Mr Deepak Nair1
1Wellington Free Ambulance, Wellington, New Zealand
Biography:
Deepak Nair is a New Zealand–based emergency medical services professional specialising in prehospital care and dispatch systems. His work focuses on inequities in emergency access, especially for diverse populations. He is interested in how system design and health literacy affect outcomes, and improving equity through research, education, and practice.
Abstract:
Aims This study examines disparities in Emergency Medical Service use among culturally and linguistically diverse populations in Australia and New Zealand, particularly in acute coronary syndrome presentations. It aims to identify multilevel barriers contributing to delayed care and reduced ambulance utilisation.
Methods A narrative synthesis of key studies was conducted, including national cohort data from New Zealand, population-based ambulance utilisation research from Victoria, and international evidence on prehospital delay. Findings were analysed using a socio-ecological framework to categorise barriers at individual, community, and system levels.
Results Significant disparities were observed across all datasets. Māori, Pasifika, and Asian populations in New Zealand were substantially less likely to utilise ambulance services compared with European populations. In Australia, culturally and linguistically diverse groups including Aboriginal and Torres Strait islander peoples demonstrated lower ambulance use and longer decision times for chest pain and trauma related incidences. Barriers at the individual level included cultural beliefs, language limitations, and cost concerns. Community-level barriers included limited awareness and low use of interpreter services. System-level challenges included inadequate policy prioritisation and limited inclusion of culturally diverse populations in health planning frameworks.
Conclusions Culturally and linguistically diverse populations experience consistent inequities in access to emergency care across both countries. Addressing these disparities requires coordinated, multilevel strategies including culturally responsive education, improved interpreter access, and stronger policy integration. Enhancing cultural competence within emergency systems is essential to improving timely access and achieving equitable health outcomes.