Culturally And Linguistically Diverse Research Articles

A perspective on mental health literacy and mental health issues among Australian youth: Cultural, social, and environmental evidence!

Mental health literacy (MHL) helps improve mental health outcomes and reduce the impacts of mental illness. This study aims to reflect on scientific evidence on MHL levels, barriers to MHL, their impacts on mental health among Australian youth and interventions to overcome these barriers. The factors explored in the Perspective included; influence of social determinants, culturally and linguistically diverse (CALD) communities, help-seeking attitudes and behaviors. MHL intervention programs and MHL for improving mental health outcomes due to the recent COVID-19 pandemic were also explored. Adequate levels of youth MHL significantly improved one's ability to recognize own mental health status as well as provide peer support. Practical considerations such as designing more gender and culturally specific youth MHL programs are proposed.

Rethinking cancer prevention for migrant populations in Queensland, Australia: A retrospective cohort study comparing culturally and linguistically diverse and Australian born cancer patients

ABSTRACT International evidence suggests migrants experience significant cancer inequities. In Australia, there is limited information assessing equity for Culturally and Linguistically Diverse (CALD) migrant populations, particularly in cancer prevention. Cancer inequities are often explained by individualistic, behavioural risk factors; however, scarce research has quantified or compared engagement with cancer prevention strategies. A retrospective cohort study was conducted utilising the electronic medical records at a major, quaternary hospital. Individuals were screened for inclusion in the CALD migrant or Australian born cohort. Bivariate analysis and multivariate logistic regression were used to compare the cohorts. 523 individuals were followed (22% were CALD migrants and 78% Australian born). Results displayed that CALD migrants made up a larger proportion of infection-related cancers. Compared to Australian born, CALD migrants had lower odds of having a smoking history (OR = 0.63, CI 0.401–0.972); higher odds of ‘never drinking’ (OR = 3.4, CI 1.473–7.905); and lower odds of having breast cancers detected via screening (OR = 6.493, CI 2.429–17.359). Findings affirm CALD migrants’ low participation in screening services but refute the assertion that CALD migrants are less engaged in positive health practices, enabling cancer prevention. Future research should examine social, environmental, and institutional processes and move beyond individualistic, behavioural explanations for cancer inequities.

'It's really important to be collaborating': Experiences of participatory research for Chinese and Vietnamese parents of autistic children.

Participatory research involves academic partners working together with the community that is affected by research to make decisions about that research. Such approaches often result in research that is more respectful of, and responsive to, community preferences - and is vital in the context of autism research with culturally and linguistically diverse (CALD) communities. Whilst participatory approaches are becoming more commonplace within CALD autism research, no studies have explored the experiences of being involved in autism research from the perspectives of CALD community partners over the course of a study. This paper intended to address this gap by reporting on the experiences of CALD parents of autistic children who were community partners in a 1-year Australian research project exploring home-school partnerships for CALD parents of autistic children. We aimed to: (1) report on how parents' involvement in the research process shaped the home-school partnerships study over time and (2) understand their experiences of being community partners on the home-school partnerships project. Using key principles of participatory approaches, we established Chinese and Vietnamese parent advisory groups to contribute to a project exploring home-school partnerships for parents of autistic children from CALD backgrounds in Australia. Advisory groups included parents of autistic children from Chinese/Vietnamese backgrounds, as well as interpreters, professionals and researchers. We documented how parents' participation as community partners shaped the home-school partnerships study over the course of the project. We also elicited parents' own views and experiences of being community partners through informal, open-ended questions at the beginning and end of the study. We found that parents' input fundamentally shaped the broader home-school partnership study, from meaningful, accurate translation of interview schedules through to making decisions regarding community-specific recommendations and dissemination plans. Parents themselves reported being keen to collaborate and to hear and share opinions for the purpose of the home-school partnership study - although they noted how emotionally difficult sharing their stories could be. While they initially had some concerns about combining being involved as a community partner with their existing responsibilities, ultimately, parents were surprised by the scope of the home-school partnership study and their level of involvement as community partners. Through hearing others' stories and sharing their own in advisory group meetings, parents reported ancillary benefits of their involvement, including increased self-advocacy and well-being. These findings show how research that is conducted in partnership with diverse members of the autism community has the capacity to improve the quality of the research and benefit community partners. This study clearly documents the benefits and potential challenges of participatory approaches with CALD communities. These findings emphasise to researchers and funders the importance of including extra time and money within budgets in order to produce meaningful research that is respectful and responsive to communities.

