Our Language - Glossary of Terms

Taken simply, ‘multicultural’ means recognising that societies are made up of multiple cultural groups – some dominant and large, and others smaller and/or more marginalised. ‘Multiculturalism’ encourages acceptance and inclusion of, and respect for all of these groups and promotes community harmony.
(adapted from source)¹

Guidance for use
‘Multicultural’ is the preferred term to use when referring to groups who bring cultural, linguistic and racial diversity to Australia. However, in some instances, it may be appropriate to use either Culturally and Racially Diverse (CARD) or Culturally and Linguistically Diverse (CALD), such as when communicating with other stakeholders that use or have greater understanding of these acronyms.

• Opt for ‘multicultural’ when referring to a heterogenous collective, where there are/likely to be multiple cultures within the group being described (e.g. community, population). Here we are commonly describing a plural, for example ‘multicultural populations’ or ‘communities from diverse cultural backgrounds’.
• When referring to a unit that is itself homogenous (e.g. an individual, or a single culture), use the person’s/group’s preferred identity. This is because, in this context, their cultural background is a personal characteristic, not a reflection of how many different ancestries they have. For example, rather than ‘an individual from a multicultural background’ use ‘an individual who brings linguistic and cultural diversity/richness to Australia’

Alternative definitions
To a degree, multiculturalism challenges the normative system of the dominant culture by bringing to the fore issues of integration of cultural minorities into the so-called mainstream and by rejection of democracy and in particular separation of state and religion.²

Sources
1. Dr Sev Ozdowski AM, Australian Multiculturalism
2. The Australian Collaboration: A Collaboration of National Community Organisations. A multicultural Australia

Diversity is about what makes each of us unique. It includes our experiences, beliefs, personality and backgrounds, including our age, gender, ethnicity, race, religion, disability and sexual orientation among others.
(adapted from source)³

Guidance for use
Use ‘diverse’ to describe a heterogenous group where the group members differ in characteristics beyond simply their cultural background (where ‘multicultural’ would be appropriate), such as in age, location, income or education level, carer status, and many more. For example, ‘communities from diverse backgrounds’ or ‘groups with diverse experiences’ or ‘diverse populations’.

Diversity is about what makes each of us unique and includes our backgrounds, personality, life experiences and beliefs, all of the things that make us who we are. It is a combination of our differences that shape our view of the world, our perspective and our approach. Diversity is also about recognising, respecting and valuing differences based on ethnicity, gender, age, race, religion, disability and sexual orientation. It also includes an infinite range of individual unique characteristics and experiences, such as communication style, career path, life experience, educational background, geographic location, income level, marital status, parental status and other variables that influence personal perspectives.

Alternative definitions
Cultural diversity means having a mix of people from different cultural backgrounds – it can include differences in cultural/ethnic identity (how we identify ourselves and how others identify us), language, country of birth, religion, heritage/ancestry, national origin, and/or race.⁴

Sources
3. Deloitte. Only skin deep? Re-examining the business case for diversity
4. Diversity Council of Australia. Culture and Religion – Overview

Preferred definition
The acronym CARD can be used to refer to people who cannot be racialised as ‘white’, such as people who are Black, Brown, Asian, or any other non-white group.
(adapted from source)⁵

Guidance for use
In most instances, it’s better to use CARD than CALD as it recognises the many things that make up someone’s culture and race, beyond just the language they speak – which may not be as relevant for people born in Australia or other English-speaking countries.

Sources
5. Diversity Council of Australia. Words at work: Should we use CALD or CARM?

Preferred definition
Our population includes many people who were born overseas, have a parent born overseas or speak a variety of languages. Together, these groups of people are known as culturally and linguistically diverse (CALD) populations.
(adapted from source)⁶

Guidance for use
Opt for ‘multicultural’ or ‘CARD’ where possible, reserving the use of CALD for instances where you are engaging with others who use and prefer this term. For example, government departments and other policy stakeholders, some health and settlement service providers and any communities who self-identify with this acronym.

Alternative definitions
Culturally and linguistically diverse is a broad and inclusive descriptor for communities with diverse language, ethnic background, nationality, dress, traditions, food, societal structures, art and religion characteristics. This term is used broadly and often synonymously with the term ‘ethnic communities’. CALD is the preferred term for many government and community agencies as a contemporary descriptor for ethnic communities.

