From 'White Australia' to 'part of Asia': recent shifts in Australian immigration policy towards the region

This article examines migration policy in Australia with reference to the "White Australia" policy prior to 1975 and the multicultural policy thereafter. Mass immigration has not caused major social tensions. Mass tourism has been welcomed. Australian attitudes have changed from fear of massive numbers of Asians and mass poverty and ignorance to multiculturalism. Suspicious attitudes toward Asians, however, are still present among a minority of Australians. The most influential arguments against Asians are the concerns about employment of new arrivals and the environmental impact of an increasing population. Although there are many cultural differences, Australia is linked to Singapore, Malaysia, and the Philippines in that all have a history of British or American influence. Educated Indians and Sri Lankans are linked to Australians by their common language and Christian religion. The integration of Asians in the business and financial community holds the potential for economic gain over the years. The author finds that the Australian relationship to Asia is more acceptable in public arenas than the comparable changing relationship between Britain and Europe. The roots of a Whites-only policy extend back to 1901, when the Commonwealth Immigration Restriction Act was ratified. The exclusion of non-European immigrants was not specified in the law. The mechanism for exclusion was included in the law. Undesirable immigrants could be excluded. Under mass migration programs after 1947 the population of non-English speaking Europeans increased. By 1973 government shifted from an assimilationist approach to a multicultural approach due to pressure from the Department of Foreign Affairs. Numerous historical events occurring during 1942-80 drew Australia out of its isolationist position in the world. At present about 25% of the total population are of non-British origin. Over 900,000 would have been excluded under the old migration policy. In 1991, 665,315 persons were born in Asia, of which the largest numbers came from Mainland China, Malaysia, and the Philippines. Asian immigrants are either refugees from Viet Nam, Cambodia, and Laos or voluntary Asian immigrants.     

A Contested Identity: Resisting the Category Muslim-Australian

The role of the media in contributing to the construction of identity based groups is both overt and subtle. The term Muslim-Australians has come into prominence in recent media reports, yet an umbrella term which lumps all Australian followers of Islam into a single subset of all Australians ignores the complex diversity of Muslims in Australia. This article reports on a new research project which has recently been undertaken with Australians of Turkish background, in order to untangle some of the complexity involved when a Muslim community which comes from a relatively liberal, secular country finds its Islamic identity being foregrounded by the mainstream media. The research has focused on the ways that Turkish Australians are using traditional and new forms of media and information technology to negotiate a place in a multicultural society which is increasingly perceiving Muslims as ‘the other’.     

Coordinating health, extended care, and community support services: reforming aged care in Australia

Under pressure to maximize the cost-effectiveness of programs, efforts to improve coordination have become increasingly central to the development of the broader health and welfare service delivery system in Australia in the past few years. This article reviews recent experience in two related fields: (1) the coordination of different community care services for older people and people with disabilities, funded by the Home and Community Care program; and (2) the attempt to enhance links between community and residential care services, hospitals, and other health care providers. Why coordination has emerged as such an important issue in the field of community care and, increasingly, across the entire system of what the Australian government now terms health and family services is discussed. A number of measures that have been introduced or are proposed to improve a coordination of services are briefly reviewed. These range from individualistic approaches based on information and referral, through schemes involving gatekeeping, case management and brokerage of services, to models involving the reconfiguration of organizational structures, linkages, and finances. These measures are not mutually exclusive and are increasingly likely to be applied in more complex mixed models of service coordination. It is argued that coordination at the level of direct-service provision is difficult if government policies that direct services lack coordination.     

Coordinating Health,Extended Care,and Community Support Services

Abstract

Under pressure to maximize the cost-effectiveness of programs, efforts to improve coordination have become increasingly central to the development of the broader health and welfare service delivery system in Australia in the past few years. This article reviews recent experience in two related fields: (1) the coordination of different community care services for older people and people with disabilities, funded by the Home and Community Care program; and (2) the attempt to enhance links between community and residential care services, hospitals, and other health care providers. Why coordination has emerged as such an important issue in the field of community care and, increasingly, across the entire system of what the Australian government now terms health and family services is discussed. A number of measures that have been introduced or are proposed to improve a coordination of services are briefly reviewed. These range from individualistic approaches based on information and referral, through schemes involving gatekeeping, case management and brokerage of services, to models involving the reconfiguration of organizational structures, linkages, and finances. These measures are not mutually exclusive and are increasingly likely to be applied in more complex mixed models of service coordination. It is argued that coordination at the level of direct-service provision is difficult if government policies that direct services lack coordination.     

