The Political And Legal Determinants Of CALD Communities: An Unhealthy (Modern) Healthcare Paradigm

Khaled Al-Kassimi ,Angela TH Kwan ,Jacob S Portnoff ,Heena Akbar
Keywords: Cultural and Linguistically Diverse (CALD), Cultural Competence; Denial of Coevality, League of Nations, Life-Course Approach, Pacific Diaspora, Secular-Humanist, Sovereignty ,


Culturally and Linguistically Diverse (CALD) groups experience disproportionately poorer health outcomes in Canada and Australia due to a secular-humanist ontology. The intergenerational trauma caused by widespread systemic discrimination has led to a higher prevalence of chronic illnesses, mental health disorders, poorer health literacy, lower income status, geographic displacement, and food insecurity. To accurately conceptualize these health outcomes, a life-course approach incorporating a phenomenological lens that accounts for the social determinants of health is adopted. Such a framework will elucidate the disparities unique to different cultures adhering to an epistemology beyond secular humanism. Our commentary provides greater insight into the impact of structural intermediary factors – socio-economic, legal, environmental, and political – to understand better the healthcare experience and outcomes of CALD and Indigenous groups in Canada and Australia – including the Pacific diaspora in Australia. This analysis will help develop tailored advocacy strategies and clinical practice guidelines to implement and reframe the unhealthy (modern) healthcare paradigm into a culturally sensitive strength-based intervention approach. Such a model will help promote resilience and address the underlying implicit biases that reinforce institutional prejudices, thereby bridging the gap in health equity. The manuscript concludes by suggesting five clinical practice guidelines moving beyond a Western biomedical model of care.