CALD people are generally defined as those people born overseas, in countries other than those classified by the Australian Bureau of Statistics (ABS) as “main English speaking countries”. The set of main English speaking countries other than Australia used by the ABS comprises: Canada, the Republic of Ireland, New Zealand, South Africa, the United Kingdom (England, Scotland, Wales, Northern Ireland) and the United States of America.⁷

Sources
6. Australian Institute of Health and Welfare (2018). Australia’s Health 2018 – 5.3 Culturally and Linguistically Diverse populations
7. Ethnic Communities’ Council of Victoria. Glossary of terms

Ethnicity is a social construct that refers to the self-identified social and cultural characteristics, backgrounds or experiences a group of people share.
(adapted from source)⁸

Guidance for use
Self-identifying and grouping people together according to ethnicity is most commonly based on perceived similarities in:

1. national or tribal background
2. religion
3. language
4. cultural expression or identification

Sources
9. Yudell, M., et al. (2016). Taking race out of human genetics. Science 351, 564-565 DOI:10.1126/science.aac4951

Race is a social construct used to help group people together, or for them to group themselves, based on perceived similarities, usually in appearance.
(adapted from source)¹⁰

Guidance for use
Self-identifying and grouping people together according to race is often done based on perceived similarities:

1. in appearance (e.g. skin colour, facial features, hair texture)
2. ancestry, or
3. a shared social and cultural identity (more commonly thought of as ethnicity).

Alternative definitions
While genetic ancestry is a measurable biological parameter, race is a social construct that has often been labelled biological. It is the product of historical, social, and political processes and not a “natural” or biological division of human variation. While human racial groups are not biological categories, “race” as a social reality — as a way of structuring societies and experiencing the world — is very real.¹¹

Sources
10. National Cancer Institute. Dictionary of terms
11. Krainc, T., & Fuentes, A. (2022). Genetic ancestory in precision medicine is reshaping the race debate. PNAS 119 (12) e2203033119 https://doi.org/10.1073/pnas.2203033119

Intersectionality refers to the ways in which different aspects of a person’s identity overlap or ‘intersect’. This overlapping or layering can expose them to a range of different experiences – some positive (e.g. opportunities) and some negative (e.g. discrimination, disadvantage).
(adapted from source)^{12, 13}

Guidance for use
Use an intersectional lens when communicating about people and groups. This involves:

1. first recognising that people’s lives are shaped by their identities, relationships and social worlds;
2. secondly, understanding that individuals are individuals. Their identity is personal, drawn from their life experience which will differ from others – even those with other similarities;
3. lastly, that there are overlapping aspects to people’s lives that make them more or less at risk of privilege or oppression.

Use an intersectional lens to help avoid homogenising, stereotyping or creating inappropriate groupings that are not based in reality.

Sources
12. Victorian Government. Understanding intersectionality
13. UN Women Australia. Intersectionality explained

Equity is about everyone achieving equal outcomes. We all have the same value and deserve a good life, but we all start from a different place. We are also all different and experience the world in our own unique way. It’s because of these differences that we sometimes need to be treated differently for us all to live safely, healthily, happily and equally. This means that we need to look at what individual people and communities need in order to achieve equity, and then equality.
(adapted from source)¹⁴

Guidance for use
‘Use this definition of ‘equity’ when introducing it as a concept, describing the reason it is importance, and how it may play out (e.g. into different treatments).

Alternative definitions
Equity is “the state, quality, or ideal of being just, impartial and fair.” The concept of equity is synonymous with fairness and justice. To be achieved and sustained, equity needs to be thought of as a structural and systemic concept. How is equity different from equality? Equity involves trying to understand and give people what they need to enjoy full, healthy lives. Equality, in contrast, aims to ensure that everybody gets the same things in order to live full, healthy lives.¹⁵

Sources
14. Australian Human Rights Commission. Let’s talk about equality and equity
15. Stanford Social Innovation Review. Equity Is Fundamental to Implementation Science

The notion that everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential if it can be avoided.
(adapted from source)¹⁶

Guidance for use
Use ‘health equity’ when emphasising, specifically, the rights to health and wellbeing and all that is needed to access it (i.e. as opposed to other human rights where ‘equity’ may be suitable).