The transnational effect of multicultural policies on migrants' identification: the case of the Israeli diaspora in the USA

While it is difficult to gauge the effect of multicultural policies within countries, it is even more difficult to measure them across countries. In this article, I use fundamental multicultural changes that have occurred in Israeli society in recent decades as a case study, and track their effect on how Israelis who reside in the USA identify with Israel. Analysing the US census and the American Community Survey, I have focused my research on three groups of Israeli‐born migrants in the USA – Israeli Arabs, ultra‐Orthodox Jews and the Jewish majority. Findings indicate that originating from a minority community in the homeland predicts not only a different rate, but also different longitudinal trends of Israeli identification. I offer several possible explanations for these variations, but an in‐depth analysis of the Israeli case indicates that the transnational effect of the changing multicultural agenda in Israel is the leading mechanism at play.     

Healthcare Use in the Heartland: How Health Care Selection Varies Between Rural,Retirement‐Age Migrants and Long‐Term Residents

One increasingly important problem affecting rural health care selection is the tendency of older residents to bypass local health care providers. This research investigates how the effects of community characteristics and attachment on health care bypass behavior vary between rural retirement‐age migrants and retirement‐age long‐term residents. Non‐health‐related behaviors, such as purchasing goods and services outside one's community during a health care trip, that is, “outshopping,” could influence bypass if individuals combine trips for their medical care with other consumer needs. Basing our work on the outshopping theory, we argue that bypass behavior is one facet of consumer consumption patterns for both rural retirement‐age migrants and long‐term residents. In addition, dissatisfaction with local health care and services like shopping can “push” rural residents to bypass local health care and travel greater distances for primary health care. We further contend that strong community attachment has an opposite “pull” effect that can help to negate the push of outshopping and reduce the likelihood of bypass. Our results reveal retirement‐age migrants are significantly more likely to bypass local primary health care providers than retirement‐age long‐term residents. Furthermore, our analysis bridges the rural health care and retirement community development literature to suggest that outshopping theory can now be applied to rural primary health care bypass behavior.     

Meeting immigrant health challenges: An integrated model in New York City

New York City has traditionally been the portal to America for millions of foreign‐born immigrants. Current immigration echoes this past. Each year, tens of thousands of immigrants and migrants enter New York City. These individuals and families come from diverse cultures and health care systems which continue to impact on their health care needs. How can New York's health care system provide culturally sensitive and epidemiologically informed health services to these immigrants? In 1990, with a grant from the Aaron Diamond Foundation, an interdisciplinary group of professionals established the New York Task Force on Immigrant Health. This paper will describe the work of this unique multi‐disciplinary organisation as it seeks to address issues of health status and service delivery to immigrant populations. The paper will discuss specific issues and strategies with respect to a) the development of data bases, b) ethnographic investigations, c) cross‐cultural and structural barriers to care, d) the creation and analysis of models to integrate traditional and Western bio‐technical health care, and e) the informing and transforming of public policy and programs to result in more linguistically appropriate, culturally sensitive and effective health and social services. The successes of the New York Task Force on Immigrant Health, in a relatively brief period of time, provide both a model and a stimulus for other localities and nation‐states interested in preventing illness and improving the health status of their diverse populations.     

The limits of multiculturalism in elder care services

Over the past decade, policymakers and practitioners in the field of aging have been increasingly challenged to develop appropriate health and social services for elders from diverse ethnic communities. This has largely resulted from concerns regarding the significant barriers to care faced by disenfranchised elders. However, advances in the articulation of multicultural practice and policy dealing with ethnic communities have focused almost exclusively on developing competency skills based on individual communication and understanding between formal service providers and clients rather than on exposing and altering institutional structures and power relations marked by racism. Indeed, antiracist agendas are rarely articulated in gerontological settings. This article reports on some of the central findings of a qualitative institutional ethnographic study on health care access among ethnic elderly women. It addresses the question of how multicultural programs and policies operate in elder care services and how they are experienced by ethnic elderly female clients and their service providers.     

The Development of a Black and Ethnic minority health policy at the department of health

Britain is a truly multiracial and multicultural society. Immigration into Britain in 1960s and 1970s was mainly fiom South East Asia, Africa and the West Indies. A large number of immigrants have now become residents of Britain and we have a second generation of Black and ethnic minority groups in this country who were bom in Britain. More recently we have been joined by a number of refugee groups and asylum seekers. In the last 10 years, there have been a number of initiatives which have been taken to develop appropriate policies to improve access to health services by ethnic groups and to understand their health and disease patterns. The main issues are: (1) What policies have been developed? (2) The main areas of concern. (3) The differing health and disease patterns among ethnic minority groups. (4) How the policies are being implemented at the health service level and the lessons learned. (5) How the health professionals are being trained to deliver appropriate services to these groups. (6) How volunteer groups are invoked in planning services. (7) The national health services have recently been reformed and have introduced the idea of separating the delivery of health care from its planning and of the purchasing of services by health authorities. It is important to examine whether these have an impact in changing health services to make them more accessible to ethnic minority groups. (8) What the future plans in this area of work are.     

