Indian Australians • Indians were first brought to Australia Population of India-born people in from the early 1800s to work as 1 3 Australia (2006 Census): 147,105 , Indian labourers and domestic workers . From 2 the 1860s to the early 1900s, many ancestry: 234,720 Indians arrived to work as agricultural Population of India-born people in labourers, hawkers in country towns Queensland: 10,974, Indian ancestry: 3 i and to work in the gold fields . 26,0422 • The number of Anglo-Indians and India- Population of India-born people in born British citizens migrating to Brisbanei: 7545, Indian ancestry: 19,2181 Australia increased following India’s 3 Gender ratio (Queensland): 82.1 females independence in 1947 . The number of per 100 males1 non-European Indian nationals migrating to Australia increased after Median Age (Australia): The median age 1966 and included many professionals of India-born in 2006 was 35.8 years such as doctors, teachers, computer compared with 46.8 years for all programmers and engineers3. By 1981, overseas born and 37.1 for the total the India-born population of Australia Australian population3. numbered 41,6573. • In 2001, there were 95,460 India-born people in Australia3. The 2006 Census Age distribution (Queensland)1: recorded 147,110 India-born people in Australia, an increase of more than 50 Age Per cent per cent in five years3. In the five years 0-19 9.8% from 2006 to 2010, 107,597 India-born 20-39 41.9% people settled in Australia4 including many skilled migrants and students5. 40-59 28.6% • In addition to India, the three major 60+ 19.6% countries of immigration of India-born people to Australia are Pakistan, 5 Bangladesh and Sri Lanka . Immigrants Arrivals – past five years (Source – from an Indian background also Settlement Reporting Database4) migrate from Fiji, United Kingdom, United States, Canada, New Zealand, Year Australia Queensland Singapore, Malaysia, Indonesia, 2006 21,553 1469 Philippines, the Middle East, Mauritius, South Africa, East Africa, Madagascar 2007 23,183 1776 5 and the Caribbean . 2008 25,719 1866 • Ethnicity: The two major ethnic groups 2009 22,927 1875 of India are Indo-Aryan (72 per cent) 2010 14,215 1086 and Dravidian (25 per cent)6. Other ethnicities, including Mongoloid, make up the remaining three per cent of the Indian population6. population. However, more than 200 languages are spoken by people • Language: India has 15 official throughout India. languages. Hindi is the most widely spoken and the primary language of 41 per cent of the Community Profiles for Health Care Providers 47 www.health.qld.gov.au/multicultural • The 15 official languages of India are6: • The main languages spoken at home by India-born people in Australia were: − Hindi – 41 per cent − English – 34.4 per cent − Bengali – 8.1 per cent − Hindi – 19.9 per cent − Telugu – 7.2 per cent − Punjabi – 10.3 per cent − Marathi – 7 per cent − Tamil – 6.5 per cent. − Tamil – 5.9 per cent • The main religions of India-born people − Urdu – 5 per cent in Australia were: − Gujarati – 4.5 per cent − Hindu – 44.2 per cent − Kannada – 3.7 per cent − Catholic – 23.5 per cent − Malaylam – 3.2 per cent − Sikh – 11.2 per cent − Oriya – 3.2 per cent − Anglican – 5.1 per cent. − Punjabi – 2.8 per cent Communication − Assamese – 1.3 per cent • Indian Australians usually greet each − Kashmiri, Sindhi and Sanskrit – less other with the word namaste and a than 1 per cent each. slight bow with the palms of the hands together. Greetings are usually formal • Maithili is a non-official language and respectful. spoken by 1.2 per cent of the 6 population . English has the status of • Some Indian Australians may be 6 subsidiary official language of India . uncomfortable with physical contact with strangers7. In most cases, a • Many Indians grow up learning several 7 handshake is appropriate. However, it languages at once . is usually not appropriate to shake 11 • Religion: The majority of people in hands with the opposite sex . India are Hindu (80.5 per cent). Other Handshakes are usually gentle, rather religions include6: than firm12. − Islam – 13.4 per cent • Naming conventions vary across India12. Many Indians do not use − Christianity – 2.3 per cent surnames. People are usually referred − Sikhism – 1.9 per cent. to by their title (e.g. Mr, Mrs) and their first name7. However, many Indian • More information on the religious Australians have adopted Australian beliefs of Hindu, Muslim and Sikh naming conventions12. It is advisable to patients can be found in the series of request permission to use an Indian Health Care Providers’ Handbooks Australian patient’s first name13. published by Queensland Health Multicultural Services8-10. • Sikh people use given names followed by either Singh (for men) or Kaur (for Ancestry, language and religion in women). Muslim people are known by Australia (2006 Census for India-born) their given name followed by bin (son ii of) or binto (daughter of) followed by • The top three ancestry responses of 7,9 India-born people in Australia were: their father’s given name . For older Hindus, the term ji (for both men and − Indian – 70.1 per cent women) or da (meaning big brother for men) is added to the end of a person’s − English – 10.2 per cent name or title to indicate respect (e.g. 8,13 − Anglo-Indian – 4.3 per cent3. Anita-ji or Basu-da) . 