THE rise in new COVID-19 cases in Melbourne last week shone a light on some of the cracks in our health system and our society more broadly.
Centred around a number of suburbs in the city’s multicultural north, the disease hotspots are in areas with “very strong pockets of disadvantage”, according to Victorian Health Minister Jenny Mikakos, who herself lives in one of the affected suburbs.
“We acknowledge the challenges in some communities for whom English may not be their first language in understanding the public health messaging, and this is why we are going to double our efforts in working with those communities,” Mikakos told SBS News.
The new push has been welcomed by community leaders, but it does raise questions about why this was not more of a focus from the beginning.
Accessing reliable health information, and fully understanding it, is a challenge for most people, but far more so for those whose first language is not English.
Despite long-standing efforts to address the problem, research continues to show an association between limited English skills and poorer health outcomes, as an Australian Institute of Health and Welfare (AIHW) report noted last year.
Solutions have been hard to find, not least because of shortfalls in data on experiences and outcomes for culturally and linguistically diverse people in the health system.
Australian Bureau of Statistics standards establish the minimum indicators that should be collected (country of birth, main language other than English spoken at home, and proficiency in English), yet even this basic information is not consistently included in national health datasets, the AIHW report said.
If we really want to identify, and address, the specific needs of different groups, we need to collect more detailed information, including length of residency in Australia, language use patterns, need for an interpreter, parents’ country of birth, and refugee status, the report went on.
So how does all this relate to COVID-19?
Sociologist Andrew Jakubowicz argues the pandemic has exposed a “dark data hole” in Australian health records, one that puts multicultural communities at risk.
The National Notifiable Diseases system does not collect data on ethnicity, Professor Jakubowicz writes, and his multiple requests to health authorities have failed to elicit any information on COVID-19 infection or testing rates in different communities.
“The failure to collect data on cultural background and language leaves potentially vulnerable groups without adequate information, and epidemiologists and public health officials without a realistic sense of the landscape in which they need to move,” he argues.
“If sanitary social distancing and testing are the key weapons against the disease at least in the short term, then rigorous documentation of how the pandemic is affecting different groups must underpin strategies that seek to protect the vulnerable and ensure potential ‘spreaders’ can take appropriate and rational precautions.”
Australia has so far largely dodged the COVID-19 bullet. Protected by our geographical distance, we have also been fortunate that federal and state leaders have taken a mostly bipartisan approach and one based on the advice of medical experts.
The catastrophe unfolding in the US shows what the alternative might have looked like.
Melbourne’s rise in new cases, though, is a warning that we cannot be complacent about our success so far.
If we are to maintain that record, the pandemic response needs to reflect the reality of our multicultural society in all its complex diversity – and that means everything from data collection to communications strategies.
Jane McCredie is a Sydney-based health and science writer.
The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.