Generic Work with Diverse People CHCDIV001 Work with diverse people Clinical Education Work with Diverse People Health Training Package HLT The learning material provided in this Study Guide has been developed to meet the requirements of the Health Training Package HLT. Training packages are a key feature of vocational education and training in Australia. They are developed nationally by industry, for industry. Qualifications are recognised nationally. Work with Diverse People Study Guide relates to the following national unit of competency: CHCDIV001 Work with diverse people The Work with Diverse People Study Guide relates to the following National Safety and Quality Health Service Standards: Every effort has been made to trace and acknowledge copyright material. occurred accidentally the authors and publishers tender their apologies. Should any infringement have Copying Except as permitted under the Act (for example a fair dealing for the purpose of study, research, criticism or review) no part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without prior written permission. All enquiries should be made to the publisher at the address below. Chief Executive Officer SA Ambulance Service GPO Box 3 Adelaide SA 5001 Published by SA Ambulance Service RTO Code:0264 Clinical Education Version: 1.0 161031 © SA Ambulance Service - October 2016 2 Work with Diverse People Contents Introduction 5 Cultural Diversity in Australia 6 Disability 8 Religious or Spiritual Beliefs 9 Gender 10 Transgender 11 Intersex 12 Generational 13 Sexual Orientation 14 Reflect on Own Perspectives 15 Diversity and Inclusiveness 19 Communicating with Diverse People 22 Promoting Understanding of Diversity 25 Influences and changing practices in Australia 27 Marginalised Groups 28 Glossary 29 Other Resources 30 References 31 © SA Ambulance Service - October 2016 3 Work with Diverse People eBook Symbol Key Click on this icon to play a Video Click on the orange text to be taken to the Glossary Click on this icon to play Audio Click on this icon to be taken to a related study guide Click to open a link to an external website Click on this icon to be taken to related SAAS eLearning courses. Click to return to the Contents page Click on the following icons to open relevant documents on the SAAS Intranet. Please ensure you are logged into the Intranet prior to clicking on the icon. > Clinical Documents Click to open relevant Clinical documents on the intranet (e.g. Clinical Communications, CPPs) > Information Notice Click to open relevant Information Notices on the intranet. > Safety Alert Click to open relevant Safety Alerts > Procedure Click to open relevant Procedures > Policy Click to open relevant Policies > General Resources Click to open relevant Intranet pages and resources > SA Health Guidelines Click to open relevant SA Health Guidelines and Directives © SA Ambulance Service - October 2016 4 Work with Diverse People Introduction The term diversity is used to describe identifiable differences of people in their cultural backgrounds or lifestyles. This includes differences in: • Race or ethnicity • Age • Gender • Religion • Philosophy • Physical abilities • Physical or mental health • Socioeconomic background • Sexual orientation • Gender identity • Genetic attributes • Behaviour. The concept of diversity encompasses acceptance and respect. It means understanding that each individual is unique and recognising individual differences. These can be along the dimensions of race, ethnicity, gender, sexual orientation, socio-economic status, age, physical abilities, religious beliefs, political beliefs or other ideologies. It is the exploration of these differences in a safe, positive and nurturing environment. It is about understanding each other and moving beyond simple tolerance to embracing and celebrating the rich dimensions of diversity contained within each individual. © SA Ambulance Service - October 2016 5 Work with Diverse People Cultural Diversity in Australia Australia has one of the most culturally and linguistically diverse populations in the world. It is estimated that about 40% of the Australian population is made up of immigrants and their children and that about 15% speak a language other than English at home. Today there are approximately 22 million Australians speaking almost 400 languages, including Indigenous languages identifying with more than 270 ancestries and observing a wide variety of cultural and religious traditions. Australia remains a socially stable country, not despite its cultural diversity but because of the acceptance of it and the firm belief that diversity is one of the country’s enduring strengths. The Australian community From Australia’s original Aboriginal and Torres Strait Islander clans, the Australian society has emerged to become a diverse community embracing many cultures. There are many reasons for the population of a country becoming diverse. One common reason is hardship in the originating country of the immigrant. Such hardships include famine, war and oppressive regimes. There are of course, people who just wish to experience living in a new country or those who move here because of their jobs. Indigenous Australians The Australian Indigenous population is made up of Aboriginal and Torres Strait Island people. Indigenous Australians often face issues related to: • Health • Social expectations • Cultural identity. When working with Indigenous communities and other cultures, staff could draw on significant events in their own family history that influence their current perspectives, beliefs and values. It is possible these experiences could lead to an empathetic understanding, so the impact of cultural or background differences are minimised. > Aboriginal Cultural Awareness Training © SA Ambulance Service - October 2016 6 Work with Diverse People Migrants and refugees The migrant population in Australia generally fit within one or two broad classifications: 1. Immigrant - those who chose to migrate to Australia voluntarily. Immigrants choose when to leave their country, where they go and when they return. 