Examination of Physical Activity, Organized Sport, and Sitting Time Among Women and Mothers From Culturally and Linguistically Diverse Backgrounds.

Little evidence is available from culturally and linguistically diverse (CALD) communities on the association between motherhood and physical activity (PA). This study aimed to examine independent and joint associations of cultural background and motherhood with meeting PA guidelines, participation in organized sports, and high sitting time (>8h/d). We used self-reported cross-sectional data from survey 8 of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. PA was measured using the Active Australia Survey while organized sport and sitting time were measured using single items. CALD was defined as being born in a non-English speaking country or primarily speaking a non-English language at home. Multivariable-adjusted logistic regression analyses were used to examine independent and joint associations. Data from 5967 women (mean age 42.4 [SD 1.5] y, 6.9% CALD, 81.2% mothers) were analyzed. Women of CALD background had lower odds of meeting PA guidelines (odds ratio; 95% confidence interval: 0.80; 0.64-0.98) and participation in organized sports (0.68; 0.54-0.86), but no statistically significant association with sitting time (0.90; 0.72-1.14). Mothers had lower odds of meeting PA guidelines (0.75; 0.64-0.87) and high sitting time (0.42; 0.36-0.49). Compared with non-CALD women without children, mothers (irrespective of cultural background) were less likely to meet PA guidelines and have high sitting time. The association of "cultural background and motherhood" with organized sports participation was only significant for CALD mothers. Increased efforts and investments are needed to ensure that sports and other PA promotion interventions are culturally sensitive and engaging for CALD women and those with children.

Educational Card Games: One Way of Assisting the Communication Skills Development of Nursing Students Whose First Language is Not English

Aim/Purpose. This study seeks to determine the impact of a card game intervention in improving the English verbal communication of nursing students from culturally and linguistically diverse backgrounds. Background. Many international students studying in Australia experience setbacks in their university studies due to English language difficulties. This paper outlines how an educational card game designed can be played by nursing students from culturally and linguistically diverse (CALD) backgrounds as an intervention for their English verbal communication development. Methodology. The study used a descriptive qualitative approach to analyse the learning experiences of forty-five (N=45) nursing students from CALD backgrounds undertaking their second semester at a metropolitan university in Victoria, Australia after being introduced to an educational card game developed by the first author. The card game was designed to explore the use of English pragmatic markers, which are words, phrases, or verbal cues that signal or emphasise the intentions of the speaker. Following the intervention, participants were queried in a survey about their experiences with English language speaking and how the game improved their verbal communication skills. Contribution. This paper provides knowledge about how a game can be designed to enhance the English verbal communication skills of nursing students from CALD backgrounds which could help them in their clinical placements and their adjustment into Australian society. Findings. Three intertwining themes that emerged from the data analysis were education content, skills development, and fun and creativity. These themes signify the importance of providing opportunities for learners to creatively practise the educational content in simulative contextualised situations within a safe, comfortable, and inclusive learning environment. Recommendations for Practitioners. Educators still need to consider the importance of inclusivity of students from culturally and linguistically diverse (CALD) backgrounds as part of successful integration into the culture of their host countries. Recommendations for Researchers. The findings emphasise the need for educators and researchers to understand the challenges facing these students in relation to marginalisation and discrimination and how they can design an intervention that is engaging and inclusive. Impact on Society. The findings also put forward the awareness of pragmatics as part of both English language learning and integration into the society of a host country as students learn how to express intention appropriately in various interactions. Furthermore, the themes presented in this paper suggest that not only should an educational game or an intervention contain relevant educational content and practical activities for skills development, but they must also be enjoyable by encouraging creativity and social interaction. Future Research. The results of this study also open possible future studies that involves the adaptation of a digital version of the card game or possible implementation of the game in other health professional programs in universities and other educational institutes.

Palliative and End-of-Life Care Access for Immigrants Living in High-income Countries: A Scoping Review.

