Health for all: considering marginalised groups
Nothing shines a spotlight on global health like a pandemic. Despite lines of ‘we’re all in this together’, countries around the world have unique struggles depending on geographical, political and social factors, which shape their health systems and communities’ responses.
As we have seen from the COVID-19 vaccination rollout, access to health care is not enjoyed by all. Marginalised communities, including immigrants and refugees, rural or remote people and the youth community, are just some examples of groups in Australia and around the world that may feel they are last in line when it comes to health.
Migrants and refugees
Immigration Advice and Rights Centre Solicitor Gregory Rohan said immigration policy in Australia is highly politicised, which is resulting in poorer health outcomes for migrants and refugees.
“Everyone in Australia should receive the care they need regardless of immigration status or financial means,” Rohan said.
“Unfortunately, the reality is that immigration status is a barrier to accessing care and support. Many temporary visa holders cannot access Medicare but are unable to pay for private treatment. New Zealand citizens living in Australia are ineligible for the NDIS. Our carer visa system is slow and complex with poor outcomes, denying people from migrant backgrounds with disabilities the benefit of being cared for at home by loved ones.
“We believe that the health of migrants and refugees needs to be treated as a health issue and not an immigration one, so that every migrant or refugee in Australia can reach their potential and fully participate in our community.”
People in rural and regional areas
Umbo CEO Weh Yeoh highlighted that people in rural and regional areas of Australia have limited access to health services including allied health.
“Significant travel distances to see a therapist, wait times of up to 18 months and poor continuity of care means that children waiting for care see their chances of thriving diminish,” he said.
“There is a reliance on ‘fly-in fly-out’ therapists, which creates a burden on the public health system and individuals paying privately.”
Yeoh added that 4.5% of speech pathology practitioners provide service to rural communities, which constitute 30% of the total Australian population.
“To promote better health care, we need true representation. As of August 2020, not one of the eight people on the board of the NDIS has lived experience of disability. We need to truly listen to the voices of marginalised groups, even if they do not commonly have a seat at the table. We need to move beyond ‘providing for’ and get to ‘providing with’.”
Humanity Matters Youth Street Services Manager Selim Ucar said that mainstream approaches to health care often exclude the most vulnerable populations in society.
“For the youth population, especially those who are culturally or socially marginalised, there exists many challenges when it comes to navigating health care. This can be anything from lack of trust toward adult figures, inaccessibility of healthcare services, particularly for those in rural areas, or discriminatory attitudes that make them reluctant to seek help,” Ucar explained.
“The last year proved to be a challenging one for our youth communities. We’ve seen states across the country report stark rises in mental health issues among our young populations, with a recent report revealing that one in four teens have mental health issues and self-harm being one of the top five reasons for medical admissions.”
Ucar explained that we need to ensure health services become better at reaching the most vulnerable, to ensure young people struggling with health issues don’t fall through the cracks of our social fabric.
“The health system needs to be more flexible and pursue engagements even in non-traditional settings — like on the streets, or in rural and remote areas where services aren’t easily accessible — so that no one gets left behind. From giving young people with lived experiences a seat at the table to design youth-focused approaches to health care, to taking services to where marginally disadvantaged youth are, it is important to commit to building specialised services and infrastructure that support the wellbeing of our future generations.
“Now is the time we step up to ensure no health issue goes unseen and explore inclusive policies that support every Australian’s quest for better health, including those most disadvantaged.”
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