2. People displaced from their home country, such as refugees because of persecution on the basis of their race, religion, nationality, membership of a particular social group or political opinion. Immigrants and refugees from other cultures often face problems such as: • Recognition of professional qualifications and experience • Level of cultural difference between cultural origin and new host culture • Language barriers. Refugees may also be affected by persecution in their home country, loss of family and friends and trauma, during migration. © SA Ambulance Service - October 2016 7 Work with Diverse People Disability Disability is seen as an umbrella term for any or all of the following components: • Impairments: problems in body function or structure • Activity limitations: difficulty in executing activities • Participation restrictions: problems an individual may experience in involvement in life situations. Disability in Australia 18.5% of the Australian population (approximately 4.2 million people) have severe or profound disability. The proportion of Indigenous people who need help with core activities is around double that of non-indigenous Australians © SA Ambulance Service - October 2016 8 Work with Diverse People Religious or Spiritual Beliefs Religions span national, geographic, cultural and ethnic backgrounds and play an important role in catering for people’s social, psychological and cultural needs as well as their spiritual needs. In the 2011 Census, Christians represented 61% of the Australian population. Non-Christians represented approximately 8% of the population. The Census recorded over 120 different religious denominations, each with 250 or more followers. Indigenous Australians have been affiliated with various religions. However, for Aboriginal and Torres Strait Islander people, the concept of ‘spirituality’ refers to a more holistic view of life, in particular, one’s link with the land, sea and air. Consequently, this relation confirms one’s identify and place as an Indigenous Australian. © SA Ambulance Service - October 2016 9 Work with Diverse People Gender Gender diversity includes male, female and transgender individuals. Females make up just over half (50.2%) of the Australian population. While women comprise roughly 46% of all employees in Australia, they take home on average $283.20 less than men each week. The national gender ‘pay gap’ is 18.2% and it has remained stuck between 15% and 18% for the past 2 decades. Australian women account for 92% of primary carers for children with disabilities, 70% of primary carers for parents and 52% of primary carers for partners. Barriers to gender equality include: • A quarter of women were sexually harassed in the workplace between 2007 and 2012 with the harasser most likely to be a co-worker (52%). • In 2014, one in two (49%) mothers reported experiencing discrimination in the workplace at some point during pregnancy, parental leave or on return to work and one in five mothers indicated that they were made redundant, restructured, dismissed or that their contract was not renewed because of their pregnancy, when they requested or took parental leave or when they returned to work. • One in three Australian women aged 15 years and over has experienced physical violence and nearly one in five has experienced sexual assault. © SA Ambulance Service - October 2016 10 Work with Diverse People Transgender The term transgender refers to an individual whose gender identity does not match their assigned birth sex. For example, a transgender person may self-identify as a woman but was born biologically male. Being transgender does not imply any specific sexual orientation (attraction to people of a specific gender). Therefore, transgender people may additionally identify as gay, lesbian, bisexual or heterosexual. In its broadest sense, the term transgender can encompass anyone whose identity or behaviour falls outside of stereotypical gender norms. A person’s gender identity and expression encompasses multiple factors, including genetic influences, brain chemistry, learned behaviours and personal choices. These factors - shaped by culture, custom, social constraints and beliefs - affect us all. There are currently no official statistics available on the number of transgender individuals within Australia as previous Census data collection has only accommodated male or female gender identification. © SA Ambulance Service - October 2016 11 Work with Diverse People Intersex Intersex people are born with variations in physical sex characteristics that don’t fit typical medical definitions of female or male. Intersex people have diverse bodies, identities and life experiences. The term intersex was first used by science in the early 20th Century; historically, the term ‘hermaphrodite’ was used. Intersex variations or traits are always congenital and can originate from genetic, chromosomal or