Cultural Sensitivity in Healthcare Services

The assignment discusses the challenges faced by indigenous Australians in accessing healthcare services due to cultural insensitivity and lack of culturally acceptable care. The author reflects on their own cultural background and how it differs from that of indigenous Australians, gaining a deeper understanding of their experiences and struggles. The assignment highlights the need for Australia to implement initiatives that integrate culturally sensitive care into its healthcare system, including designing flexible services, employing indigenous staff, and training other staff in cultural competence skills.

Running head: BACHELOR OF NURSING
Bachelor of nursing
Name of the student:
Name of the University:
Author’s note

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Topic: cultural diversity in Australia and health issues specific to indigenous people in
Australia
Reflection of feelings, thoughts and behavior using the SI template:
C. Wright Mills gave the term social imagination to establish the relation between
personal experience and the wider society. It can also be defined as the method of using
imaginative thought to interpret and understand sociological issues in society (Giddens et al.,
2016). Germov, (2014) argued that sociological imagination is a type of thinking approach in
which realities of our lives are connected with larger social realities. Reflection by the use of
sociological template shows enables focusing not just on own personal problems, but also
understand the issues of the wider society. The sociological imagination template is widely used
in real life to understand the social issues experienced by certain sections of society. The
sociological imagination template facilitates understanding of wider social issues by focusing on
the following interrelated factors:
 Historical factors Cultural factors Structural factors Critical factors
The above mentioned factors enables reflection on personal values and beliefs and what
factors shape or influence behavior of a person. The same factors can be analysed from the
perspective of the wider society too. This reflective paper particularly focused on applying the
sociological imagination template to discuss about cultural diversity in Australia and how

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Australian health care system meet the needs of the diverse population groups. Reflection is also
given on specific health issues present in this group.
While working in Australia, I came to about the cultural diversity in the country. It’s unique
history has contributed to the diversity in people, cultures and behaviors of people residing in the
country. Today, it is known as the most culturally and linguistically diverse nation in the world
because immigrants, indigenous population and the people from British colonial past comprise
the Australian demographic (Face the facts: Cultural Diversity | Australian Human Rights
Commission, 2017). Through my experience in the health care field, I got to learn about the
immense challenges the staff face due culturally diverse patient group and the preparedness of
the system to meet the needs of such people. The Australian Government now realizes the
reasons for health inequality between indigenous and non-indigenous people after the publication
of the data on health status and life expectancy of indigenous Australians. In the past, cultural
competence levels were increased only in case of particular situations. However, after the
enactment of the Close the Gap policy, embedding cultural competence became a priority at both
administrative level and operational level. I have seen many new developments are now taking
place to develop a culturally competent health service (Cultural competency in the delivery of
health services for Indigenous people, 2017). My professional work also gave me the
responsibility to interact with the indigenous people. Before doing this task, I was not ware about
the history of their migration and the negative experience that has contributed to adverse health
issues in them. However, after doing the research work for this reflective assignment, I have
more respect for indigenous people because they have experienced negative health outcome due
to experience of discrimination and they deserve all the right to be treated equally in society.

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Reflection on the topic using SI template:
Historical factors:
After shifting to Australia, I became aware of the vast culturally diversity and rise in
immigrants population in the country. I saw a huge cultural shift due to wide difference in the my
own cultural background and indigenous people of Australia. I was born and raised in Nepal and
I follow Hindu religion. Language barrier was also a challenge for me while working in Australia
because only 16% of the population spoke in English and about 61,000 people spoke in
indigenous language. Although my first language is Nepali, however I have been speaking
English since childhood. So, I had the expectation that knowledge of English language would be
enough to work in Australia. However, the diversity in language and culture made me amazed. I
saw that the indigenous people choices were highly influence by their culture and past
experience. I also have an affinity towards my culture and my society taught me to be respectful
and helpful towards other people. The events of discrimination and poor experience faced by
indigenous people shocked me because in my own community, we had a strong bonding and I
never expected such inequality could exist in society. In our society, people always lend a
helping hand in different events such as festivals, marriages or funeral. However, in the Australia
culture, I found very different concept regarding interacting with people and bonding with them.
The multiculturalism in Australia has been seen mainly because people from diverse
culture, ethnic, linguistic and religious group reside in the country. For instance, the indigenous
group of Aboriginal and Torres Strait Islander people have been residing in the country since
many thousands years and currently they comprise about 2.8% of the population (Census:
Aboriginal and Torres Strait Islander population, 2017). Secondly, immigrants are coming in the
country since thee past two centuries (Multicultural Australia, 2017). Indigenous people have

