Our recent report, We all stand on sacred ground, draws attention to the harmful impact of racism in Australia’s healthcare system. This discrimination can have dire health impacts, up to and including death. The report brings together findings from over 400 studies. It raises alarm bells about the urgent need for systemic change to ensure equitable and effective healthcare for all Australians.
Giridharan Sivaraman, Australia’s Race Discrimination Commissioner expressed the need for racism, including structural racism, to be exposed and eradicated inside healthcare settings. He explained that people tend to suffer grave consequences when they are refused care or incorrectly diagnosed. On top of that, to be treated with suspicion because of their race makes everything worse. Sivaraman shared those concerns in a Tuesday interview with SBS News.
“This report confirms what communities have been saying for decades: racism in the health system is not just unfair—it can kill.” – Giridharan Sivaraman
The AHRC report illustrates how racism adversely affects the quality of care received by patients, particularly those from diverse cultural backgrounds. Sivaraman also noted that shortcomings in providing interpretive services disproportionately affect those with non-English speaking backgrounds. He proposed using micro-credentials and more training to diversify the health care workforce. This method can help close gaps, develop recognition of varied cultural practices, and eventually improve cultural safety within healthcare environments.
“What can be done about it is that you mandate cultural safety standards and you provide anti-racism training and micro-credentials for health professionals because that’s the way in which you actually improve cultural safety,” – Giridharan Sivaraman
Dr. Alana Gall, a postdoctoral research fellow at Southern Cross University, is an emerging expert on First Peoples’ health. She is a fierce proponent for broad reform. Lastly, she raised up the idea that cultural awareness isn’t sufficient. Our healthcare services must undergo profound structural changes in order to dismantle pervasive biases and design a safe space for all constituents involved.
“First Peoples face poorer health outcomes partly because of racism in the healthcare setting. For example, healthcare providers can assume that First Peoples are ‘drug-seeking’ or ‘non-compliant’. Often, they are spoken down to, dismissed, or not believed when describing symptoms,” – Dr. Alana Gall
In the words of Sivaraman and Gall, discomfort and fear are the everyday emotions of marginalized communities. This emotional burden can deter them from pursuing the medical aid they require. To illustrate how impactful this can be, Sivaraman shared how folks stay away from help as they do not feel culturally secure. This reluctance can aggravate their existing health issues and lead to additional complications.
“It can be that people of different backgrounds don’t feel culturally safe, so they don’t attempt to get help, or they don’t get the help that they need, or they don’t come back because they don’t feel safe. Meaning that they get sicker, and their problems aren’t treated,” – Giridharan Sivaraman
The State of Stress report makes clear that distress caused by the perception of feeling unheard or invisible leads to harmful health impacts. This fear, Sivaraman illustrated, leads people to not feel safe in their cultural clothing. It further prevents them from practicing their cultural beliefs without fear of proscription.
“Distress comes from that feeling of: ‘I won’t be understood, I won’t be believed, I won’t feel safe in my traditional dress or with my language or my religious beliefs’. And that adds to the negative symptoms you experience and the detrimental impact on your health,” – Giridharan Sivaraman
While their solutions differ, both experts are in accord about the need for government and health institutions to do better. Sivaraman reflected that improving cultural safety could help alleviate a lot of stress that comes with moving through healthcare systems.
“Both government and health institutions really need to improve, and I’m sure they want to, because at the end of the day, that’s what we all want, for everyone to be healthy and happy.” – Giridharan Sivaraman
