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Culturally and Linguistically Diverse (CaLD) is a term used to describe communities that differ from English-speaking Anglo-Saxon and Aboriginal and Torres Strait Islander populations, due to their ethnicity, religion, language and race.

WA has a rapidly increasing CaLD population, made up of a variety of different CaLD communities, each with their own unique identity and experiences.

According to the Australian Census, in 2021, 38% of Western Australians indicated they were born overseas (n=1,011,232).¹

In WA, 21.2% of households use a language other than English language at home, reinforcing the multilingual nature of the population.¹

Incidence of injury for Culturally and Linguistically Diverse Western Australians

Quantifying the prevalence of injury within WA’s CaLD communities is an ongoing challenge. Limitations contributing to the challenge include the inability to identify CaLD populations within health services injury data and limited research studies exploring the prevalence of injury within Australia’s CaLD communities.

Despite these limitations, the unique demographics of CaLD communities in WA and several contributing factors can increase the risk of injury within WA’s CaLD communities.

Determinants of injury for Culturally and Linguistically Diverse Western Australians

There are several factors which can contribute to the prevalence of injury among CaLD communities, including;

• cultural values,
• low levels of language proficiency,
• lack of local knowledge,
• underdeveloped injury prevention skills,
• change in socioeconomic status,
• unemployment,
• an inability to access ‘mainstream’ support services,
• lack of culturally appropriate support services,
• social isolation, and
• psychosocial impacts related to the individual’s migration and settlement process.²

Leading injury areas affecting people from CaLD communities in WA

Drowning

In WA between July 2021 and June 2022, 19.9% of drowning involved a person born overseas.³

This prevalence of drowning fatalities among individuals born overseas has been attributed to;

• lower levels of swimming ability,
• limited awareness of hazards and risks,
• alcohol and drug use, and
• the individual having pre-existing medical conditions.^4,5,6

Suicide and intentional self-harm

The rate of suicide and intentional self-harm among Western Australians born overseas varies.⁷ This can be attributed to the rate often reflecting the rate in the individuals country of origin, and differing spiritual and religious beliefs regarding suicide and intentional self-harm, influencing the rate of suicide and intentional self-harm.^7,8

Despite these variances, the mental health of individuals from a CaLD background has been attributed to pre-migration, migration and settlement stresses. Mental health risk factors can include;

• experiences of trauma,
• stressors associated with a new residence,
• social isolation,
• unemployment,
• changes in socioeconomic status,
• discrimination,
• different cultural beliefs regarding the treatment of mental health issues,
• difficulty understanding local health services,
• an inability or unwillingness to access ‘mainstream’ support services,
• a lack of culturally appropriate services, and
• information and support not being available in their primary language.^7,9

However, there are also protective factors against suicide for individuals from CaLD backgrounds, including; religious beliefs, negative views of suicide, family cohesiveness, community support, an increased resilience from past experiences and having family responsibilities.⁷

Violence

Individuals from CaLD backgrounds can experience higher rates of violence due to several factors including;

• low levels of language proficiency,
• different understandings of violence,
• dependence on an Australian sponsor,
• minimal support networks,
• cultural shame, and
• stigmatisation.¹⁰

In addition to experiencing higher rates of violence, research indicates that victims of family and domestic violence from CaLD backgrounds are less likely to report family and domestic violence to police or to access services.¹⁰ This may be due to several barriers, including; a belief that the individual would not understand their particular situation, fear that the services would not respond appropriately, language barriers, fear of deportation due to their residency status, racism, social isolation and a lack of understanding of the systems available to support them.¹⁰

Injury prevention interventions targeting CaLD communities

When developing any injury prevention initiative, it is important to consider that there is never a ‘one size fits all’ approach. This is of heightened importance when developing interventions for CaLD communities, due to the diversity that falls within CaLD communities.

Effective interventions to reduce the prevalence of injury within CaLD communities include strategies that;

• address the underlying cultural, social and psychosocial factors,
• are developed in partnership with CaLD communities,
• consider cultural competence and safety needs,
• reduce racial and ethnic health disparities, and
• empower individuals and communities to reduce their risk of injury.²

Evidence supports that CaLD communities are likely to access and implement health-related information from both mainstream and culture-specific channels. Additionally, communicating via these channels has proven to increase engagement from individuals who were seeking to access local health services.¹¹

WA injury prevention activities targeting CaLD communities

Injury Matters’ Stay On Your Feet^® program

Ishar Women’s Health Service – Family and Domestic Violence programs 

Mental Health Australia’s Embrace Multicultural Mental Health project

Multicultural Communities Council of WA – Road Safety Workshops

Royal Life Saving WA’s multicultural participation programs

Multicultural Services Centre of Western Australia Inc. (MSC)

Kidsafe WA

Injury Matters Culturally and Linguistically Diverse Community Resources

References

1. Australian Bureau of Statistics. Western Australian 2021 Census All persons QuickStats. https://www.abs.gov.au/census/find-census-data/quickstats/2021/5 (2023).
2. National Health and Medical Research Council (Australia). Cultural competency in health: a guide for policy, partnerships and participation. (National Health and Medical Research Council, 2006).
3. Royal Life Saving Western Australia. WA Drowning Report 2022. (2022).
4. Pidgeon, S., Barnsley, P. & Mahony, A. A ten year study of overseas born drowning deaths 2005/06 – 2014/15. (2018).
5. Matthews, B. & Grace, S. Drowning prevention in culturally and linguistically diverse communities. Injury Prevention 18, A135–A136 (2012).
6. Willcox-Pidgeon, S. M., Franklin, R. C., Leggat, P. A. & Devine, S. Identifying a gap in drowning prevention: high-risk populations. Injury Prevention 26, 279–288 (2020).
7. Life In Mind Australia. Culturally and linguistically diverse communities. Life in Mind Australia https://lifeinmind.org.au/about-suicide/priority-populations/culturally-and-linguistically-diverse-communities.
8. Embrace Mental Health. Suicide prevention and people from culturally and linguistically diverse (CALD) backgrounds. (2020).
9. The Federation of Ethnic Communities’ Councils of Australia (FECCA). Mental Health and Australia’s Culturally and Linguistically Diverse Communities. A Submission to the Senate Standing Committee on Community Affairs. (2011).
10. Western Australia & Parliamentary Commissioner for Administrative Investigations. Investigation into issues associated with violence restraining orders and their relationship with family and domestic violence fatalities. (2015).
11. Jang, H. et al. Cultural influences on exercise participation and fall prevention: a systematic review and narrative synthesis. Disability and Rehabilitation 38, 724–732 (2016)