Cultural support workers in the Aotearoa New Zealand healthcare setting: Challenge and opportunity for health social work
Keywords:Cultural support, healthcare services, social work, health disparities
INTRODUCTION: In Aotearoa New Zealand, as elsewhere in the world, healthcare providers are seeking better ways to engage with increasingly ethnically and linguistically diverse communities. The use of cultural support workers (CSWs) to act as a bridge between services and such communities is proving to be an effective strategy for achieving this. For the social work profession, the advent of CSW roles presents both challenges and opportunities.
APPROACH: A review of literature outlines the challenge of delivering culturally responsive and appropriate services to migrant and refugee communities and describes the role played by CSWs to increase the cultural understanding of healthcare providers and improve health outcomes for these communities. The impact of such roles on health social work is explored and how current social work education prepares practitioners for practice in an increasingly multicultural society.
CONCLUSIONS: This article outlines the key issues that arise from the introduction of CSWs, the potential for collaboration and the opportunity that exists for health social work to refocus and redefine its role in the healthcare setting.
Alvillar, M., Quinlan, J., Rush, C., & Dudley, D. (2011). Recommendations for developing and sustaining community health workers. Journal of Health Care for the Poor and Underserved, 22(3), 745-750. doi:https://doi.org/10.1353/hpu.2011.0073
Aotearoa New Zealand Association of Social Workers (ANZASW). (2014). ANZASW Social work practice standards: Enhancing competent social work practice. Retrieved from https://anzasw.nz/wp-content/uploads/ Practice-Standard-Publication-Full-Nov-14.pdf
Aotearoa New Zealand Association of Social Workers (ANZASW). (2019). ANZASW code of ethics. Retrieved from https://anzasw.nz/wp-content/uploads/ANZASW- Code-of-Ethics-Final-1-Aug-2019.pdf
Auckland City Council. (2013). Ethnicity and migration in Auckland. Technical Report 2013/012. http://knowledgeauckland.org.nz/assets/publications/ TR2013-012-Ethnicity-and-migration-in-Auckland.pdf
Beddoe, L. (2018). Social work education in Aotearoa New Zealand: Building a profession. Practice, 30(4), 305–320. doi:10.1080/09503153.2018.1478955
Beddoe, L., & Deeney, C. (2012). Discovering health social work in New Zealand in its published work: Implications for the profession. Aotearoa New Zealand Social Work, 24(1), 41–55.
Chen, M. (2015). Superdiversity stocktake: Implications for business, government and New Zealand. Superdiversity Centre for Law, Policy and Business: Wellington,
Craig, S. L., & Muskat, B. (2013). Bouncers, brokers, and glue: The self-described roles of social workers in urban hospitals. Health & Social Work 38(1), 7–16. doi:10.1093/hsw/hls064
Craig, S. L., Bejan, R., & Muskat, B. (2013). Making the invisible visible: Are health social workers addressing the social determinants of health? Social Work in Health Care, 52(4), 311–331. doi:10.1080/00981389.2013.764379
Crawley, L.M., Marshall, P.A., Lo, B., & Koenig, B.A. (2002) Strategies for culturally effective end-of-life care (for the End-of-Life Care Consensus Panel). Annals of Internal Medicine, 136(9), 673–679. doi: https://doi.org/10.7326/0003-4819-136-9- 200205070-00010
Darnell, J. S. (2007). Patient navigation: A call to action. Social Work, 52(1), 81–84. doi:10.1093/sw/52.1.81
Dohan, D., & Schrag, D. (2005). Using navigators to improve care of underserved patients: Current practices and approaches. Cancer, 104(4), 848–855. doi:10.1002/cncr.21214
Fischer, S. M., Sauaia, A., & Kutner, J. S. (2007). Patient navigation: A culturally competent strategy to address disparities in palliative care. Journal of Palliative Medicine, 10(5), 1023-1028. doi:10.1089/jpm.2007.0070
Fish, J., & Karban, K. (2014). Health inequalities at the heart of the social work curriculum. Social Work Education, 33(1), 15-30. doi:10.1080/02615479.2012.742502
Giles, R., Gould, S., Hart, C., & Swancott, J. (2007). Clinical priorities: Strengthening social work practice in health. Australian Social Work, 60(2), 147–165.