hormonal variations. Environmental influences, such as endocrinal disruptors can also play a role in some intersex differences. The term is not applicable to situations where individual’s voluntarily alter their own anatomical characteristics. Intersex is not about sexual orientation; people with intersex variations have as diverse a range of sexual orientations as non-intersex people. Nor is it about transition or gender identity. There are no firm population figures for people in Australia with intersex variations. The reasons for this lies in the lack of accurate reporting of data on intersex diagnosis and ideology. Although figures vary, intersex people represent a significant percentage of the population; estimates range from 1 in 1500 or 2000 births to 4%. © SA Ambulance Service - October 2016 12 Work with Diverse People Generational While many have tried to define age boundaries, these are ‘fuzzy’ and with beginnings and endpoints being approximations. For example, one text defined ‘baby boomers’ as individuals born between 1940 to 1960, while another text stated between the years 1946 to 1964. However, a generation is a group of people defined by age boundaries, those who were born during a certain era. They share similar experiences growing up and their values and attitudes tend to be similar based on their shared experiences during their formative years. In 2006, there were 5.3 million baby boomers in Australia (26% of the population); generation X made up 21% of the population in Australia and approximately 20% were considered to be generation Y. © SA Ambulance Service - October 2016 13 Work with Diverse People Sexual Orientation Sexual orientation is defined as an inherent or immutable enduring emotional, romantic or sexual attraction to other people. A person’s sexual orientation may be described as heterosexual, lesbian, gay or bisexual. Australians of diverse sexual orientation make up approximately 11% of the Australian population. However, a large number of lesbian, gay and bisexual people hide their sexuality when accessing services, at social and community events and in the workplace. Lesbian, gay and bisexual young people report experiencing verbal homophobic abuse (61%), physical homophobic abuse (18%) and other types of homophobia (9%), including cyber bullying, graffiti, social exclusion and humiliation. © SA Ambulance Service - October 2016 14 Work with Diverse People Reflect on Own Perspectives Health care providers often work with people who are vulnerable and/or who might live a lifestyle that mainstream society views as being different or unacceptable. In order to provide a service that meets the needs of target groups and help them to feel empowered, we need to be aware of important things such as patient’s personal values and social and cultural perspectives. Be prepared to adopt the professional values of SAAS – and not impose personally bound ideas on the people you deal with. Values, social perspectives and biases Values are traits or qualities that are considered worthwhile. They represent a person’s highest priorities and deeply held driving forces. Beliefs also tend to be based on values. Values are principles, standards or qualities that an individual or group of people hold in high regard. These values guide the way people lead their lives and the decisions that they make. A value or perspective is commonly formed by a particular belief that is related to the worth of an idea or type of behaviour. Some people might see great value in lowering greenhouse emissions by reducing the production of cars; however, a person who works in the automobile production industry might not place the same value on the cause of greenhouse emissions as the person campaigning to reduce them. If someone strongly values responsibility, they might believe that people who do not behave responsibly are less moral or decent. A person who has a family history of financial and emotional stability might find it difficult to sympathise with seemingly irresponsible behaviour from others. Whereas a person who has struggled through life might be more understanding of people who, due to deep feelings of hopelessness or frustration, indulge in behaviour that could be labelled irresponsible, such as alcohol and other drug addiction or crime. Values might include: • Determination to achieve • Credibility • Creativity • Love/friendship © SA Ambulance Service - October 2016 15 Work with Diverse People • Loyalty to loved ones • Independence • Learning. Significant events that can affect a person’s perspectives, value and beliefs can be extensive and arise from areas that include: • Schooling and educational experiences • Workplace (work ethics, job roles) • Family • Peers (social influences) • Migration • Significant life events (death, divorce, losing jobs, major accident and trauma, major health issues, significant financial losses and so on) • Housing arrangements • Music • Media / technology • Major historical events (world wars, economic depressions, etc.) • Religion. © SA Ambulance Service - October 2016 16 Work with Diverse People Influences A person’s understanding of their own and others’ cultural identity develops from birth and is shaped by the values and attitudes prevalent at home and in the surrounding community. Culture directs a person in making life satisfaction judgements that affects well-being and appraisal of self. For example, educational opportunities can influence cultural identity as these experiences could lead