Alternative definitions
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, or sexual orientation). Health is a fundamental human right. Health equity is achieved when everyone can attain their full potential for health and well-being.¹⁷

Sources
16. VicHealth. Promoting health equity – An evidence summary
17. World Health Organization. Health equity

As human beings, we all have the same value. This means, we all have the same rights and should all receive the same level of respect, and have the same access to opportunities.
(adapted from source)¹⁸

Guidance for use
Use this definition when discussing goals or visions for equality, as they relate to human rights or other ideas of justice and fairness. Remember that not everyone starts from the same starting point, and therefore treating everyone the same, does not address everyone’s needs. Be mindful of this, and consider when you might need to use ‘Equity’ instead.

Sources
18. Australian Human Rights Commission. Let’s talk about equality and equity

Factual and measurable differences in health status or outcomes between population groups.19

Guidance for use
Use ‘health inequality’ to describe what happens/what the outcomes are, when inequities/health inequities are not addressed.

Sources
19. VicHealth. Health equity

The failure of systems and institutions to provide equal opportunities or resources to people, and/or to otherwise treat them unfairly because of their race or cultural background.
(adapted from sources)²⁰

Guidance for use
Use ‘systemic racism’ when referring to the actions and/or characteristics of organisations, groups of organisations or entire sectors that lead to unfair treatment or unequal opportunities, such as:

1. Laws
2. Policies and practices
3. Cultural norms
4. Ideologies

The legacies of the above list, even if abolished, can also lead to racism.

Alternative definitions
Systemic racism refers to the way that the cultural norms, laws, ideologies, policies and practices of a particular society, organisation or institution result in unequitable treatment, opportunities and outcomes.

However, systemic racism can also happen without specific laws, policies or practices keep it in place. In many cases, the legacy of those norms, laws, policies and practices continues to reinforce the inequalities they created, long after they have ended. That’s why we need laws, policies and practices that are actively anti-racist to address ongoing injustices.21

Sources
20. Australian Human Rights Commission. Racism: Nobody wins
21. Australian Human Rights Commission. Racism: It stops with me

Structural racism is a term often used to describe inequalities and barriers that prevent people from accessing equitable opportunities within a society. It refers to the kinds of racism that operate deep within the social structures of society.
(adapted from sources) ^{22, 23}

Guidance for use
Use ‘structural racism’ when referring to the barriers and inequalities that exist in society whose causes are not always visible or easy to pin-point. In many cases the causes of structural racism are abstract, complex and multi-dimensional.

Sources
22. Chelsea Watego, David Singh and Alissa Macoun, Partnership for Justice in Health: Scoping Paper on Race, Racism and the Australian Health System (Discussion Paper, The Lowitja Institute, 2021)
23. Australian Human Rights Commission. Racism: It stops with me

Institutional racism exists when racism is normalised through the policies and practices of an organisation, institution, or society.
(adapted from sources)²⁴

Guidance for use
Use ‘institutional racism’ when there is clear evidence of racism being embedded, endorsed or encouraged (even subtly) within resources such as policies that guide behaviour and operations.

Sources
24. Australian Human Rights Commission. Racism: It stops with me

The non-medical factors that influence our health but are often out of our control. These include the social, economic and political environments around us; our exposure to different experiences and the resources and services we have access to.
(adapted from sources)²⁵

Guidance for use
When discussing the social determinants of health, highlighting only the fact that they are non-medical and out of the individual’s control may leave readers a little vague. Consider including the follow-on sentence to describe in a little more detail where these determinants originate.

Alternative definitions
The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.

The SDH have an important influence on health inequities – the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health. The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:
(1) Income and social protection (2) Education (3) Unemployment and job insecurity (4) Working life conditions (5) Food insecurity (6) Housing, basic amenities and the environment (7) Early childhood development (8) Social inclusion and non-discrimination (9) Structural conflict (10) Access to affordable health services of decent quality.26

Sources
25-26. World Health Organization. Social determinants of health

Cultural safety means an environment which is spiritually, socially and emotionally safe, as well as physically safe for people; where there is no assault, challenge or denial of their identity, of who they are and what they need.
(adapted from sources)²⁷

Guidance for use
Use ‘cultural safety’ to describe safety that is both real (i.e. there are no threats to safety) and perceived (i.e. where people feel safe, even if they are unsure whether or not they are).

