More needs to be done to ensure that people from culturally and linguistically diverse backgrounds have access to healthcare, including blood pressure checks for older people, according to Dr Isabella Tan from The George Institute for Global Health.
Below, Tan calls on health organisations, community health workers, and researchers to work together to bridge the gap in healthcare access for people from culturally and linguistically diverse communities.
Isabella Tan writes:
Australia has one of the best health systems in the world, yet people from culturally and linguistically diverse (CALD) backgrounds tend to utilise healthcare less due to language barriers, lower health literacy, and a range of other factors.
Despite being of CALD background myself (I was born in Hong Kong and have lived in Australia since I was a teenager), this only became apparent to me last year when I had the opportunity to work alongside a Community Hearing Advisor from Hearing Australia.
Hearing Australia organises community events regularly throughout the year to provide hearing health information and free hearing checks to the community all around Australia.
As part of the May Measure Month campaign, a global blood pressure screening awareness campaign, Hearing Australia and The George Institute for Global Health joined forces to provide free hearing and blood pressure checks at various community hearing events over the course of one month in Sydney, NSW in 2023.
This was a pilot venture to see if it would be feasible to add blood pressure checks at all community hearing checks run by Hearing Australia.
On one occasion, we visited a group of around 25 to 30 older women of Cambodian (Khmer) background at their weekly meeting place and, with the help of a translator, spoke on the importance of hearing health and heart health.
After the talk, we provided free blood pressure checks for the women present. In a short span of one hour, 15 women queued to have their blood pressure checked. Many of these women mentioned they did not regularly visit a doctor, much to my surprise. These women were 70 years or older, and quite a few of them had measured high blood pressure and therefore at risk of a stroke or heart attack.
Since then, I have had further opportunities to present health information – specifically on high blood pressure, atrial fibrillation and stroke – alongside other colleagues and provide blood pressure and atrial fibrillation checks to other CALD communities as part of the May Measure Month and World Stroke Day campaigns.
Each time, I was overwhelmed by the engagement community members showed toward the health information and their enthusiasm for health checks, and the fact that there was always more than one person who indicated they hadn’t been to a doctor for at least two years.
Bridging the gap through community health talks
When we bring health information and health checks to culturally and linguistically diverse communities in their familiar environment and in their own language – whether it be through a translator or through a presenter who can speak the same language – they tend to engage much better.
Attendees at these events often asked thoughtful questions, including: “What is the best time for taking blood pressure at home?” and“How tight does the cuff on my arm have to be when taking blood pressure?”.
Another question – “Can I still have coffee or tea if I have high blood pressure?” – has long been subject of debate in the cardiology community but latest research suggests moderate caffeine consumption appears to be okay and perhaps even beneficial for heart health, unless you have very high blood pressure.
Admittedly, the number of participants attending these events is not large. All together, we screened just over 100 individuals in 2024 across four separate events, with one event having more than 50 attendees.
However, considering the people who attended were in their 60s, 70s, and even 80s – some who had not had a health check in more than two years and were found to have high blood pressure – the return on our time was significant.
Whilst these events have not been formally evaluated, I like to think we may have helped participants get motivated enough to see a doctor, get treated, and ultimately prevented them from having a stroke or heart attack before it was too late.
This emphasises the need to have follow-up measures in place to ensure screening results in further action. We know that screening alone is not enough.
Improving healthcare access
Due to lack of funding and resources, we were not able to continue the joint venture with Hearing Australia last year, nor present our community health talks and health checks on a regular basis beyond May Measurement Month and World Stroke Day campaigns.
We are now seeking further resources and support to continue these events in 2025 and beyond.
It will take many people, organisations and the government to work together to improve access to healthcare for CALD communities who have settled in multiple cities and call our beautiful country home.
While the gears of research, multidisciplinary care and government policy are turning, health organisations, community health workers, and researchers can reach our CALD communities – together.
We can bring health information and fundamental health checks like blood pressure checks to them, one health talk at a time. We cannot wait for the community to come to us.
About the author
Dr Isabella Tan is a Research Fellow in the Cardiovascular Program at The George Institute for Global Health. She is currently involved in several blood pressure trials at The George Institute and would like to see more health partners work together to achieve efficient and cost-effective multidisciplinary care, particularly through combined health screening in at-risk populations including CALD communities.
Dr Tan would like to acknowledge everyone who supported, facilitated or volunteered at the community events, in particular Dr Zien Zhou who co-presented the health talks.
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