This scoping review aimed to explore what is known about palliative and End-of-Life (EOL) care access by immigrants with culturally and linguistically diverse (CALD) background living in high-income Organization for Economic Co-operation and Development (OECD) countries. CaLD immigrants have low utilization of palliative care services with patients' family members taking up the role of caring, leading to immigrants not fully benefiting from the specialized services that are offered to alleviate suffering and promote quality of life. While there is some research in this area mainly in Europe, it cannot be said about all high-income OECD countries. Achieving person-centered care in high-income countries, requires identifying and addressing barriers to care access, especially by immigrants with CaLD background. Five-stage methodological framework by Arksey and O'Malley was used to undertake the review. Immigrants in OECD countries experience challenges in accessing palliative and EOL care services. The review also identified limited literature on the subject and establishes need for more research on the subject.

Exploring Cultural Identity and Language Development Through Digital Storytelling: Tales of Culturally-Linguistically Diverse Secondary Students

This study explores how digital storytelling influences the cultural identity development of secondary culturally and linguistically diverse (CLD) students from Bhutanese-Nepali backgrounds. Utilizing the theoretical framework of multiliteracies, cultural identity and sociocultural theory in Second Language Development, this research investigates the benefits and challenges of digital storytelling. Data were collected through semi-structured interviews, digital story artifacts, and observations during a seven-week after-school program. The findings reveal that digital storytelling allows CLD students to connect deeply with their cultural identities, express their experiences, and advocate for themselves and the broader immigrant community. Students integrated linguistic, visual, and audio elements to create rich, multimodal narratives, enhancing their language skills in both heritage languages and English. However, they also faced challenges such as technical difficulties and language barriers, underscoring the need for additional support.

The Natural Helper approach to culturally responsive disease management: protocol for a type 1 effectiveness-implementation cluster randomised controlled trial of a cultural mentor programme

IntroductionChronic disease is a leading cause of death and disability that disproportionately burdens culturally and linguistically diverse (CALD) communities. Self-management is a cornerstone of effective chronic disease management. However, research...

Focused Attention on Positive Aspects of Dementia Care in Culturally and Linguistically Diverse Communities: Qualitative Insights from Australia

ABSTRACT Objectives Dementia care scholarship focuses on care challenges and less on positive aspects of care, especially among culturally and linguistically diverse (CALD) carers outside the United States. This article investigates positive aspects of dementia care across eight CALD groups in Australia. Methods We analyzed interviews of 112 family carers using a four-domain framework covering: a sense of personal growth, feelings of mutuality, increases in family cohesion, and a sense of personal accomplishment. Results Positive associations with care are derived from past relationships, feelings of mutual obligation, valuing changed relationships and enjoying spending time with the person with dementia. Positive aspects of care were not associated with increased family cohesion except in Vietnamese and Arab families; neither was use of ethno-specific residential aged care, except for Greek and Italian families. Religion and spirituality as a coping and comforting mechanism was inconsistently expressed. Conclusions The study reveals the multi-dimensional nature of care, what resonates, and diverges across CALD populations. Knowing which parts of the framework apply and which do not is useful for interventions seeking to enhance positive aspects of care. Clinical implications Migrant populations are varied and dynamic, and practitioners should be mindful of differences within and between ethnic minority groups.

What Quality-of-Life Dimensions Are Most Important to Older Adults from Culturally and Linguistically Diverse Backgrounds Receiving Aged Care Services? An Exploratory Study.

There is little research on what aspects of quality of life (QoL) are most important to culturally and linguistically diverse (CALD) older adults. This study aimed to identify what QoL dimensions were most important to CALD older adults receiving aged care services, and therefore, how relevant a new six dimensions QoL instrument developed for use in aged care is to this population. A three-stage, mixed-methods study was undertaken. Stage 1: n = 3 focus groups with aged care providers. Stage 2: n = 30 semi-structured interviews with Italian-born older adults in ethno-specific residential aged care. Stage 3: survey of n = 63 older adults from mixed CALD backgrounds receiving community aged care services. Overall, older adults asserted the importance of the six dimensions of the new QoL instrument. The importance of 'identity' and 'purpose and meaning' were identified via the focus groups; however, the community-based CALD older adults identified these aspects of quality of life as more important than older Italians in residential care. Being in ethno-specific residential aged care where needs relating to language, food, and religion were met and they continued to live with others from their community may have meant that the meeting of cultural needs was more taken for granted.

