Quality Standards for Diabetes Care Toolkit

Immigrants and refugees

Health care for this group needs to take into consideration that:

health care for these persons should be individualised

extra consultation time will be required

services of a professional interpreter may be required

clear communication is imperative to avoid miscommunication

cultural and religious diversity must be considered

health care professionals should be aware that an individuals’ cultural and religious beliefs and practices may impact on health care choices (Ministry of Health 2012).
Mortensen’s (2011) publication suggests that while it is understood that refugees have high health and social needs, New Zealand has not yet developed ‘institutional means to include this diverse ethnic group in policy, strategy and service planning’ (p 1). Mortensen breaks findings from her study about responsiveness in the New Zealand public health system into three sections: responsiveness at national, regional and local levels. The study revealed that at a local level there are some signs of activation in the health sector, but that overall the ‘opportunity structures’ in the public health system are restricted. The services that were available to refugees had developed in response to health providers identifying health needs and initiating specific projects to address these locally. Many such projects had been funded through voluntary fundraising, charitable grants, or out of baseline health agency budgets. These activities are significant because they signal potential openings in the health structure for accommodating refugee groups and their ethnic communities. However, what is required to achieve a more responsive public health system are national changes to the ethnicity classification system used in health, an overarching framework for addressing cultural diversity, and the instruments and resources (such as policy and funding formulas) that recognise high needs in refugee groups (Mortensen 2011, p 10). It is unclear from the development of this standard whether or not these issues have been addressed or improved.
Although older, a further document (Henderson 2004) suggests that language is the most frequently identified barrier for immigrants in relation to seeking access to health care and services, and post-migration discrimination, underemployment and unemployment which are related to anxiety, depression and other health problems. Elderly immigrants and their families are often in particular need of support and there remains a need for culturally appropriate social services, social support and health services.