48 Community Profiles for Health Care Providers • Indian Australians usually prefer women living in the United States are minimal eye contact and in India it is at high risk for osteoporosis13. considered rude to look someone A United States study has shown that directly in the eye, especially where • 11,14 lactose intolerance is very common in they feel deference or respect . older people of Indian background13. • In many cases Indian Australians will Cardiovascular disease is higher in often avoid saying no and may prefer • Indian migrants in the United States13. to avoid conflict by giving an answer 7 such as I will try . In some • Other health problems of importance circumstances, shaking of the head among Indian migrants to the United 12 may indicate agreement . States include hypertension, nutritional deficits, tuberculosis, • Indian Australians may say yes in order malaria, filariasis, protosoal and other to please a health professional, even if parasitic infections, hepatitis A, dental they do not understand the medical 5 caries and periodontal disease, and concept or treatment plan . It is sickle cell disease13. advisable that health professionals ensure that the patient understands all • Worldwide, Indian women have higher 5 instructions . rates of suicide than women of other nationalities19. • Indian Australians may avoid the words please and thank you, believing that Health beliefs and practices actions are performed from a sense of duty and do not require these courtesies7. • Many Indian Australians use Australian medicine in conjunction with Older Indian Australians may expect • traditional remedies including respectful and deferential treatment13. traditional medicine and spiritual In turn, they often treat doctors with practices such as Ayurveda, Siddha, respect and deference and try to Unani, Tibbi, homeopathy, naturopathy closely follow the doctor’s 12,13 and acupressure . Ayuveda places recommendations13. emphasis on herbal medicines, Health in Australia aromatherapy, nutrition, massage and meditation to create a balance 13,20 • Average life expectancy in India is 66.5 between the mind and body . years (male 65.5, female 67.6) The involvement of family members in compared to 81.7 years for all people in • 6 major and minor medical decisions is Australia (male 79.3, female 84.3) . crucial for many Indian Australians14. • There is limited research on the health Disclosing a serious or terminal of Indian Australians. diagnosis is best undertaken with great care and with the consultation and help • Cancer rates for India-born Australians of family members. It may be are lower than for people born in appropriate to ask a patient his or her Australia, but higher than rates in 17 wishes about confidentiality and India . The most common cancers privacy before discussion of any among Indian migrants in the United sensitive issues14. States are prostate, lung and colorectal in men, and breast, genital and • Many Indian Australian women, colorectal in women18. particularly older Hindus, may prefer to be examined by health professionals of • United States studies have shown that the same gender13. Having a female people from an Indian background are relative in attendance when examining at high risk of insulin resistance and 15,16 an older Hindu woman is Type II diabetes . recommended as it may facilitate a 13 • Vitamin D deficiency is a common more open interaction . health problem and Indian-born 49 Community Profiles for Health Care Providers 8,9,13 • An Indian cultural practice that may audibly chant Vedic hymns . It is influence health care is the designation very important for family members to of left and right hands for specific be at the bedside of a dying tasks. The right hand is typically used patient8,9,13. for sanitary tasks such as eating while • More information on the health beliefs the left hand is reserved for unsanitary 14 and practices of Hindu, Muslim and tasks . This may affect a patient’s Sikh patients can be found the series of comfort with the use of one arm or the Health Care Providers’ Handbooks other for drawing blood or for the 14 published by Queensland Health insertion of an IV . Multicultural Services8-10. • Mental illness has severe negative connotations, especially among the older Social determinants of Hindu population13,14. Some believe that health mental illness is due to possession of the iii evil eye13.