‘Culture' may be defined as; "a set of standards for perceiving, believing, valuing and acting that are imposed on and make sense of the world and that guide relationship with and behavior with the social groups and with the environment". It may also be described as a set of rules or behaviors and a pattern that is inherited by one generation from another.
Whereas, ‘multicultural' means, a concept that is based on pluralism and is associated with the recognition, acceptance and respect to all citizens' (in this case) rights in terms of expression as well as sharing of their cultural heritage. Hence; it ensures the inclusiveness in spite of division. (Leask et al. 2006)
Study of culture in context of health care has become compulsory these days as it has been observed that a patient's illness presentation can get influenced via his culture. In fact, the meaning of health experience is constructed via an individual on the basis of his cultural background and such multicultural health issues are able to impact the primary care and general practitioners in an adverse manner. (Tiong et al. 2006)
"Men hate each other because they fear each other, and they fear each other because they don't know each other, and they don't know each other because they are often separated from each other."
-Dr. Martin Luther King, Jr.
For instance, there could be observed linguistic as well as cultural diversity in Australia as, only 3% of Australians are of indigenous origin while, 97% settled there. According to data, in 2001, there were 23.1% of people living in Australia were born in overseas (in comparison to 14.35% in 1991) while, 43% of Australians were born overseas or at least had one parent who was born overseas (in 1991, the datum was 26%). Even, 25.2% Australians also spoke a language other than English (here again is the difference as; in 1991 this percentage was only 18.9%). (Harkness et al. 2002)
Such multinational diversity can raise many issues in terms of health care as due to these it might be difficult for all the patients to access such facilities. For instance; patients from a CALD (Cultural And Linguistic Diversity) background could find it difficult to get advantage from health care services in compare to other individuals owing to poverty, lack of education, transportation problem etc. (Tiong et al. 2006)
Religion or other types of cultural barriers also play a significant role in it as; it has also been analyzed that people who belong to a particular culture may not achieve equity of health care not only because of, access issue but also due to, discrimination from health care system owing to their country of origin, cultural background as well as religious beliefs. A language difficulty in context of it is another potential problem which might impact the care achieved by the patients from different cultures. (Leask et al. 2006)
In fact, there are 200 languages spoken in Australia. In addition, non verbal communication, style of communication, involvement of family or a third person for the purpose of communication support and different understanding of English words and phrases all are able to impact clinical care. For example; different cultures consider different means of body parts and types of illness due to which illness presentation as well as compliance with treatment both can get affected. (McKelvey et al. 2002)
It could be understood via analysis of following data:
Life expectancy for ‘Aboriginal and Torres Strait Islander' people is 20 years (for males) and 19 years (for females) below that of other Australians. Mortality rate of this community is 3.1 times higher than the rate for total Australian population. (Tsai et al. 2004)
Death and low birth weight of new born babies is approximately two times in comparison to others while, prevalence of diseases such as; diabetes, hypertension and a range of communicable ailments is also higher among these. In addition, non-fatal injuries and self-harm, mental illness and harmful substance usage is additionally greater in these citizens. (Tsai et al. 2004)
So, there is need to tackle such issues to overcome the health inequality and to reduce the barriers which restrict access in terms of health care. This could be achieved via adoption of following domains regarding general practices:
1. Effective Communication:
Language difficulties might be overcome with the help of interpreters and in this way, conversation that is focused on doctor and patient could be established. Besides, it is better for health care providers to get information about the world views, beliefs in context of diseases, health care and further impacts of such faiths etc. (Tiong et al. 2006)
2. Application of Professional knowledge and skills:
A holistic approach could be applied to address the multicultural health issue in which attention can be focused on following factors:
This includes both physical as well as emotional dimensions.
It considers social and relationship dimensions.
Its center of attraction is mainly cultural as well as political dimension. (Tsai et al. 2004)
3. Population health and general practices
A general practitioner needs to learn how to deal with barriers in terms of accessing services for instance; breast screening, palliative care, pap tests as well as immunization. (McKelvey et al. 2002)
4. Professional and ethical role
This is also expected from medicos that they would be aware of existence of any power differential between them and patient(s) in terms of cultural beliefs and attitude and there would not be any adverse impact on management of such patients' health complications. (Tsai et al. 2004)
It should also be ensured that patient's confidentiality could be respected and informed consent would be taken from them.
‘Consent' implies to the ‘provision of approval or agreement'. For instance, there are cases when to get a treatment (as, surgery) a patient has to sign a ‘consent form' that he is ready for this. But, in extra ordinary cases, prior information about treatment process is provided to the patient before getting his signature at any consent form.
Such information helps patient to decide whether he wants to undergo prescribed treatment or not. (Harkness et al. 2002)
And the most important concept is that patients' treatment process should be based on equality. (McKelvey et al. 2002) so that, any negative health outcomes because of cultural differences could be overcome and health of all citizens might be insured as, ‘Cicero' has truly stated that, "in nothing do men more nearly approach the Gods than in giving health to men".