Public policy in a multicultural Australia

The debate on the consequences of large-scale immigration in the making of public policy began in 1968. Muliculturalism is for all Australians and any social policy designed for the benefit of one group in the population must have profound consequences on all people. 40% of the Australian population was born overseas or have at least 1 parent born overseas. Almost 1/4 of the population has ethnic roots in other than the Anglo-Celtic majority. The ideal of moral progress, greater equality, and improvement is the motive force in society. The presence of social heterogeneity--religious or ethnic--is linked with the issue of stability in a democratic system. There are 2 models of multiculturalism and corresponding public policy approaches. 1 model emphasizes the role of the political processes in Australian ethnic relations and sees ethnic structures (political, social, economic) as legitimate but separate interest groups, each having the exclusive responsibility for the realization of ethnic goals. The leading feature of this model is the structural fragmentation of Australian society into parallel segments of varying degrees of exclusiveness each with its own "ethnic" label. The 2nd model stresses the priority of the wholeness and welfare of the entire society. It assumes that a society based on satisfaction of individual needs through voluntary exchange is fertile ground for cultural enrichment. The goal is cohesion and unity in living together in Australia, seen as of central concern and consistent with the ideals of intercultural understanding and improved communication. The model assumes that the culture must be seen as a living, dynamic, changing, and interacting set of life patterns. The author prefers the 2nd model which stresses that the future vision of a multicultural Australia must be a shared one because only then can cultural diversity and national cohesion coexist within the 1 economic and political unit.     

The social investment approach as a field of job creation. From the ‘recalibration’ to a resurgent trade-off between employment growth and low wage (white) jobs. A comparison between Germany and Italy

The social investment approach emerged as a new welfare paradigm, aimed at reconciling the traditional functions of the welfare supply with a productive social agenda, designed at preparing people to confront the ‘new social risks’, whether they be related to the problem of balancing paid work and family responsibilities, upgrading the skills, preventing inequalities and promoting the availability of in-kind services. In order to achieve these objectives, especially those related to care needs and work-life balance, the adoption of social investment-based strategies necessarily implies an expansion of the jobs related to health and social care services. In more recent years, many studies have analysed the limitations of the social investment policies because of their different redistributive impacts on social groups. Several studies have found a higher use of these policies for high-income families. Another source of criticism on social investment is that spending on these policies would seem to crowd out more traditional passive social expenditures. In this article, we examine another question related to the widespread of this approach: what are the effects of the social investment policies in terms of direct job creation? In fact, one of the more controversial issues, related to social investment policies, is their direct contribution to the labour market in terms of both quantity and quality of work within welfare services. The article analyses these issues focusing on Germany and Italy, two countries that represent not only two different care regimes but also two distinct models regarding job creation strategies in the care sector. In doing so, particular attention will be paid to long-term care policies, as they represent one of the pivotal areas of the social investment approach, both in terms of social services, to address new social risks, and new jobs related to welfare services     

Carers of People with Mental Illness from Culturally and Linguistically Diverse Communities

Australia is a multicultural country and it is common for families from culturally and linguistically diverse (CALD) communities to care for their relatives with mental illness. However, there are limited Australian studies examining the experiences of informal carers of people with mental illness from CALD communities. A scoping review was conducted to search for peer-reviewed articles reporting the perception of carers regarding their caregiving experiences, wellbeing, and needs. Using cultural responsiveness as a conceptual framework, this study analysed the findings of the identified studies to generate themes. Findings show that carers experience severe caregiving challenges and face considerably poor culturally oriented services in mental health. Social work implications concerning the need to provide culturally responsive practice in mental health services are discussed.     

Barriers to accessing HIV and sexual health services among gay men in Tasmania,Australia

We examined barriers to accessing HIV and sexual health services among gay and bisexual men (GBM) in Tasmania, Australia, using in-depth interviews. Most participants were satisfied with the care they had received at public sexual health services. Barriers included the limited number of services, concerns about anonymity and privacy in small communities, difficulties accessing services via a general practitioner, and perceived stigma and discrimination. Improving the accessibility and availability of HIV and sexual health services in Tasmania is crucial to promote the engagement of GBM, which could be achieved via combined efforts of government services and community organizations.     