Goh, M. (2018). Exploring the role of cultural support workers in the New Zealand healthcare setting. Aotearoa New Zealand Social Work, 30(2), 68–74. doi:http://dx.doi.org/10.11157/anzswj-vol30iss2id453
Henderson, S., & Kendall, E. (2011). “Community navigators”: Making a difference by promoting health in culturally and linguistically diverse (CALD) communities in Logan, Queensland. Australian Journal of Primary Health, 17(4), 347–354. doi:10.1071/PY11053
Immigration New Zealand. (2019). From INZ Refugee and Protection Unit Statistics Pack - October 2019. Retrieved from https://www.immigration.govt.nz/documents/ statistics/statistics-refugee-and-protection.pdf
International Federation of Social Workers (IFSW). (2014). Global definition of the social work profession. Retrieved from http://ifsw.org/policies/definition-of-social-work/
Kagawa-Singer, M., & Backhall, L. (2001). Negotiating cross- cultural issues at end of life. Journal of American Medical Association, 286(23), 2993-3001.
Koenig, B. A., & Gates-Williams, J. (1995). Understanding cultural difference in caring for dying patients. In Caring for patients at the end of life [Special issue]. Western Journal of Medicine, 163, 244–249.
Lawrence, J., & Kearns, R. (2005). Exploring the “fit” between people and providers: Refugee health needs and health care services in Mt Roskill, Auckland, New Zealand. Health & Social Care in the Community, 13(5), 451–461. doi:10.1111/j.1365-2524.2005.00572.x
Lickiss, J. N. (2003). Approaching death in multicultural Australia. Medical Journal Australia, 179, S14-S16. PMID: 12964928 Version: 1.
Maidment, J., Egan, R., & Wexler, J. (2011). Social work with older people from culturally and linguistically diverse backgrounds: Using research to inform practice. Aotearoa New Zealand Social Work, 23(3), 3-15. doi:10.11157/anzswj-vol23iss3id156
Mortensen, A. (2011). Public health system responsiveness to refugee groups in New Zealand: Activation from the bottom up. Social Policy Journal of New Zealand,
Mortensen, A., Latimer, S., & Yusuf, I. (2014). Cultural case workers in child disability services: An evidence-based model of cultural responsiveness for refugee families. Kotuitui: New Zealand Journal of Social Services Online. http://dx.doi.org/10.1080/1177083X.2014.911752
Nadan, Y. (2014). Rethinking “cultural competence” in international social work. International Social Work, 60(1), 74–83. https://doi.org/10.1177/0020872814539986
Nash, M., & Trlin, A. D. (2004). Social work with immigrants, refugees and asylum seekers in New Zealand:New Settlers Programme. Palmerston North New Zealand: Massey University.
National Association of Social Workers. (2001). NASW standards for cultural competence in social work practice. Washington, DC: Author.
Nemcek, M., & Sabatier, R. (2003). State of evaluation: Community health workers. Public Health Nursing, 20(4), 260–270.
Nguyen, D. D., Ho, K. H., & Williams, J. H. (2011). Social determinants and health service use among racial and ethnic minorities: Findings from a community sample. Social Work in Health Care, 50(5), 390–405.
Papps, E., & Ramsden, I. (1996). Cultural safety in nursing: The New Zealand experience. International Journal for Quality in Health Care, 8(5), 491–497.
Park, H.-J., & Anglem, J. (2012). The “transnationality” of Koreans, Korean families and Korean communities in Aotearoa New Zealand: Implications for social work practice. Aotearoa New Zealand Social Work, 24(1), 31-40. doi:10.11157/anzswj-vol24iss1id139
Perese, L., Ulugia-Veukiso, A., Samu, K. S., Sepuloni, C., & Peteru, C. (2009). Workforce development: A study of Pacific non-regulated workers. Report prepared for the Health Research Council Partnership Programme. Auckland, NZ: University of Auckland.
Pockett, R. (2014). “Health in all placements” as a curriculum strategy in social work education. Social Work Education, 33(6), 731–743. doi:10.1080/02615479.2013.874411
Pockett, R., & Beddoe, L. (2015). Social work in health care: An international perspective. International Social Work, 60(1), 126–139. doi:10.1177/0020872814562479
Ramsden, I. (1990). Kawa whakaruruhau: Cultural safety in nursing education in New Zealand. Wellington, NZ: Ministry of Education.
Ramsden, I. (2000). Cultural safety/Kawa whakaruruhau ten years on: A personal overview. Nursing Praxis in New Zealand, 15(1), 4–12.
Rosenthal, E. L., Wiggins, N., Brownstein, J. N., Johnson, S., Borbón, I. A., & De Zapien, J. G. (1998). Final report of the National Community Health Advisor Study. Baltimore, MD: Annie E. Casey Foundation.
Rosenthal, E., Wiggins, N., Ingram, M., Mayfield-Johnson, S., & De Zapien, J. (2011). Community health workers then and now: An overview of national studies aimed at defining the field. The Journal of Ambulatory Care Management, 34(3), 247–259.
