Looking beyond ‘culture’ to understand health inequity

Since the election, there has been a lot of talk about women in politics, especially women from migrant communities as a new wave of culturally diverse politicians enter Parliament. We are so excited to see this representation because it's of course important for a government to represent its community. With almost a third of the Australian population born overseas, it's wonderful to see our government reflecting the variety of cultures that make up this country.

However, while cultural and linguistic background is important, there are so many factors that influence who we are and what we need to live safe and healthy lives. Migrant and refugee women can also be people with disabilities, people who are LGBTIQA+, older people, young people, and people who occupy different social classes. When we apply an intersectional lens to thinking about health, we can see how it is more than just our ‘culture’ that impacts migrant and refugee women’s ability to access and navigate the healthcare system.

As our Sexual and Reproductive Data report points out, migrant and refugee women experience higher rates of stillbirth, higher rates of birth intervention, greater risk of gestational diabetes and lower access to effective contraception and antenatal care. These statistics point to a deep problem that is systemic. Evidence shows that for migrant and refugee women, ‘culture’ or ‘biology’ is not the central driver of poor health outcomes. Rather, it is structural and social factors that create and reinforce health inequities, such as gender inequality, social isolation, lack of culturally responsive healthcare, migration policies and cost.

Structural barriers to accessing support services can result in more severe and prolonged family violence endured by migrant and refugee women. Visa restrictions can prevent migrant and refugee women from accessing government support services, and for women on visas, the out-of-pocket costs can be excessive. As a recent report by Women’s Health Tasmania demonstrates, the temporary visa system in Australia can cause significant harm towards migrant and refugee women.

Tailoring health initiatives to people because they speak the same language or are from the same cultural background is only a starting point. A gendered intersectional approach to health is the next step, by addressing the ways that culture intersects with structural and systemic forces to create inequities in health outcomes for migrant and refugee women. With more migrant women than ever in our elected government now, we are hopeful we can transform conversations about intersectionality into policy action for migrant women.

First published in edition #109 of The WRAP on 30 May 2022.