to greater prospects that also provide individuals with structure to move forward in their lives. Current forms of social communication processes all play a part in creating identity, particularly: • Mainstream media, advertising, television and film • Family, friends, teachers • Political agendas, religion • Society’s rules • Personal perceptions, perspectives, interpretations and assumptions. Sometimes these external factors are more of a subconscious influence in the creation of a cultural identity. Many choices that people make are determined more from their cultural background than from individual beliefs. Being a member of a dominant cultural group can influence cultural identity in a different way than being a member of a minority cultural group that could suffer stigmatisation or racism. Migration To work effectively, it is critical for a health care provider to understand their own perspectives, values, beliefs, limitations and to understand the importance of not allowing them to affect the way in which they work with others. Own limitations and self-awareness Understanding and valuing ourselves is the first step to valuing others. If we have a positive sense of self, we are able to be more open and accepting of diversity. By exploring personal identity and cultural diversity, health care providers can learn about and connect their own with those of others in different times and places. © SA Ambulance Service - October 2016 17 Work with Diverse People Good mental health is based on the social, emotional and cultural well-being of the whole community. An important task in healing for indigenous patients is to know who they are and where they come from. Cultural competence Cultural competence is: • The capacity for people to increase their knowledge and understanding of cultural differences • The ability to acknowledge cultural assumptions and biases • The willingness to make changes in thought and behaviour to address those biases. Culturally competent is characterised by: • Knowledge of or sensitivity to the first language of patients • Understanding of the cultural nuances of the patient population • Backgrounds similar to those of the patient population • Treatment methods that reflect the culture-specific values and treatment needs of patients • Inclusion of the patient population in program policy making and decision making. Providing culturally competent, sensitive care, through understanding and appreciating a patient’s cultural background will expand treatment opportunities. You are more likely to build a rapport with patients and therefore be able to provide better care and/or elicit more information from them and their family regarding their condition. © SA Ambulance Service - October 2016 18 Work with Diverse People Diversity and Inclusiveness Cultural disconnect Gaining experience of diverse communities enhances resilience by enriching understandings about difference, therefore making it less threatening. However, outsiders sometimes stereotype some cultural communities. This is particularly so if they represent values that are different from and sometimes in opposition to the values of outsiders. Relationships A health care provider builds rapport and relationships with patients. They make certain their patients understand they are genuinely concerned with their welfare and are willing to help. Relationships are connections that exist between two or more people in order to accomplish something – in the case of community service work, the accomplishment must be high quality care for patients and their families. Inclusiveness Strategies used to eliminate bias and discrimination in the workplace is grounded in legislation. From this legislation, organisational policies and procedures are developed. All staff must comply with these policies and procedures. > Policy - Code of Ethics and Conduct for the South Australian Public Sector Legislation Equal Employment Opportunity (EEO) legislation states the principle of merit must be applied fairly in the workplace. Anti-discrimination legislation – discrimination refers to treating one person or group less favourably than another, due to some personal characteristic. Racial vilification, anti-harassment, anti-bullying and human rights legislation are also related and relevant. © SA Ambulance Service - October 2016 19 Work with Diverse People Human Rights Human Rights versus Human Needs/Dignity The concept of human rights is to ensure that there is equality amongst all and that humans are free from degrading behaviour, discrimination and prejudice views. Human rights have been acknowledged globally through the Universal Declaration of Human Rights. The idea of human needs or dignity is different for each individual; however, a common interpretation is the idea that one’s self-esteem, self-regard and self-respect is preserved. When our dignity is interfered with, we can often feel degraded, embarrassed and humiliated, however, our human rights are there as a protection and preservation in order for this interference to be eliminated. Human dignity is not something that can be measured and is not defined by the contributions we make to others or to society, it is not based on our concrete lives in terms of personality, religion or culture. It is something that cannot be replaced by money nor anything of equal value, dignity is personal and irreplaceable. Universal Declaration of Human Rights The Universal Declaration of Human Rights is an international document that states basic