Ruwhiu, L. (2001). Bicultural issues in Aotearoa New Zealand social work. In M. Connolly (Ed.), New Zealand social work — Contexts and practice (pp. 54–71). Auckland, NZ: Oxford University Press.
Sauaia, A. (2014). Quest for health equity. New York, NY: Nova Publishers.
Schofield, V. (2001). Health social work. In M. Connolly (Ed.),
New Zealand social work: Contexts and practice (pp. 146–156). Auckland, New Zealand: Oxford University Press.
Social Workers Registration Board. (2011a). SWRB competence to practise social work with different ethnic and cultural groups in New Zealand. Retrieved from http://swrb.govt.nz/policy
Social Workers Registration Board. (2011b). SWRB competence to practise social work with Ma ̄ori. Retrieved from http://swrb.govt.nz/policy
Social Workers Registration Board. (n.d.). Core competence standards: The SWRB ten core competence standards. Wellington, NZ. Retrieved from https://swrb.govt.nz/for- social-workers/core-competence-standards/
Spencer, M., Gunter, K., & Palisano, G. (2010). Community health workers and their value to social work. Social Work, 55(2), 169–180.
Vernon, R., & Papps, E. (2015). Cultural safety and continuing competence. In D. Wepa (Ed.), Cultural safety in Aotearoa New Zealand (2nd ed., pp. 51–64). Melbourne, VIC: Cambridge University Press.
Walker, R. (2014). Auckland Region DHBs Asian & MELAA (Middle Eastern, Latin American and African) 2013 census demographic and health profile. Auckland, NZ: Auckland Region District Health Boards.
Walker, S., & Eketone, A. (2013). Biculturalism as an approach to social work. In H. K. Ling, J. Martin, & R. Ow (Eds.), Cross-cultural social work: Local and global (pp. 67–86). South Yarra, VIC: Palgrave Macmillan.
Wang, J. (2000). Highlighting the gaps in existing New Zealand social services: Settlement programmes and Asian services. Unpublished paper presented at the Aotearoa New Zealand Association of Social Workers (Inc) Biennial Conference, Auckland, New Zealand.
Weld, N. (2009). Resuscitating health social work. Aotearoa New Zealand Social Work Review, 21/22(4), 25–33.
Wepa, D. (Ed.). (2015). Cultural safety in Aotearoa New Zealand (2nd ed.). Melbourne, VIC: Cambridge University Press.
Wilson, D., & Haretuku, R. (2015). Te Tiriti o Waitangi/Treaty of Waitangi 1840. In D. Wepa (Ed.), Cultural safety in Aotearoa New Zealand (2nd ed., pp. 79–93). Melbourne, VIC: Cambridge University Press.
How to Cite
Authors who publish with this journal agree to the following terms:
By completing the online submission process, you confirm you accept this agreement. The following is the entire agreement between you and the Aotearoa New Zealand Association of Social Workers (ANZASW) and it may be modified only in writing.
You and any co-authors
If you are completing this agreement on behalf of co-authors, you confirm that you are acting on their behalf with their knowledge.
By submitting the work you are:
- granting the ANZASW the right of first publication of this work;
- confirming that the work is original; and
- confirming that the work has not been published in any other form.
Once published, you are free to use the final, accepted version in any way, as outlined below under Copyright.
You assign copyright in the final, accepted version of your article to the ANZASW. You and any co-authors of the article retain the right to be identified as authors of the work.
The ANZASW will publish the final, accepted manuscript under a Creative Commons Attribution licence (CC BY 4.0). This licence allows anyone – including you – to share, copy, distribute, transmit, adapt and make commercial use of the work without needing additional permission, provided appropriate attribution is made to the original author or source.
A human-readable summary of the licence is available from http://creativecommons.org/licenses/by/4.0, which includes a link to the full licence text.
Under this licence you can use the final, published version of the article freely – such as depositing a copy in your institutional research repository, uploading a copy to your profile on an academic networking site or including it in a different publication, such as a collection of articles on a topic or in conference proceedings – provided that original publication in Aotearoa New Zealand Social Work is acknowledged.
This agreement has no effect on any pre-publication versions or elements, which remain entirely yours, and to which we claim no right.
Reviewers hold copyright in their own comments and should not be further copied in any way without their permission.
The copyright of others
If your article includes the copyright material of others (e.g. graphs, diagrams etc.), you confirm that your use either:
- falls within the limits of fair dealing for the purposes of criticism and review or fair use; OR
- that you have gained permission from the rights holder for publication in an open access journal.