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resided in Australia since 60, 000 years and history of migration starts from the time before
European settlement. At that time, no direct interaction between aboriginals and other people
were seen in the country (Our shared history | Sections | Share Our Pride 2017).
The White Australian policy also imposed restriction on the migration of the non-
European people to preserve British cultural identity. However, after the enactment of Racial
Discrimination Act and many other reforms, the Aboriginal people got the right to leave in the
country. The Assimilation policy was one of the policy that encouraged people to enhance their
cultural competency skills and embrace people from all culture. The health care department also
prepared themselves to address the health needs of the indigenous people by extending training
to improve the cultural competency of health care staff (Rumbaut, 2015).
Cultural factors:
Culture has a vast impact on health and health related choices. For instance, in my
birthplace Nepal, I have found people to believe on the supernatural elements for illness and pain
and so they mostly try to seek relief from illness by means of prayers and other rituals. Although
my cultural beliefs also influence my decisions in life, however I have prioritized my health by
focusing on the biomedical aspects of health care.
Different cultural beliefs affect perception of health, causes illness, manner of seeking
treatment and preference for particular treatment too. I got to know this by investigating about
the reasons for great gap in health outcome between indigenous and non-indigenous population.
The Australian culture is mixed culture where great difference is seen in the common beliefs and
values of people. This has an impact of health outcome and life expectancy of both group. The
statisctical data shows that life expectancy of the indigenous population is much lower than the

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rest of the population for almost all age groups. Circulatory disease was found to be the major
cause of mortality in indigenous people (Life expectancy (AIHW), 2017). The excess mortality
rate has been linked to poor health behavior of the group such tobacco smoking, alcohol
consumption, obesity, poor nutrition and poor utilization of health service. All behavioral risk
factors were influence by their cultural beliefs and values too and the social gradient. For
instance, susceptibility to disease was high due to their lower social standing (Shepherd, Li, &
Zubrick, 2012).
The health behavior of indigenous Australians was also highly influenced by their
cultural beliefs and values. Their culture, social network, socioeconomic disadvantage, racism
and psychological distress affected their health behavior and choices. Secondly, connection to
family and focus on cultural obligation disrupted positive health behavior. In addition, the
acceptability of the health service was affected because of the effects of colonization, lack of
trust and poor cross-cultural communication (Waterworth et al., 2015). Different concepts about
health and treatment of illness further deteriorated their health status and well-being.
Structural factors:
Just like indigenous Australians, my cultural beliefs affected the manner in which I
interact with the social structure in societies. For instance, while deciding to go to college or
while proceeding ahead with professional choices, following family obligations was important
for me. These obligations helped me to decide which type of jobs I can take and which I cannot
take because of cultural or religious obligations of Hinduism.
In Australia, the health care is not designed to tackle people from culturally diverse
background. Health care professionals and nurse’s focus more on biomedical model of care and

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social element has not been include in health care delivery. This has been the reason for poor
utilization of health service by the indigenous group. While investigating about the reasons for
poor utilization of health service among indigenous people, I found that apart from cultural
obligations, language and communication barrier was a major reason for poor utilization of
service. Health professionals failed to comprehend message of indigenous group and they were
not aware about the ways to approach indigenous patient. Another gap in health structure was
that there is lack of non-discriminatory service to support the complex health needs of the target
group. In addition, poor physical availability of the service for indigenous people affected the
accessibility of the service in remote setting (Ware, 2017).
Critical factors:
My cultural values had never affected my life because in my birthplace, no disparity was
seen due to cultural background of people. However, after reviewing the health status of
indigenous Australian and the increase in mortality rate in people, major flaws have been found
in the Australian health care system. There is lack of culturally acceptable health care service and
Australia needs to urgent implement initiatives to integrate culturally sensitive care in current
service and improve the factors leading to accessibility of the service. Some of the beneficial
strategies many include designing flexible service, indigenous specific service and culturally
appropriate health promotion campaigns, employing indigenous staff and training other staffs in
cultural competence skills (Truong, Paradies, & Priest, 2014).

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Discussion on achievement of ACU Graduate attributes through reflection:
This reflective exercise on comparing my own cultural background and beliefs and
cultural beliefs and health behavior of indigenous population was a useful learning exercise for
me. I was not aware that cultural difference could affect health service and health status of a
person in a significant way as my country does not have culturally diverse population
demographics like Australia. However, after getting the knowledge about the history of
multiculturalism in Australia and the reasons for health disparity in indigenous population, I have
more respect for this group. I feel that the society has done injustice to them for which they
needed to leave their homeland and come to Australia. Secondly, they witnessed racism and
heath issues also because of lack of cultural sensitivity in the Australian health care system.
Now, I have more respect for this group and I feel that human diversity should be respected and
no one should be discriminated on grounds of cultural background and past history. Hence, I
have achieved the ACU graduate attribute respect for the diversity of each individual through
this reflective exercise.

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Reference
Census: Aboriginal and Torres Strait Islander population. (2017). Abs.gov.au. Retrieved 6
September 2017, from
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6B7CA25814800087E03?OpenDocument
Cultural competency in the delivery of health services for Indigenous people. (2017). Retrieved 6
September 2017, from
http://www.aihw.gov.au/uploadedFiles/ClosingTheGap/Content/Our_publications/2015/
ctgc-ip13.pdf
Face the facts: Cultural Diversity | Australian Human Rights Commission.
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