Sexual agency,risk and vulnerability: a scoping review of young Indigenous Australians’ sexual health

This review of qualitative research examining young Indigenous Australians’ sexual health highlights the profoundly social nature of young people’s sexual lives. Nineteen peer reviewed published papers were identified for inclusion. Findings reveal efforts made by some young Indigenous Australians to control their sexual lives, mitigate risk and maintain their sexual health. The review identified factors which are conducive to sexual health risks and vulnerability, including incomplete knowledge about STIs and safer sexual practices; gossip and ridicule concerning sexual activity and its consequences; damaging expectations about male prerogatives with respect to sexual relationships; limited inter-generational communication about sexual health issues; inadequate school-based sexual health education; and tensions between Indigenous and biomedical explanations of sexual health issues. Future research priorities include a focus on young Indigenous people in cities and towns across Australia, and in regional and remote settings in New South Wales and Victoria; understanding how Indigenous cultural values support young people’s sexual health; young men’s sexual and service-based practices; and the experiences of same-sex attracted and gender diverse youth. This research would inform the design and delivery of culturally safe and acceptable sexual health services and programmes, underpinned by an understanding of factors in young Indigenous Australians’ everyday sexual lives.     

Developing an early intervention programme to prevent child maltreatment

This paper describes the development and implementation of a programme to prevent child maltreatment in a multicultural, inner city community setting with very high rates of physical abuse and neglect. The rationale and philosophy underpinning the prevention programme is outlined. It has a unique approach, combining several features present to varying degrees in other home visiting programmes within a well‐structured framework. This includes the identification of vulnerable parents during the antenatal period, the use of generic health professionals (health visitors) in identification and intervention with families, an ‘active engagement’ strategy, the development of specialist non‐stigmatizing clinics for parents and the creation of a consultation service for generic workers. A variety of interventions are briefly described which are used to support vulnerable families. These include antenatal parenting workshops; baby massage; dedicated crying, sleeping and feeding clinics; and clinics to help parents manage toddler behaviour.Evaluation over the first 5 years of these clinics shows almost 75% of cases have successful outcomes. Copyright © 2001 John Wiley & Sons, Ltd.     

Long-Term Care Alternatives:

Definition of Life Care Community. A continuing care requirement community (CCRC), or life care community, is a long-term care alternative providing a package of services, including housing, health care and social services, to the elderly. More specifically, a CCRCL (1) provides independent living units, either apartments, rooms or cottages; (2) guarantees a range of health care and social services, which may include intermediate or skilled nursing care, usually available on the premises; (3) requires some type of prepayment, generally an entrance fee and/or monthly fees; and (4) offers a contract that lasts for more than one year or for life and that describes the service obligations of the community and the financial obligations of the resident.     

Social Rights and Disability: the language of 'rights' in community care policies

Social rights and disability: the language of 'rights' in community care policies. The paper argues that what disabled people mean when they speak of 'rights' is relatively under-developed with regard to health and social services. Furthermore, while a claim of 'rights' is typically presented as a fairer alternative to the needs-based character of welfare policies, how such an approach would change the delivery of health and social care is unclear. The paper draws on a landmark test case in community care to explore the problems of a rights-based approach to social justice for disabled people. It demonstrates the weaknesses of rights, especially the more problematic 'social rights', and urges caution in seeking solutions to social problems through the courts. It ends by suggesting that, given the anecdotal evidence about local authorities' tightening their eligibility criteria in the light of the 'Gloucestershire case', that limits on coverage may be the trade-off for implementing rights.     

The Perspectives of Older Greek-Australians Toward Changes in the Nature of Family Support: Implications for Family Care Policies

Internationally, public policies encourage “aging in place,” and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n?=?27) and five focus groups (n?=?63 total participants) with older Greek-Australians in modern Greek. While “cultures of care” remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.     

Telemedicine,rural elderly,and policy issues

Historically, rural America has had a difficult time providing health care to its residents, particularly its frail elderly population. Rural health care is often faced with a shortage of health care specialists, facilities with inferior equipment, and insufficient resources compared to health care in more urban areas. It is anticipated that the use of telemedicine will help address many of the problems facing the delivery of health care services to rural elderly. This paper reviews some innovative projects delivering services to the elderly. Also, the paper discusses several issues that need to be addressed before telemedicine can reach its full potential in improving access to health care, including reimbursement policies, patient and provider liability and confidentiality, and the infrastructure supporting telemedicine. Although telecommunications has tremendous potential to address the care needs of frail isolated elderly, without comprehensive reimbursement policies, guidelines for ethical conduct of a teleconsultation, acceptable security measures of patient records, and adequate as well as compatible infrastructure, that potential cannot be completely realized.     

Community care or therapeutic stalking: two sides of the same coin?

Although the government of the United Kingdom strives to address the needs of individuals engaged in mental health services, its policies must, by their nature, reflect a utilitarian approach. When a client chooses to disengage from services, mental health professionals can find themselves in an ethical dilemma in which adhering to policies can lead them to hyperactive conduct, whereby the client may experience what feels more like stalking behavior than therapeutic care.