At a recent forum a public health researcher was asked whether her large population study had included any groups from non-English speaking backgrounds. The researcher responded that there was ‘no single population group big enough in Australia that would be worth doing … it would be prohibitively expensive.’ Although the choice of words is unfortunate, the comments do provide a clue to the dismal state of available data in relation to immigrant and refugee communities.
‘Doing culture’ in research has always been couched as a problem: it’s too costly, too complex, or just too difficult. While some of these reasons are valid in some resource-poor settings, at other times it might be a lack of political will. As benign as numbers might appear, data is highly political. The way in which data is collected, interpreted and analysed is a politicised process because there are conscious and unconscious decisions being made about what to include and, as a consequence, who is made invisible. The lack of available, accurate and comprehensive data on immigrant and refugee women not only places them at greater risk, but also further marginalises them to the point of invisibility.
We know, for example, that overseas-born women are at a greater risk of poorer maternal and child health outcomes and are less likely than Australian-born women to have adequate information about modern contraceptive methods. However this knowledge only gives us a partial picture of what is happening in immigrant and refugee women’s lives because demographic indicators lack consistency (country of birth, ethnicity, non-English speaking, or overseas-born data sets can’t be compared and monitored), and contextual information such as visa category, religion and sexuality would involve piecemeal detective work across a diverse range of possible sources.
It’s clear that there are many gaps we need to address in the systematic and ongoing collection of disaggregated data. In the meantime, there is also a need to ask exactly why data on immigrant and refugee communities are not being collected, especially when we do know that some overseas born communities are at risk of developing adverse health conditions and more vulnerable to poorer health outcomes.
Unless we bring the margins into the centre of our analysis, we risk perpetuating that marginalisation through our research. If we have the data, we can better advocate for more equitable policies, programs and services that are gender and culturally appropriate. And most important of all, if we have the data at the outset, immigrant and refugee women themselves can have access to all the relevant information that will enable them to make decisions about their health. Surely that’s good for the whole population. Surely that’s worth doing.