Public Health Interventions to Address Housing and Mental Health amongst Migrants from Culturally and Linguistically Diverse Backgrounds Living in High-Income Countries: A Scoping Review.

Migrants from culturally and linguistically diverse (CaLD) backgrounds experience factors that may increase health inequities related to a range of determinants of health including housing and mental health. However, the intersection between mental health and housing for migrants is poorly understood. A scoping review searched four academic databases for concepts related to cultural and linguistic diversity, housing conditions, and public health interventions to address homelessness. A total of 49 articles were included and seven key themes identified: housing provision; mental health intersections and interventions; complexity and needs beyond housing; substance use; service provider and policy issues; the role of cultural and linguistic diversity; and consumer experience. The intersection of ethnicity with other social determinants of health and housing was highlighted though there were limited interventions tailored for migrants. Studies generally pointed to the positive impacts of Housing First. Other sub-themes emerged: social connection and community; shame, stigma, and discrimination; health and support requirements; and employment, financial assistance, and income. Consumer choice was identified as vital, along with the need for systemic anti-racism work and interventions. To support secure housing for migrants and mitigate mental health impacts, closer attention is required towards migration factors along with broader, tailored services complementing housing provision.

Conceptualisations of mental illness and stigma in Congolese, Arabic-speaking and Mandarin-speaking communities: a qualitative study

BackgroundAustralia is an ethnically diverse nation. Research has demonstrated an elevated risk of developing a mental illness in culturally and linguistically diverse (CaLD) communities yet uptake of mental health services is low. To improve mental health treatment seeking and outcomes for CaLD individuals in Australia there is an urgent need to deeply understand barriers to treatment such as stigma. Using an exploratory qualitative approach, the aim of the study was to explore how CaLD communities’ conceptualise and interpret mental illness and associated beliefs and experiences of stigma.MethodsThe study focused on three key CaLD groups: the Congolese, Arabic-speaking and Mandarin-speaking communities residing in Sydney, Australia. A series of eight focus group discussions (n = 51) and 26 key informant interviews were undertaken online using Zoom during the period of November to December 2021. Focus group discussions and key informant interviews were digitally recorded, transcribed, and analysed using NVivo software.ResultsThree major themes were identified. The first theme related to mental illness terminology used in the three communities. Despite variation in the terms used to refer to ‘mental illness’ all three communities generally distinguished between ‘mental illness’, a more severe condition and ‘mental health problems’, considered to arise due to stressors. The second theme centred on beliefs about mental illness; with all three communities identifying migration-related stressors as contributing to mental illness. Culturally related beliefs were noted for the Congolese participants with the perception of a link between mental illness and supernatural factors, whereas Mandarin-speaking participants highlighted lack of inter and intrapersonal harmony and failure to adhere to values such as filial piety as contributing to mental illness. The final theme related to mental illness related stigma and the various ways it manifested in the three communities including presence of collectivist public stigma felt across all three groups and affiliate (family) stigma reported by the Arabic and Mandarin-speaking groups.ConclusionsWe found rich diversity in how these communities view and respond to mental illness. Our findings provide some possible insights on both service provision and the mental health system with a view to building effective engagement and pathways to care.

Using The Prism Model as A Framework for Preparing Educators on Study Abroad

The important role of study abroad in the preparation of competent teachers for the 21st-century globalized world cannot be underestimated. Yet, the percentage of teacher education programs that have incorporated study abroad into their curriculum is still negligible. While there are approximately 5.3 million emergent bilinguals in U.S. K-12 public schools, and they constitute the fastest growing sector of K-12, the demographics of teachers have changed very little, with most of them being White, middle-class, monolingual, and monolithic females. Additionally, teacher education curricula do not incorporate the appropriate training for the accommodations that must be made in order to educate culturally and linguistically diverse (CLD) students effectively. As a result, teachers continue to have difficulties meeting the demands of today’s pluralistic society. Based on this premise, this exploratory study surveyed education majors participating in a summer study abroad program in Spain to determine their expectations and perceptions about the program with a focus on the sociocultural and linguistic dimensions of the prism model. Findings revealed that the students’ expectations were in consonance with the framework, indicating their dispositions toward acquiring the required knowledge and skills for the implementation of biography-driven instruction (BDI). The data also revealed the appropriateness of the study abroad program for preparing educators for BDI.

