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Learning modules

Activity 2: Culturally diverse populations in Australia

Multicultural Australia

Australia is a multicultural society with almost a third (30.2%) of the population born overseas.  The most common countries of birth of people born overseas living within Australia include England, New Zealand, China, India and Italy. [1]

Cultural and linguistic diversity refers to different cultures and language groups represented within a society. In Australia a quarter of households speak languages other than English at home. Other common languages spoken in Australian households include Mandarin, Italian, Arabic, Cantonese and Greek. [1] Culture does not mean the ethnic group from which a person comes. Rather culture refers to their beliefs, morals, values and attitudes that might arise from a culture group. [2]

Cultural safety

Cultural safety creates a safe environment without risk of assault, challenge of who they are or what they need whilst promoting shared respect, shared meaning, knowledge and experience. [3] Cultural safety looks at a person as an individual rather than the country or ethnic group they originate from. It is an approach to care that protects them from physical, psychological, social and environmental harm. [4]

For example, a culturally safe health care service should include:

  • welcoming environment including the staff
  • orientation to service & staff
  • honest open communication
  • culturally diverse staff
  • enabling interactions
  • access to language interpreters
  • ongoing training for care staff about cultures, diversity within, and languages of, people they are caring for
  • encouragement of self-reflection
  • literature and signs in languages reflecting people cared for. [5]

If uncertain about a person’s culture or belief, don’t be afraid to ask questions in a respectful way, of the person, family or liaison staff member. For example “Good Morning Mrs Bahram, I was wondering about a few things, could I ask you about them”. Accessing information from programs such as Partners in Culturally Appropriate Care (PICAC) can assist health care services and professionals with education and training in culturally appropriate care. [6]

Cultural competence  

Cultural competence refers to behaviours, attitudes and policies that come together in a system or network that enable working effectively with people from diverse cultures. This competence is based on positive two-way cultural interactions that recognise advanced verbal and non-verbal communication skills. For example, information can be exchanged by simply using resources or even drawing diagrams, to draw on visual, auditory and kinaesthetic senses.

Rather than stereotyping, cultural competence respects other cultures while gaining an understanding of cultures including your own through self-reflection. Cultural competence skills are developed through awareness, ongoing encounters, evaluation of encounters, observation and positive participation with people from other cultures.  Simply speaking the same language as the patient does not render health care staff to be culturally competent.

Health professionals risk stereotyping a person by trying to care for them based on the culture and the beliefs about that culture. [7] A person’s own life experiences and beliefs need to be considered. A person from a particular ethnic cultural group may identify a little or a lot with that culture depending on level of acculturation. [8] Acculturation explains cultural changes that occur when members of cultural groups adopt beliefs and behaviours of another cultural group.

Cultural competence in health care requires specific practice knowledge, communication, skills, attitudes and behaviours, relating to: 

  • their history eg. global, local
  • communication styles, verbal and non-verbal
  • disclosure and consent  
  • decision making including how and when the person and family are involved
  • individual’s worries
  • concepts of disease, pain and other symptoms
  • attitudes to medication and nutrition
  • spirituality and religion
  • concepts of life cycle, including end-of-life
  • customs surrounding end-of-life, burial or cremation and grief. [8]

However cultural competence respects the diversity within cultural groups, and supports an approach to care that seeks to understand and respond to individuals within the context of their culture.

Thinking points


  1. Australian Bureau of Statistics. (2011). ABS Census Data. Data and Analysis. Retrieved July 22, 2013, from
  2. Culture. (2013). In Oxford Dictionaries. Retrieved from
  3. Williams, R. (1999). Cultural safety-what does it mean for our work practice? Australian and New Zealand Journal of Public Health, 23(2), 213-214.
  4. Papps, E., & Ramsden, I. (1996). Cultural Safety in Nursing: the New Zealand experience. International Journal for Quality in Health Care, 8(5), 491-497.
  5. Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., & Normand, J. (2003). Culturally competent healthcare systems: A systematic review. American Journal of Preventive Medicine, 24(3), 68-79.
  6. Partners in Culturally Appropriate Care (PICAC) Program. (2012). Support for people with special needs. Aged Care. Retrieved October 22, 2013, from
  7. Waxler-Morrison, N., Anderson, J., Richardson, E., & Chambers, N. (2005). Cross-Cultural Caring: A Handbook for Health Professionals (2nd ed.). Vancouver, Canada: UBC Press.
  8. Lickiss, J. (2003). Approaching death in multicultural Australia. The Medical Journal of Australia, 179, S14-S16.