Traditional medicines must be integrated into health care for culturally diverse groups

May 30, 2019 | | Say something

This article is the fifth part of a series, where culture meets health.


Many people seek complementary treatments for various ailments. Maybe herbal remedies to cure a cold, or acupuncture to relieve pain in the lower back.

"Complementary medicine" refers to practices outside Western medicine, taken from other cultures and often used in high-income countries.

But "traditional medicine" covers a range of practices and therapies indigenous to its practicing population. Based on historical and cultural foundations, it operates outside of general medical care.

Thus, for example, traditional Chinese medicine is indigenous to Chinese medicine and, therefore, classified as a traditional medicine. But when it is used by non-Chinese ethnic groups, we would call it a complementary medicine.

Read more: Almost 1 in 4 of us are not native English speakers. In a healthcare environment, interpreters are essential.

While many people use complementary medications, traditional medications have a particularly important influence on the way migrants look after their health.

This can present a challenge in the provision of Western medical care to various communities in their destination countries.

But even when there is little consensus about its effectiveness, since we strive to achieve better health outcomes for people with cultural and linguistic diversity, we must recognize that traditional and complementary medicines are an essential component of their medical care.

A holistic approach

Traditional and complementary medicines used among culturally and linguistically diverse populations include herbal medicine, acupuncture, massage, traditional Chinese medicine, yoga, ayurveda, homeopathy and tai chi. Different modalities are favored in different communities.

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Ayurveda is more than 5,000 years old and is native to India. It combines lifestyle, diet, exercise and predominantly plant products as treatment options. After translating it into "life sciences," its goal is to cleanse a person of the substances that cause disease and restore balance in the body.

Ayurvedic practitioners believe that this approach is effective in controlling a range of acute and chronic conditions, such as diabetes, cancer, anxiety and rheumatoid arthritis.

Read more: Does traditional Chinese medicine have a place in the health system?

While some studies indicate its efficacy (one found that Ayurvedic formulations were comparable to those of conventional medications, such as glucosamine to treat knee osteoarthritis), mixed results and limited study designs make it difficult to draw firm conclusions.

Meanwhile, traditional Chinese medicine has evolved since it was used for the first time more than 2,000 years ago. However, he remains firm in his goal of treating the whole body, instead of tackling the problem alone.

Traditional remedies often accompany migrants to their destination countries. From shutterstock.com

Encompassing practices that include tai chi, acupuncture and a variety of herbal remedies, Chinese medicine is used today to prevent and treat many conditions.

Patients with osteoarthritis of the knee who practiced tai chi recorded significant improvements, while positive results have been obtained for acupuncture to relieve back pain and nausea associated with chemotherapy.

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Traditional Chinese medicine has also been used for the prevention of heart disease and stroke, and to improve the quality of life of people with chronic heart failure.

A recent review found that certain Chinese medicines can control some risk factors for heart disease, such as diabetes and high blood pressure. But several studies were limited by small sample sizes and flawed research designs.

Read more: Do you know what is in the herbal medicine that you are taking?

The herbal remedies of Chinese medicine and beyond are used to treat a variety of conditions. St. John's Wort has been used to treat mild depression, Ginkgo Biloba for memory loss and ginseng for musculoskeletal conditions.

Despite some promising results, there is still a substantial gap between the strength of the evidence supporting many of these practices and the use and acceptance by consumers of traditional and complementary medicines.

If the evidence is limited, why should we pay attention?

Some migrant communities experience poorer health than their host populations. For example, rates of type 2 diabetes are higher among migrants than in the Australian population in general.

It is important to recognize that for minority groups, feeling that a doctor does not understand their cultural needs can be a barrier to seeking help.

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For example, if a person does not believe that their doctor approves their use of traditional medicines, they may not disclose it. We know that the non-disclosure of the use of traditional and complementary medicine is common among culturally diverse groups.

This can be dangerous, since some traditional and complementary medicines can interact negatively with other drugs.

Read more: Go to the naturopath or a yoga class? Your private health does not cover it.

When patients feel that their doctors do not judge or accept their use of traditional medicine, they are more likely to disclose it.

Therefore, medical providers can benefit from education around different types of traditional and complementary medicines, including culturally sensitive methods to ask about their use.

Acupuncture, a popular complementary therapy, has its roots in Chinese medicine. From shutterstock.com

What does Australia need to do?

The most mature comprehensive health care systems are evident in Asia. Countries such as South Korea and India have regulated traditional and complementary medicines in their national health policies.

To effectively address inequities in health, our health systems must consider and address the impact of cultural influences on patients' health care decisions. This is vital even when the treatments they value may not be based on evidence.

Investigating and considering these practices will help us design and facilitate safe, effective, culturally sensitive and coordinated care for all patients and communities throughout Australia.

Professor Jon Adams contributed to this article.


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