An integrated interpreting service normalizes access to care for culturally and linguistically diverse (CALD) patients with colorectal cancer.

To compare access to the initial management and overall survival with colorectal cancer for limited English proficient (LEP) patients compared with patients from an English background. All newly diagnosed patients from 2017 with colorectal cancer from a single health service with a highly multicultural catchment area and a well-developed and integrated translation and language support (TALS) department were recruited. Time from referral to: biopsy, date seen by a surgeon, oncologist, discussion at a multidisciplinary meeting (MDM), and day of commencement of the first treatment modality, and overall survival were analyzed. One hundred sixty-two patients were analyzed, including 57 LEP patients from 22 countries of birth. Interpreters were present at 687/782 appointments with LEP patients. There were no differences in demographics or cancer staging. There were no differences between English background and LEP patients with regard to times from referral to biopsy (1vs. 0 days), specialist review (surgical: 4vs. 6 days, oncological: 45vs. 57 days), MDM discussion (23vs. 15 days), or commencement of treatment (32vs. 28.5 days). There were no differences in treatment for colorectal cancer, although a higher rate of stomas was noted in LEP patients. There was no difference in overall survival between groups. Time to critical initial checkpoints and overall survival were similar in LEP and English background patients with colorectal cancer. An integrated TALS department may abrogate the language and cultural barriers that are known to disadvantage LEP patients and may contribute to normalizing care for the culturally and linguistically diverse community.

Collateral positives of COVID-19 for culturally and linguistically diverse communities in Western Sydney, Australia.

To investigate whether culturally and linguistically diverse (CALD) communities in Western Sydney have experienced any positive effects during the COVID-19 pandemic, and if so, what these were. A cross-sectional survey with ten language groups was conducted from 21st March to 9th July 2021 in Sydney, Australia. Participants were recruited through bilingual multicultural health staff and health care interpreter service staff and answered a question, 'In your life, have you experienced any positive effects from the COVID-19 pandemic?' Differences were explored by demographic variables. Free-text responses were thematically coded using the Content Analysis method. 707 people completed the survey, aged 18 to >70, 49% males and 51% females. Only 161 (23%) of those surveyed reported any positive impacts. There were significant differences in the proportion of those who reported positives based on age (p = 0.004), gender (p = 0.013), language (p = 0.003), health literacy (p = 0.014), English language proficiency (p = 0.003), education (p = <0.001) and whether participants had children less than 18 years at home (p = 0.001). Content Analysis of open-ended responses showed that, of those that did report positives, the top themes were 'Family time' (44%), 'Improved self-care' (31%) and, 'Greater connection with others' (17%). Few surveyed participants reported finding any positives stemming from the COVID-19 pandemic. This finding is in stark contrast to related research in Australia with participants whose native language is English in which many more people experienced positives. The needs of people from CALD backgrounds must inform future responses to community crises to facilitate an equitable effect of any collateral positives that may arise.

‘The future of migration, multiculturalism and diversity in Australia's post-COVID-19 social recovery’

This paper considers the future of multiculturalism, migration, and mobility post-pandemic. Taking Australia as a case study, the paper examines how the pandemic is affecting the multicultural agenda and contemplates its multiple cultural, social and political impacts. That is; the ways it is shaping intercultural relations, particularly how it is exacerbating racism and other forms of discrimination; its effects on the equity of social and health service provisions; and how mobility and border issues are being managed within Australia and internationally, specifically in relation to Australian citizens with culturally and linguistically diverse (CALD) backgrounds. Secondly, the paper examines the extent to which the pandemic has already revealed new ways of understanding, representing, and characterising multiculturalism in Australia. This analysis considers the significant gaps in data collection on ethnically and religiously minoritised peoples and the ways in which this has hindered public health initiatives. Thirdly, the paper offers insights for how Australia could approach new drivers and patterns of (im)mobility in the post-COVID-19 social recovery, and in subsequent decades, to sustain the country's multicultural social fabric and its economic prosperity.

