Shared Language

Shared Language forms a critical part of effective collaboration. Clear definitions are incredibly important when communicating at a systems level, particularly when that communication centres on addressing the health inequities experienced by underserved populations.

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

A

Refers to the many Aboriginal groups and Torres Strait Islander groups within Australia. This can also be applied when referring to other topics such as Aboriginal and/or Torres Strait Islander cultures. By doing so, you are referencing two cultures rather than a joint ‘culture’.

Video: Talking terminology for Aboriginal and Torres Strait Islander people

Source: ACT Council of Social Service (ACTOSS), Gulgana Good Practice Guides

People can obtain health care at the right place and right time, taking account of different population needs and the affordability of care. 

Video: New RFDS research on equitable health access to primary healthcare in Australia

Source: Australian Health Performance Framework

B

The term ‘bias’ is typically used to refer to both implicit stereotypes and prejudices and raises serious concerns in healthcare. Psychologists often define bias broadly; such as ‘the negative evaluation of one group and its members relative to another’ [2]. Another way to define bias is to stipulate that an implicit association represents a bias only when likely to have a negative impact on an already disadvantaged group; e.g. if someone associates young girls with dolls, this would count as a bias. It is not itself a negative evaluation, but it supports an image of femininity that may prevent girls from excelling in areas traditionally considered ‘masculine’ such as mathematics [3].

Video: What Is Bias, and What Can Medical Professionals Do to Address It?

Source: Fitzgerald, C. Implicit Bias in Healthcare professionals: a systematic review. BMC Med Ethics, 18, 19 (2017)

C

A framework that provides guidance and resources to drive changes in training, perceptions, knowledge and practice necessary to optimise cancer experience and outcomes for those who experience disadvantage and discrimination. This includes within systems of screening & prevention, early detection, investigation & referral, diagnosis, treatment & care, managing recurrent disease, organisational support, social and end-of-life care.

Source: Optimal care pathway for Aboriginal and Torres Strait Islander people with cancerPeterson, A., Charles, V., Yeung, D. The Health Equity Framework: A Science and Justice based model for public health researchers and practitioners, Health Promotion Practice, August, 2020

Co-design is a methodology for actively engaging with a broad range of people directly involved in an issue, place or process in its design and implementation.

Principles of co-design include:

  • There is an equal and reciprocal relationship between all stakeholders, enabling them to design and deliver services in partnership with one another.
  • Planning, designing and producing services with people that have experience of the problem or service means the final solution is more likely to meet their needs.
  • This way of working demonstrates a shift from seeking involvement or participation after an agenda has already been set, to seeking consumer and clinician leadership from the outset so that consumers and clinicians are involved in defining the problem and designing the solution.

Video: Introduction to Co-design

Source: Burkett, I. (2012). An introduction to co-design. Sydney: Knode, 12.
https://aci.health.nsw.gov.au/projects/co-design

Cultural awareness allows us to see that we are all shaped by our own cultural background which influences how we interpret the world around us, perceive ourselves and how we relate to other people.

Cultural awareness is generally accepted as a necessary first step and a foundation for further development, but not sufficient for sustained behaviour change.

A basic understanding of Aboriginal and Torres Strait Islander histories, peoples and cultures. There is no common accepted practice to reflect cultural awareness, and the actions taken depend on the individual and their knowledge of Aboriginal and Torres Strait Islander culture.

Source: The Wardliparingga Aboriginal Research Unit of the South Australian Health and Medical Research Institute. National Safety and Quality Health Service Standards user guide for Aboriginal and Torres Strait Islander health. Sydney: Australian Commission on Safety and Quality in Health Care; 2017. ISBN: 978-1-925665-23-9.

A set of behaviours, attitudes and policies that enable a system, service or individual to deliver quality care to clients with diverse values, beliefs and behaviours, including tailoring delivery to meet patients’ social, cultural and linguistic needs. It requires institutionalising of cultural knowledge and adapting service delivery to reflect understanding of the diversity between and within cultures.

Source: Cancer Australia: A Guide to Implementing the optimal care pathway for Aboriginal and Torres Strait Islander People with cancer.