rights and fundamental freedoms to which all human beings are entitled. It recognises ‘the inherent dignity of all members of the human family is the foundation of freedom, justice and peace in the world’. It declares that human rights are universal - to be enjoyed by all people, no matter who they are or where they live. It includes civil and political rights, like the right to life, liberty, free speech and privacy. It also includes economic, social and cultural rights like the right to social security, health and education. The Universal Declaration of Human Rights is not a treaty so it does not directly create legal obligations for countries. However, it is an expression of the fundamental values which are shared by all members of the international community. It has had a profound influence on the development of international human rights law. Strategies If you suspect or become aware of discriminatory practises, harassment or abuse in the workplace (related either to patients or staff), you have an obligation and a duty to support the person being discriminated against and to report the problem to a manager or other senior staff member. © SA Ambulance Service - October 2016 20 Work with Diverse People In extreme cases, it might be necessary to report to the Equal Opportunity Commission, an ombudsman or advocate who can take action, if they deem it necessary, on behalf of that person. > SA Health Guideline - Management of Disrespectful Behaviour Culturally appropriate work practices We like to know that our unique characteristics, qualities, cultural practices and needs are recognised and respected. Being aware and respecting the person’s cultural background and practices in turn means you can provide services that are most beneficial. A person’s cultural affiliations will influence their needs and goals and the ways in which they would like to have these met. Recognising the individual and cultural differences of people you are supporting is the first step in being able to tailor support and setting up a culturally and psychologically safe environment. Cultural safety Cultural safety is commonly defined as being the provision of an environment that is spiritually, socially and emotionally safe, as well as physically safe for people; where there is no assault challenge or denial of their identity, of who they are and what they need. It is about shared respect, shared meaning, shared knowledge and experience of learning together. © SA Ambulance Service - October 2016 21 Work with Diverse People Communicating with Diverse People Awareness of cultural difference includes realising that various cultural groups have different rules for: • Use of humour and irony • Courtesies in speech, such as when to say please, thank you or excuse me • The meaning of yes and no • Rules of politeness – who can speak to whom and who can begin a conversation • Dress • Regard for others • Food preferences, choices and taboos • Drinking alcohol • Use or perceptions of time. > Multicultural Health - Resources for Health Professionals Non-verbal communication When communicating with people from other cultures with a different language base from your own, you must be even more aware of your body language. You must also be aware that the gestures and the familiarities that you find acceptable might not be acceptable to people from other countries. In some cultures, hand gestures are used more extensively than in others - to support and to clarify what is being said. Hand gestures that are associated with speech to emphasise a point are commonly used. The gestures you make must be congruent with the content of the communication. You need to take care to understand your audience because in different cultures or regions, specific hand gestures or signals can have different meanings. Physical contact You need to have at least some idea of the social norms that are acceptable to other cultures, to use common sense and in many instances, take your cues from the clients or co-workers with whom you are dealing. For example, hand shaking is not a natural thing for Japanese people. However, many have adjusted to this westernisation. If Japanese clients introduce themselves and offer to shake hands, by all means do so. You should not, however, be the initiator. © SA Ambulance Service - October 2016 22 Work with Diverse People Other gestures such as eye contact and personal space also vary in cultures and individuals. Therefore, it is important to look for situational cues and modify gestures accordingly. Tone of voice Research indicates that voice characteristics are commonly associated with the following feelings/meanings: Para language Probable feeling / meaning Monotonal speech Boredom, condescension Slow speed, low pitch Depression, thoughtfulness High voice, emphatic speech Enthusiasm, excitement Ascending tone Astonishment, fear Abrupt speech Defensiveness, impatience Terse speech, loud tone Anger, fear High pitch, drawn-out speech Disbelief Linguistic competence Linguistic competence is the capacity of an organisation and its staff to effectively communicate with persons of limited English proficiency, those who have low literacy skills or are not literate and individuals with disabilities. Empathy Being empathetic means you can put yourself in the other person’s shoes and see problems, concerns and issues from their point of view. By doing this, you are trying to understand the other person’s feelings, opinions and attitudes. It shows that you have a genuine