Lived Experiences of Mental Health Recovery in Persons of Culturally and Linguistically Diverse (CALD) Backgrounds within the Australian Context

Lived experience research related to mental health recovery is advancing, but there remains a lack of narrative material from the perspectives of people from under-represented, non-dominant cultural backgrounds in this domain. This study aimed to explore the lived experiences of mental health recovery in people of culturally and linguistically diverse (CALD) backgrounds in the Australian context. The current study involved a secondary analysis of audio and visual data collected during the digital storytelling project Finding our way in Melbourne, Australia. Thematic analysis was used to understand the lived experience narratives of nine participants in relation to mental health recovery. Five themes were identified through an iterative process of analysis, including Newfound opportunities and care, Family as key motivators and facilitators, Coping and generativity, Cultivating self-understanding and resilience, and Empowerment through social engagement. First person lived experience narratives offer deep insight into understanding the ways in which individuals of marginalised communities conceptualise and embody recovery. These findings further the literature and understanding on how to better serve the needs of people with mental health challenges from CALD communities through informed knowledge of what may be helpful to, and meaningful in, individuals’ recoveries.

Australia

In this contribution, we provide a brief overview of the development of Hip Hop culture in Australia, looking specifically at rap and breaking (breakdancing). We show how Australian rap has for a long time been dominated by white Australian artists attempting to solidify an Aussie Hip Hop identity distinct from the United States. Because rap from Indigenous and Culturally and Linguistically Diverse (CaLD) communities did not fit the tropes of dominant (white) Australian culture, and were instead disregarded as simple mimicry of African American rap, the gatekeepers of Aussie Hip Hop for a long time locked out these minority artists. This created a divide in the rap scene that reflected broader Australian racial politics. In contrast, the breaking community has historically been more inclusive and reflective of a multicultural Australia, and has been more connected with the breakers of North America, Europe and Asia. In this contribution, we demonstrate how Australian Hip Hop has evolved over the past two decades to be more culturally inclusive, supported by key Australian artists, community radio, social media and finally validated by the Australian music industry as a distinct musical genre worth celebrating.

Dental hesitancy: a qualitative study of culturally and linguistically diverse mothers

BackgroundOral healthcare is paramount and inextricably linked to well-being. Yet, the evidence indicates that culturally and linguistically diverse (CALD) migrant communities have unequal access to mainstream dental services due to several barriers. The purpose of this study was to investigate the oral healthcare experiences, attitudes and barriers to oral healthcare utilisation in CALD mothers.MethodsA qualitative study with semi-structured interviews was conducted within a social constructivism epistemology. CALD mothers who identified as non-English speaking, foreign country born, with a child under 12, were recruited though purposive snowball sampling. Questions probed oral healthcare experiences, barriers, enablers, and attitudes. Verbatim typed transcripts were thematically analysed using grounded methodology.ResultsThirty-three CALD mothers participated; twenty from India, five from Fiji, four from China, two from Nepal and one each from Israel and Macedonia. Languages included Cantonese, Fiji-Hindi, Gujrati, Hebrew, Hindi, Kannada, Mandarin, Maharashtrian, Macedonian, Nepalese, Punjabi, Sanskrit, Telegu and Urdu. Cost was the foremost barrier to oral healthcare services, followed by Confidence in quality care for the provision of services and treatment. Confusion in navigating a public and private healthcare system was highlighted and Competing priorities took precedence. Complacency referred to ‘no need’ or lack of urgency in dental care. Subsequently, dental hesitancy (superordinate theme) described the patterning of data as comprising the five ‘C’ factors and was theorised as the dental hesitancy phenomenon to explain the occurrence of delay or avoidance in utilising dental care.ConclusionFindings highlight the utility of the dental hesitancy phenomenon unearthed within this study. CALD mothers explained five ‘C’ dimensions: cost, confidence, confusion, competing priorities and complacency as barriers to accessing timely dental care. Multisectoral collaboration between healthcare systems, universal health coverage and primary sector support is required to address dental hesitancy in CALD mothers. Further, this study contributes to the field of behavioural and social sciences in oral health and augments the literature on dental avoidance.

Trends in social inequalities in early childhood caries using population-based clinical data.

To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population-based data. Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically diverse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted. Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1-0.1 Severity: 1.0-0.1) or relative scale (ECC ratio: 1.3-1.3 Severity ratio: 1.6-1.1). Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub-groups.