The Pediatric Clinician's Approach to Acute or Chronic Neurologic Symptoms in Children with Sickle Cell Disease.

Australia is one of the most culturally and linguistically diverse countries in the world, with close to one third (30.7%) of the population born overseas () and nearly half with at least one parent born overseas (). In the South Western Sydney region of New South Wales (NSW), more than half (52.7%) of the population are overseas-born and the majority of households (68.5%) speak a language other than English at home (). In recent decades, the pattern of migration to Australia has changed significantly, shifting from European countries to Asian countries (). While such an increment in the migrant population brings opportunities for economic and social development, it also poses several challenges, including a range of health and behavioral issues. While migrants to Australia seem to have relatively better physical health than those born overseas when they first arrive in the country (), research suggests that this situation changes overtime given the social and economic challenges faced by migrants, particularly those from non-English-speaking backgrounds (; ). However, evidence relating to the prevalence of alcohol and other drug (AOD) use among people from culturally and linguistically diverse backgrounds is very limited, and the few studies conducted so far report conflicting results (; ; ). This is unsurprising given the concept of “culturally and linguistically diverse” (or as it is commonly known in Australia: CALD) encompasses a multitude of “cultures” and intersectionalities that are not (and should not be) easily compartmentalized into one category (). Nonetheless, it is useful to review and explore some of the common experiences of those who come from migrant backgrounds, particularly from non-White Western cultures, and their experiences of services to support AOD management and recovery. The most recent National Drug Strategy Household Survey in Australia found that people from non-English-speaking backgrounds are much less likely to drink alcohol at risky levels and that people with diverse backgrounds are much less likely to have ever used illicit drugs (). In contrast, a survey conducted in Sydney, Australia, that involved 2212 individuals reported higher rates of daily smoking among Vietnamese and Italian men, and men and women from Pacific and Arabic-speaking communities (). Similarly, a study conducted among Vietnamese migrants living in Melbourne reported several risky health behaviors, such as illicit drug use, harmful use of alcohol, and injecting drug use (). There are many potential contributing factors to harmful and hazardous behaviors among migrants and refugees, and these include experiencing low socio-economic conditions, low levels of health literacy, inadequate support to community and cultural adjustment, and limited access and utilization of culturally and context-specific health services (, ; ; ). However, limited evidence and understanding of the behaviors and factors related to the utilization of support services available make it more difficult to provide appropriate services for people from migrant, non-English-speaking backgrounds (). Furthermore, there is also a lack of guidelines or training on providing culturally appropriate substance use services (). Culturally safe and respectful practice requires having knowledge of how culture, values, attitudes, assumptions, and beliefs influence care providers’ interactions with service users, their families, and communities, and how these interactions impact service users ().