concern for others. To empathise does not necessarily mean you agree with the person (although you might) or that you need to make their problems your own. It does, however, enable more effective communication and a greater depth of understanding. By trying to see problems from the other person’s point of view you put yourself into a position where you are more willing to assist. This applies whether you are © SA Ambulance Service - October 2016 23 Work with Diverse People communicating over the telephone, in writing or face-to-face. Try to understand how your patients or co-workers feel and address all issues from the point of view you are willing to accept their right to be different and to both respect and accommodate that difference. Cultural misunderstandings can, in fact, be quite distressing and sometimes quite traumatic for those involved. It will be necessary for you to identify the misunderstanding, to investigate causes and to negotiate with the patient, colleague or stakeholders involved, to find a solution. Non-English speaking Consideration should be given to the use of an interpreter when dealing with people who do not speak English proficiently. Clients have the right to have information clearly and concisely explained to them in a way that is suitable for them. While this could be a family member, in most cases an accredited interpreter should be accessed as they are bound by a strict code of ethics, therefore ensuring impartiality and that accurate communication occurs. For on-road staff, interpreting services can be accessed via the EOC. EOC staff have direct access to the interpreter line. Other resources that can be used instead of an interpreter include: • Using signage or gestures • Drawing diagrams or pictures. SAAS has made available to staff the Multicultural Phrase Book to assist in the care of people who are not able to speak English. This booklet contains basic questions in 15 languages. Copies of this booklet can be found in the glove box of all Ambulances. © SA Ambulance Service - October 2016 24 Work with Diverse People Promoting Understanding of Diversity Key points about awareness and understanding Some of the key points which will help you in developing the skills to work more effectively with diverse people are: 1. Be aware of the fact that many people in the world are different from you. Do not expect other people to automatically share your values 2. Be aware of the fact your own values influence your understanding of every part of your day-to-day lives 3. Respect the fact that people are different and respect their right to do things differently. Imagine your own feelings when others do not respect the values which are vital in your own life 4. Accept the fact you will never fully understand a culture or lifestyle which is not your own 5. Do not expect diversity awareness and understanding to come easily. something we all have to work on all the time It is 6. Be prepared to challenge your initial reactions to diverse people. Be aware of the fact your reactions are based on your own values and experiences 7. Try to avoid stereotyping and labelling people. Treat people as individuals. A misunderstanding can result in complaints, embarrassment and frustration, which can be detrimental to providing quality patient service. The key to successful problem solving is to ensure the right people are involved and necessary follow-up action is taken. Conflict Conflict related to different cultural background can arise when: • There is a verbal and non-verbal language barrier • Offensive jokes are made • Physical gestures are misinterpreted © SA Ambulance Service - October 2016 25 Work with Diverse People • Eye contact and facial expressions are used inappropriately • Someone asserts that certain values or beliefs are wrong • Someone tries to impose their values or beliefs on others • Discrimination occurs. For some staff, working with differences might be difficult either due to lack of understanding or exposure to diversity. Cultural conflicts need to be handled sensitively with a good understanding of the issues involved. Yet, it is accurate to say, culture does not actually cause conflict. What it does is shape perceptions, attitudes, behaviours, plus expected and actual outcomes. It generates feelings, attitudes and expectations in people. When people perceive these things to be endangered, slighted or interfered with, they have such major influences on their actions and interactions that conflicts can result. Working across cultures is complicated, however, interacting with a health care provider is such a personal relationship that it is important the provider understands the values and beliefs of their patient when determining quality care. If the health care provider doesn’t have the cultural context of the patient, they are not going to be as effective as they could be. © SA Ambulance Service - October 2016 26 Work with Diverse People Influences and changing practices in Australia Australia is a product of a unique blend of established traditions and new influences. Within the framework of Australia’s laws, all Australians have the right to express their culture and beliefs and to participate freely in Australia’s national life. Given the diverse nature of today’s Australia, there is the question as to whether there is a ‘typical’ Australian. There is of course no shortage of popular stereotypes, many of which have some truth to them, with most Australians conforming to at least some of them. But