Cultural diversity means having a mix of people from different cultural backgrounds - it can include (but is not limited to) differences in cultural/ethnic identity (how we identify ourselves and how others identify others), language, country of birth, religion, heritage/ancestory, national origin and/or race. Cultural diversity can also refer to diversity within socio-economic, geographic, or gender groups.

Video: Cultural Diversity Week

Source: Diversity Council Australia (O’Leary, J. and Groutsis D.), Cultural Diversity Definition, Sydney, Diversity Council Australia, 26 June 2020.

The non-Indigenous cultural and linguistic groups represented in the Australian population who identify as having cultural or linguistic connections with their place of birth, ancestry or ethnic origin, religion, preferred language or language spoken at home.

Source: https://fecca.org.au/wp-content/uploads/2020/10/CALD-DATA-ISSUES-PAPER-FINAL2.pdf

The recognition, protection and continued advancement of the inherent rights, cultures, and traditions of Aboriginal and Torres Strait Islander people.

Source: Cancer Australia: A Guide to Implementing the optimal care pathway for Aboriginal and Torres Strait Islander People with cancer.

Cultural safety is determined by Aboriginal and Torres Strait Islander individuals, families, and communities. 

Culturally safe practice is the ongoing critical reflection of health practitioner knowledge, skills, attitudes, practising behaviours and power differentials in delivering safe, accessible, and responsive healthcare free of racism. 

The goal of cultural safety is for all people to feel respected and safe when they interact with the healthcare system. People are supported to draw strengths from their identity, culture and community. 

Video: Aboriginal cultural safety video

Source: Australian Health Practitioner Regulation Agency. National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy.

D

Factors used to define the characteristics of a person or a population. The characteristics of a person typically include age, sex, level of education, amount of income, marital status, occupation, religion, etc. The characteristics of a population include average income, birth rate, death rate, the average size of a family, the average age at marriage, etc.

Source: Bierer B.E., White S.A., Meloney L.G., Ahmed H.R., Strauss D.H., Clark L.T., (2021). Achieving Diversity, Inclusion, and Equity in Clinical Research Guidance Document Version 1.2. Cambridge and Boston, MA: Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center). Available at: https://mrctcenter.org/diversity-in-clinical-trials/

Discrimination happens when a person, or a group of people, is treated less favourably than another person or group because of their background or certain personal characteristics. This is known as ‘direct discrimination’.

It is also discrimination when an unreasonable rule or policy applies to everyone but has the effect of disadvantaging some people because of a personal characteristic they share. This is known as ‘indirect discrimination’.

Video: The Invisible Discriminator

Source: https://humanrights.gov.au/quick-guide/12030

E

A category of people who identify with each other, usually on the basis of presumed similarities such as common language, ancestry, history, society, culture, practices, beliefs, or nation.

Source: Bierer B.E., White S.A., Meloney L.G., Ahmed H.R., Strauss D.H., Clark L.T., (2021). Achieving Diversity, Inclusion, and Equity in Clinical Research Guidance Document Version 1.2. Cambridge and Boston, MA: Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center). Available at: https://mrctcenter.org/diversity-in-clinical-trials/

Each individual or group of people are given the same resources or opportunities, with the expectation that the outcome will be the same.

Source: Milken Institute School of Public Health
Race Matters Institute

Equity is the absence of unfair, avoidable or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other dimensions of inequality (e.g. sex, gender, ethnicity, disability, socio-economic status or sexual orientation).

Health inequities systematically put populations who are already socially disadvantaged (for example, by virtue of being poor, female, or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health.

Video: Equity and Equality

Source: World Health Organization
Braveman P, Gruskin S. Defining equity in health. Journal of Epidemiology & Community Health 2003;57:254-258.

G

The roles, behaviours, activities, attributes, and culture typically associated with one’s sexual identification. Gender interacts with, but is different from, the categories of biological sex.

Genderbread Person v4.0 | The Genderbread Person

Video: What is gender?

Source: Bierer B.E., White S.A., Meloney L.G., Ahmed H.R., Strauss D.H., Clark L.T., (2021). Achieving Diversity, Inclusion, and Equity in Clinical Research Guidance Document Version 1.2. Cambridge and Boston, MA: Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center). Available at: https://mrctcenter.org/diversity-in-clinical-trials/

H

The absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically, or geographically or by other means of stratification. "Health equity” or “equity in health” implies that ideally everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.

