Migrants Health: Social Determinants of Health and Health Inequities Among East African Australians - An Ethnographic Approach

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Health inequity among migrant populations remains a persistent public health problem in Australia, with access to appropriate, culturally safe healthcare shaped by the intersecting effects of migration pathway, settlement duration, and structural disadvantage. East African Australians are a rapidly growing migrant population whose healthcare experiences remain poorly understood, despite substantial evidence of elevated health risk during resettlement, and few qualitative studies have explored these experiences from a critical, community-based approach. This critical ethnographic research addressed this gap by examining how social, cultural, and structural determinants influence healthcare access and outcomes for East African Australian migrants.

East African Australians experience socioeconomic disadvantage that carries substantial implications for everyday health and wellbeing, reflected in elevated morbidity and mortality relative to the general Australian population and in reduced utilisation of healthcare services and public health knowledge during settlement. These inequalities arise owing to complex interdependent processes, such as low socioeconomic status, social loneliness, low access to education, and insufficient access to healthcare, which combine to establish the ongoing health disparity that requires urgent public health system intervention.

Nevertheless, irrespective of the awareness of these issues, there is a lack of understanding of how certain social determinants are manifested in East African Australian populations and how they affect the populations’ healthcare experiences. Cultural transition, a complex process, the role of structural barriers across the Australian public healthcare systems presents peculiar challenges which are not appropriately met by current policies and practices. Moreover, a combination of cultural beliefs, language barriers, and systemic healthcare problems creates compounding effects that increase the exacerbation of health inequity between generations, which endangers the health of this community.

Thus, the proposed research followed an ethnographic design based on the philosophies of interpretivism to seek the lived experiences of 21 East African migrants living in Australia and how social determinants influenced their interactions with public healthcare systems and health results. The study established five important social determinants that create disparities in health, including culture and beliefs, structural barriers, language and communication issues, lack of social support networks, and systemic healthcare problems. These results demonstrate population-specific aspects affecting access to healthcare and present evidence-based premises grounded in practical changes. This research shows that these determinants necessitate dual-level change to address health disparities. Systemic barriers should be eradicated by policy reforms, improving the provision of interpreter services, ensuring the provision of cultural competency training to health professionals, and the dissemination of health information equitably. Cultural responsiveness should be incorporated into the practice-level changes by building trust, collaborating with communities, and engaging with other cultural perspectives. These culturally sensitive and inclusive measures can help eliminate health disparities, enhance health equity, and live conditions of East African migrants or other culturally and linguistically diverse groups in multicultural Australia.