Sources
27. Williams, R. (1999). Cultural safety — what does it mean for our work practice?, Australian and New Zealand Journal of Public Health, 23, (2), 213-214, ISSN 1326-0200,
https://doi.org/10.1111/j.1467-842X.1999.tb01240.x.

Racial discrimination occurs when a person is treated less favourably, or not given the same opportunities, as others in a similar situation, because of their race, the country where they were born, their ethnic origin or their skin colour.²⁸

Guidance for use
Use ‘racial discrimination’ when discussing discrimination specifically attributable to race, ethnicity or cultural background. Use a broader definition of discrimination when describing it more generally.

Alternative definitions
Discrimination is the treatment of someone badly or unfairly because of a personal characteristic that is protected by law.²⁹

Sources
28. Australian Human Rights Commission. Racial discrimination
29. Victorian Equal Opportunity and Human Rights Commission. Discrimination

Health literacy refers to a person’s ability to find, understand and use information and services to make decisions and take actions that improve their health, and the health of their families and communities.
(adapted from sources)³⁰

Guidance for use
Use ‘health literacy’ or ‘individual health literacy’ when describing an individual and/or their capacity to have good health.

When discussing health literacy in the context of many multicultural communities, it may be more/equally appropriate to use ‘organisational health literacy’, which highlights the responsibilities of organisations to ensure they are accessible and navigable.

Alternative definitions
Health literacy refers, broadly, to the ability of individuals to “gain access to, understand and use information in ways which promote and maintain good health” for themselves, their families and their communities. While different definitions are used and health literacy is an evolving concept, there is agreement that health literacy means more than simply being able to “read pamphlets”, “make appointments”, “understand food labels” or “comply with prescribed actions” from a doctor.

Health literacy is also not just a personal resource; higher levels of health literacy within populations yield social benefits, too, for example by mobilizing communities to address the social, economic and environmental determinants of health. This understanding, in part, fuels the growing calls to ensure that health literacy not be framed as the sole responsibility of individuals, but that equal attention be given to ensure that governments and health systems present clear, accurate, appropriate and accessible information for diverse audiences.³¹

Sources
30-31. World Health Organization. Defining health literacy

Digital literacy is the ability to safely and appropriately use digital technologies to find, make sense of, create and share information. It often refers to the basic skills to use a computer and office software (e.g. word processors, email and presentation software) and the ability to use a web browser and internet search engines.
(adapted from sources)³²

Sources
32. Canberra Health Literacy Hub. Digital literacy

Human rights recognise the inherent value of each person, regardless of background, where we live, what we look like, what we think or what we believe.

They are about being treated fairly, treating others fairly and having the ability to make genuine choices in our daily lives.³³

Guidance for use
The definition and concept of ‘human rights’ are often useful when explaining other principles like equity, social justice and equality; and in particular when identifying and describing when these have not been met. As such, it is often used in deficit-based ways – as a baseline for what is fair and reasonable to expect of each other. Consider whether you can use the concept or definition of human rights in a more strengths-based way – to encourage thinking beyond just “meeting” human rights, but to “exceeding” them.

Sources
33. Australian Human Rights Commission. What are human rights?

Social justice aims to promote a society which is just and equitable, values diversity and provides equal opportunities to all its members. It sees everyone as deserving of their human rights and fair allocation of resources regardless of their disability, ethnicity, gender, age, sexual orientation or religion.
(adapted from sources)³⁴

Guidance for use
Consider using ‘social justice’ when discussing projects, programs, policies or initiatives that seek to address inequity or inequality or to otherwise pursue fairness and justice (outside of the context of crime/criminal activity)

Sources
34. Bhugra, D. (2016). Social discrimination and social justice. International review of psychiatry 28 (4), 336-341 https://doi.org/10.1080/09540261.2016.1210359

Lived Experience is an umbrella term that is widely used to describe experiences that are relevant to the topic, initiative or community at hand. Lived experience work is about supporting people with these experience/s to understand and apply them to benefit others.
(adapted from sources)³⁵

Guidance for use
‘Lived experience’ is often used to describe:

• personal lived experience (i.e. someone who has directly had an experience). Often used interchangeably with Peer, Survivor, Service User or Consumer.
• family/carer lived experience (i.e. someone who has relevant by indirect experience, through their relationship to someone with direct experience. Often used interchangeably with Carer, Supporter, Family members.