Video: Dr Leena Gupta on addressing inequity in guideline development.

Source: World Health Organization

Health literacy relates to how people access, understand and use health information in ways that benefit their health. People with low health literacy are at higher risk of worse health outcomes and poorer health behaviours.

Video: What is Health Literacy?

Source: Australian Institute of Health and Welfare

I

The interconnected nature of categorizations such as but not limited to race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.

Video: What is intersectionality?

Source: Bierer B.E., White S.A., Meloney L.G., Ahmed H.R., Strauss D.H., Clark L.T., (2021). Achieving Diversity, Inclusion, and Equity in Clinical Research Guidance Document Version 1.2. Cambridge and Boston, MA: Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center). Available at: https://mrctcenter.org/diversity-in-clinical-trials/

P

An individual’s perception of the consequences of taking an interpersonal risk or a belief that a team is safe for risk taking in the face of being seen as ignorant, incompetent, negative, or disruptive.

In a team with high psychological safety, teammates feel safe to take risks around their team members.

Video: Building a psychologically safe workplace | Amy Edmondson | TEDxHGSE

Source: Edmondson, Amy. “Psychological Safety and Learning Behavior in Work Teams.” Administrative Science Quarterly, vol. 44, no. 2, 1999, pp. 350–83. JSTOR, https://doi.org/10.2307/2666999. 

R

 A tool or technology that continually reproduces to maintain the racial hierarchy, closely intersecting with other structures of power (i.e., capitalism, gender sexuality, class and ability) to justify oppressive and discriminatory practices that maintain white supremacy.

A political system of classification that governs people by sorting them into social groupings based on invented biological demarcations.

Video: What is race? What is ethnicity? Is there a difference?

Source: Lentin, A. (2020). Why race still matters. John Wiley & Sons.
Roberts, Dorothy E., 1956-. Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-First Century. New York: New Press, 2011.

The process by which systems and policies, actions and attitudes create inequitable opportunities and outcomes for people based on race.

Racism is more than just prejudice in thought or action. It occurs when this prejudice – whether individual or institutional – is accompanied by the power to discriminate against, oppress or limit the rights of others.

There is interpersonal racism, which is individuals’ beliefs, attitudes and actions that discriminate, exclude or disadvantage people from racially marginalised groups.

There is also systemic racism, which is organisations’ policies, procedures and practices that directly or indirectly discriminate, exclude or disadvantage people from racially marginalised groups.

Video: Racism. It Stops With Me – Ask yourself the hard questions

Source: https://itstopswithme.humanrights.gov.au/commit-to-learning
https://www.dca.org.au/research/project/racismatwork

Reciprocity describes the respectful nature of good research relationships and exchanges essential in participatory and other types of research. 

Reciprocity for Aboriginal and Torres Strait Islander Peoples is defined as shared responsibilities and obligations to family and the land based on kinship networks, and also includes sharing of benefits. 

Reciprocity should enable agreements where all groups or people have equal rights and power in relationships.  Reciprocity recognises all partners’ contributions and ensures the benefits from research outcomes are equitable and of value for Aboriginal and Torres Strait Islander people and communities.

Source: Maiter, S., Simich, L., Jacobson, N., & Wise, J. (2008). Reciprocity: An ethic for community-based participatory action research. Action research, 6(3), 305-325.
National Health and Medical Research Council, Ethical conduct in research with Aboriginal and Torres Strait Islander Peoples and communities: Guidelines for researchers and stakeholders (2018), Commonwealth of Australia: Canberra.

S

The economic and social conditions that influence individual and group differences in health status, including one's living and working conditions (e.g., income, wealth, influence, and power), rather than individual risk factors (e.g., genetics, behaviours) that influence the risk for or vulnerability to a disease or injury.

Video: Social Determinants of Health - an introduction

Source: Bierer B.E., White S.A., Meloney L.G., Ahmed H.R., Strauss D.H., Clark L.T., (2021). Achieving Diversity, Inclusion, and Equity in Clinical Research Guidance Document Version 1.2. Cambridge and Boston, MA: Multi-Regional Clinical Trials Center of Brigham and Women’s Hospital and Harvard (MRCT Center). Available at: https://mrctcenter.org/diversity-in-clinical-trials/

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