Report of the New South Wales Chief Health Officer	Table of contents Chapter key points On this page: Commentary References Print version
	Country of birth Introduction

In this chapter

• Country of birth
• Languages spoken at home
• Fluency in English
• Category of entrants
• Humanitarian entrants
• Premature births and antenatal visits
• Deaths from all causes
• Risk alcohol drinking
• Smoking
• Overweight and obesity
• Diabetes
• Heart disease
• Cancer
• Tuberculosis
• Psychological distress

Introduction

Nearly one in three NSW residents was born overseas and around one in five speaks a language other than English at home. The composition and age structure of the overseas-born population reflects patterns of migration. After World War II, there was a large migration of Europeans to NSW, initially from Eastern Europe, then from the United Kingdom and Northern Europe, Greece, Italy, and Yugoslavia. These were followed by people from the Middle East, mainly from Turkey, Lebanon, and Egypt. Most recently, migrants have come in large numbers from Asian countries, particularly China, Vietnam, and the Philippines. The net overseas migration (the difference between permanent and long-term arrivals and permanent and long-term departures) into Australia in the 2004-05 financial year was 110,095, of which NSW received the largest share (33.3%), closely followed by Victoria (29.4%)(ABS, 2006).

In general, overseas-born residents have better health than Australian-born residents. This reflects the ‘healthy migrant effect’, whereby people in good health are more likely to meet eligibility criteria, and to be willing and economically able to migrate. However, certain diseases and health risk factors are more prevalent among some country-of-birth groups. This reflects diverse social, economic, environmental, cultural, and genetic influences.

The health experiences and needs of people of refugee background are very different from those of other overseas-born residents of NSW. Experiences of persecution, psychological trauma, disrupted access to health care and other adverse effects of conflict contribute to their health needs. Health issues commonly identified in resettlement countries include psychological problems, injuries due to hostilities or torture, poor oral health, infectious diseases, under-immunisation, conditions related to under-nutrition, and developmental issues among children. Refugees are also known to face significant barriers to accessing appropriate health care.

In 1999 the NSW Department of Health published the document Strategic Directions for Refugee Health Care in NSW. This provided a framework to guide the NSW health system in developing health services appropriate to the needs of refugees.

In addition to Area and state-wide multicultural health services, there are two state-wide health services, each with a different focus, which specifically target persons of refugee background in NSW. The NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) was established in 1988. It provides a holistic range of professional services to facilitate the healing process for refugees who have been exposed to torture and trauma. The NSW Refugee Health Service was established by the NSW Department of Health in 1999 to help protect and promote the health of refugees. The service works in collaboration with Area Health Services, statewide multicultural health services and other agencies to improve access to health care for refugees and to foster more appropriate health care.

This chapter examines health differentials by country of birth, including information on specific health issues for people of refugee background.

More information on the methods used for analysing data is given in the Methods section.

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