archive of articles on primary healthcare
