Australia is failing marginalized people and it shows in COVID death rates

Newly released Australian Bureau of Statistics (ABS) data. show People living in poverty or disadvantage are three times more likely to die from COVID than the rich.

This statistic is alarming, but it gets worse when we start looking more closely at specific communities.

ABS data shows death toll from COVID for overseas-born people living in Australia was near three times more than those born in Australia, standardized by age (6.8 deaths per 100,000 versus 2.3 deaths).

The fatality rate from COVID for people living in Australia from the Middle East was over 12 times that of Australian-born people (29.3 people per 100,000).

These statistics are devastating. They tell us that if you were born here, grew up speaking and reading English, are educated and earn a good income, you are more likely to survive COVID.

They undermine the idea that Australia has quality universal healthcare that has been accessible during the pandemic.

Poverty makes you sick

Most health problems and the care required to treat them follow what we “the social gradient“.

This term is an acronym for the idea that those with the most resources – be it money or education – have better health and receive better treatment than those with fewer resources.

In short: poverty makes you ill. It does this by restricting your access to services and support through money or other factors such as the type of work you do.

People at the “lower end” of the social gradient also tend to receive poorer quality of health care.

Unfortunately, this social divide is now becoming evident in Australian COVID death data.

For example, some people from Middle Eastern countries and other migrant or refugee communities have poorer employment conditions, such as B. Janitor jobs in hospitals. These jobs expose people to COVID, who then bring the virus home. They have had to continue working in these high-risk jobs during the pandemic so they can afford basic living expenses like food and rent.

There are also major barriers to medical care for and information about COVID for specific communities. We saw this result during the Delta variant wave in Victoria and New South Wales People with refugee and migration backgrounds who die at home before receiving medical treatment for COVID.

The authorities attributed this to a Reluctance to seek medical care. This reluctance can come from a lack of culturally and linguistically appropriate healthcare communication and services.



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Many people also distrust authorities, including the police and army, because of experiences in people’s home countries. Fear of authorities is a legitimate fear when you come from a country where authorities could kill you.

This has been exacerbated by governments in Australia choosing to “monitor” the pandemic. Those found violating COVID health regulations have been threatened with heavy fines.

This fear of fines and authorities has probably contributed to a reluctance to seek medical care and thus to more deaths. And the news of authoritarian approaches to those breaking COVID health orders has likely exacerbated this.

Many were also excluded from government support.

Australian governments and health services have failed sections of our community, from those on low incomes to those from non-English speaking backgrounds.

People born abroad were three times more likely to die from COVID than people born in Australia.
AAP image/Bianca De Marchi

What can we do now?

There are a number of actions we can take to correct the high death rates in refugee and migrant communities.

In terms of policy, the federal government could expand access to Medicare and social safety net support People who have problems with temporary visas, such as B. Resident asylum seekers who are appealing a decision on a visa application and are not eligible for Medicare. Add to special Medicare items for refugees and migrants can also encourage more culturally and linguistically inclusive medical care in the healthcare system.

These changes would help provide more affordable, accessible and inclusive healthcare, particularly for asylum seekers and refugees dealing with visa issues, and help prevent loss of life.

Governments should also engage refugee and migrant communities in developing and implementing measures to reduce COVID deaths. Communities know what they need in a crisis – we need to find new ways of listening. one from top to bottom, reaction of the middle class to a pandemic, services and supports are created that only work for the middle class.

It is vital that we look at the evidence on what can best help refugee and migrant communities reduce the risk of infection, engage them meaningfully in the process and sharpen our focus on making life in Australia more just, inclusive and… hopefully making it safer for everyone.

We must avoid a top-down approach to health policy.
AAP image/Joel Carrett

What must happen next?

There are currently major gaps in understanding of what can best support refugee and migrant communities to reduce the risk of infection and harm from COVID.

Further research is required. However, this research needs to be led by peers in communities and be easily accessible and participatory. In other words, we cannot repeat the mistake of developing approaches that only work for the middle class.

Best practice tells us that multiple forms of research are required, and to do so in a culturally and linguistically inclusive way.



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Survey-based research needs to be conducted in hospitals, health centers and other clinical settings to understand how to address barriers to COVID-19 medical care and information to better serve the needs of people from refugee and migrant communities. The research could identify more culturally inclusive ways to manage vaccination, testing and recovery from virus symptoms.

This needs to be supported by in-depth research to examine the experiences of a variety of communities. Just as disadvantaged groups are not all the same, so are refugee and migrant communities (although they are commonly grouped under the term “culturally and linguistically diverse”).

Newly arrived or established communities – all from different countries – have different needs.

We need more listening and fewer punitive approaches.

About Ellen Lewandowski

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