Australians, like people everywhere, cannot be so easily stereotyped. They’re ‘typical’ Australians, but they are not all the same! Australia has changed tremendously in the last 50 years as it has hosted migrants from overseas, speaking different languages and valuing different traditions. Australia like all countries has its own identity and culture which reflect the ongoing activities in daily life like sporting events, art, music, economic developments etc. The many waves of migrants from different backgrounds have enriched almost every aspect of our national identity from business to the arts, from cooking to comedy and from science to sport. What we believe is ‘normal’ occurs through socialisation which includes: • Our parents or primary caregiver’s beliefs and how they lived their life • Our friends and peers • Institutions such as schools and churches • Our profession, or the type of work we do • Social groups we belong to • The media (TV, advertising radio) • Our own personal experiences. print media, Our concept of ‘normal’ changes significantly over time. Some behaviours that would have been considered quite normal 20 years ago (e.g. smoking in the office, smoking whilst pregnant), today are considered unacceptable. © SA Ambulance Service - October 2016 27 Work with Diverse People Marginalised Groups Marginalisation describes a state in which individuals are living on the fringes of society because of their compromised or severely limited access to the resources and opportunities needed to fully participate in society and to live a decent life. Marginalised people experience a complex, mutually reinforcing mix of economic, social, health and early-life disadvantage, as well as stigma. The experience of multiple disadvantages can have a compounding and persistent effect, reinforcing barriers to getting ahead, and increasing the likelihood of other related problems later in life. Around 5% of the working age population, or 640,000 people, experience multiple and complex disadvantage, which may affect their ability to fully participate in society. ‘Social inclusion’ is the provision of certain rights to all individuals and groups in society such as employment, adequate housing, healthcare, education and training. Much government and community effort has gone into creating a South Australia where everyone’s basic needs are met and they are able to participate in all aspects of our society. Some individuals and groups in our society experience particular disadvantage due to factors such as low socio-economic status, race, disability, culture or language background, location or gender. A combination of these factors sets up a complex reinforcing cycle which is the cause of multiple disadvantages for some people. The South Australian Government has developed Universal Access and Inclusion Guidelines with the aim to: • Reduce disadvantage • Increase economic and social participation • Give people a greater voice in decision making combined with greater responsibility. In order to advance social inclusion, services need to cater for all members of the South Australian community. © SA Ambulance Service - October 2016 28 Work with Diverse People Glossary Term Cultural diversity Culture Discrimination Ethnicity Health Care Provider Prejudice Race Definition Differences in race, ethnicity, nationality, religion, gender, sexual identity, socioeconomic status, physical ability, language, beliefs, behaviour patterns or customs among groups within a community, organisation or nation. Social norms and responses that condition the behaviour of a group of people that answer life’s basic status, physical ability, language beliefs, behaviour patterns or customs among various groups within a community, organisation or nation. The art of treating a person, issue or behaviour unjustly or inequitably as a result of prejudices, a showing or partiality or prejudice in treatment, specific actions or policies directed against the welfare of minority groups. The beliefs, values, customs, or practices of a specific group (e.g. its characteristics, language, common history or national origin). Every race has a variety of ethnic groups. Those involved in direct client care (i.e. Ambulance Officer) and/ or indirect patient care (i.e EMDSO) Preconceived judgements, opinions or assumptions formed without knowledge or examination of the facts about individuals, groups of people, behaviours or issues. These judgements or opinions usually are unfavourably and are marked by suspicion, fear or hatred. The categorising of major groups of people based solely on physical features that distinguish certain groups from others. © SA Ambulance Service - October 2016 29 Work with Diverse People Other Resources • Federation of Ethnic Community Councils of Australia −− The peak national body representing Australians from culturally and linguistically diverse backgrounds • Multicultural Mental Health Australia (MMHA) −− Promotes mental health and well-being of Australia’s diverse communities • Australian Government Human Services Finder © SA Ambulance Service - October 2016 30 Work with Diverse People References • Equal Opportunity Commission • Australian Human Rights Commission • Intersex Human Rights Australia • The Multicultural Advantage • Performance Drivers • Human Rights Campaign • Australian Institute of Health and Welfare • Racism. No Way • Gender Diversity © SA Ambulance Service - October 2016 31 Work with Diverse People Produced by: © SA Ambulance Service - October 2016 32