Sources
35. Lived experience leadership. Definitions

Co-design brings together different perspectives and expertise, from lived and professional experience to learn from each other and make things better – by design.

Co-design has a ‘co’ bit (e.g. community, co-operation) and a ‘design’ bit.

It involves working with the people closest to the solutions, sharing power, prioritising relationships, being welcoming, using creative tools, balancing idealism and realism, building and sharing skills.
(adapted from sources)³⁶

Guidance for use
Avoid using ‘co-design’ as an umbrella term for any/all collaborative or participatory activities. The principles of power-sharing, privileging lived experience voices, and using creative/design activities to unlock different parts of participants’ thinking, among others, are all required for actual co-design. It is not possible to do all of these, for every project, every time; so is perfectly fine to use ‘collaborative’ or ‘participatory’ in place of ‘co-design’ when describing your approach (unless of course you have actually done co-design).

Alternative definitions
The ‘co’ in co design stands for community or conversation. It’s about bringing together people and professionals to jointly make decisions, informed by each other’s expertise. It’s not a community only activity or a professional only activity.

The ‘design’ in co-design is about making and testing, and this is the part of co-design that’s most often neglected. What most people would have experienced is co (minus) design i.e. co-design.

What we WANT to happen is co (plus) design ie co+design.³⁷

Sources
36. Beyond sticky notes. What is co-design?
37. TACSI. Unpacking co-design

Consumer engagement is about involving consumers in decision-making. The decisions may be:

• individual (i.e. around people’s own wellbeing, treatment and management), which is sometimes referred to as client-centred care.
• communal (i.e. around policy development, service design, delivery and evaluation).

(adapted from sources)³⁸

Guidance for use
Consider using ‘client- or patient-centred’ care when referring to individuals being involved in decisions that relate specifically and only to them. When consumers are involved in informing decision making and planning that have broader, communal implications, consumer engagement is more appropriate.

Sources
36. Health Consumers NSW. Why health consumer engagement

‘Transcreation’ is a translation-related activity that combines processes of linguistic translation, cultural adaptation and (re-)creation or creative re-interpretation of certain parts of a source material.³⁷

Sources
37. Diaz-Millon, M., Olvera-Lobo, M, M. (2021). Towards a definition of transcreation: a systematic literature review. Studies in Translation Theory and Practice 31 (2), 347-364 https://doi.org/10.1080/0907676X.2021.2004177

When something is evidence-based, it has typically been trialled and evaluation has shown that it works consistently.
(adapted from sources)³⁸

Guidance for use
Typically for something to be considered evidence-based, it will have gone through a rigorous, academic evaluation. For this reason, some stakeholders may take issue with the over-use of ‘evidence-based’, particularly if describing something that has not been evaluated in this way. Consider using ‘evidence-informed’ or ‘based on best available evidence’ (rather than best practice evidence) in these circumstances to avoid disengagement or confusion.

Sources
38. Alliance for useful evidence. What counts as good evidence?

Spiritual health does not refer to any particular religious or spiritual practice or ideology but rather to our human need for meaning, purpose and connection to something greater than ourselves. This aspect of our wellbeing may be met through the practice of a religious faith, through a deeply felt connection to nature or through a passion for our professional vocation. It is a very diverse and often individualised aspect to health, but provides important context and meaning to all other parts of ourselves and our life experiences.
(adapted from sources)³⁹

Guidance for use
This definition describes the domain of spiritual health, but note it does not add any value qualification on what “good spiritual health” or “poor spiritual health” looks like (i.e. in the same way that we could describe poor mental health as mental illness). This is because very little is understood about what good/poor spiritual health looks like and how it impacts overall health. For this reason, consider avoiding making any values qualifications or judgements when using this definition to describe spiritual health or wellbeing.

Sources
39. Australian National University. Spiritual wellbeing

Health justice is an emerging framework for using law and policy to eliminate unjust health disparities.
(adapted from sources)⁴⁰

Guidance for use
Health justice is more than just creating health equity, it’s recognizing the barriers that stand in the way of access to healthcare and working to remove them.

Sources
40. Hey Jane. What is health justice?