title: Effective communication is crucial to self-management: the experiences of immigrants to Australia living with diabetes.
abstract: OBJECTIVE
  Ageing immigrant populations now pose problems for the management of chronic illness in Australia. This article asks questions about the experiences of immigrants in Australia with type II diabetes mellitus (DM). What impact, if any, have health policies had on the lives of immigrants? How do their experiences of living with DM compare with those of people with DM who were born in Australia?
  
  
  METHODS
  Semi-structured interviews were conducted with 32 participants who had DM (n = 25) or cared for someone with DM (n = 7). Fifteen participants had migrated to Australia and English was not their first language. Participants were asked to describe their experience of managing diabetes.
  
  
  RESULTS
  Immigrants to Australia confront linguistic and cultural barriers that create an extra layer of problems not experienced by Australian-born people. Older people who were born overseas face obstacles to effective engagement with the health system that weaken their ability to take an active part in the management of their conditions.
  
  
  CONCLUSIONS
  Chronic disease policy is failing immigrants to Australia. Health professionals and services must recognize the central role that cultural diversity plays in self-management and the impact that this can have on health outcomes for immigrants with chronic illness.
authors.affiliation: Australian Primary Health Care Research Institute and Menzies Centre for Health Policy, Australian National University, Ian Potter House, Australian National University, ACTON 0200 ACT, Australia. tanisha.jowsey@anu.edu.au
authors.forename: Tanisha
authors.initials: T
authors.lastname: Jowsey
authors.forename: James
authors.initials: J
authors.lastname: Gillespie
authors.forename: Clive
authors.initials: C
authors.lastname: Aspin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003142:Communication; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D054242:Emigrants and Immigrants / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006291:Health Policy; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D007802:Language; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D011369:Professional-Patient Relations; D012648:Self Care / Q000523:psychology*; D012944:Social Support