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Background
ustralia is a multicultural society whose cultural and linguistic diversity has been shaped over many years by a strong migration program (Australian Bureau of Statistics [ABS], 2012). Since 1945, the proportion of people bom in an overseas country has steadily increased, with an additional one million migrants arriving in each subsequent decade (Department of Immigration and Citizenship [DIAC], 2011). The 2011 population census (ABS, 2013) identified that 19% of Australia's 22.3 million people were bom in non-English speaking countries, rising to over 30% in major metropolitan areas such as Sydney (Woodland et al., 2010) (Table 1). The most rapid population growth between 2001 and 2013 was for people from Nepal (increase of 27%), Sudan (17.6%), India (12.7%), Bangladesh (11.9%) and Pakistan (10.2%) (ABS, 2013).
The provision of safe, high quality health care relies on health services responding appropriately to this cultural and linguistic diversity. Barriers and competing priorities exist at the organisational (leadership/workforce), structural (processes of care) and clinical (provider-patient encounter) levels (Betancourt, Green, Carrillo, & Ananeh-Firempong, 2003). Although discussion of culture and its impact on health beliefs and health seeking behaviours runs the risk of oversimplification and stereotyping, this article seeks to enhance our understanding of the clinical barriers faced by migrant populations in accessing health care and to present tools and strategies for addressing these challenges. The concepts presented are an exploration of the...