Rethinking a label: Has the term ‘Culturally and Linguistically Diverse’ lost its way?

Social categorisation – putting people who share common characteristics into boxes – helps us make sense of society. 

But when we start organising the world by those boxes, the labels themselves can begin to shape the very realities they describe. 

That’s what ANU epidemiologist Dr Davoud Pourmarzi realised when he examined the term Culturally and Linguistically Diverse, or ‘CALD’ for short. 

What began as a tool for measuring diversity in Australia, he found, has evolved into a label that can influence how inequity is perceived – and how health is experienced. 

A term for diversity 

In 1999, the Australian Bureau of Statistics (ABS) published the Standards for Statistics on Cultural and Language Diversity.  

The standards set out ways to collect cultural and language information to measure diversity in Australia and were designed to replace ‘Non-English Speaking Background (NESB) a term criticised for its conflicting definitions, negative connotations and oversimplification.

Since then, the adjective phrase, Culturally and Linguistically Diverse (CALD), spread beyond data reporting into common use in both academic literature and public discourse in Australia, one of the most culturally and linguistically diverse countries in the world. 

As its use expanded, however, the term began to reveal many of the same pitfalls as its predecessor. 

Another othering label 

“Diversity is a positive term,” says Pourmarzi. “But when I was described as culturally diverse, I couldn’t help thinking: what is the norm that I have diverted from?”  

Many Australians who are categorised as CALD share that unease. It’s not a label people choose for themselves or identify with personally.

Unintentionally, CALD implies a contrast between the dominant normative Australians – presumably, the ‘white Australians’ – and everyone else, says Pourmarzi. 

Positioning a part of the population as ‘others’, Pourmarzi argues, can erode the sense of belonging, contribute to stigmatisation and discrimination, and lead to poorer health outcomes for the group. 

A study of over 1,100 Australians classified as CALD found that nearly two-thirds had experienced racism in the previous 12 months. Other studies report that CALD communities underuse health services, and, when they do use them, often report poorer experiences. 

While the label CALD itself may not cause discrimination, its use, especially when linked to disadvantage and framed as different, can reinforce alienation. 

“Health is a very sensitive area. If you connect a group of people with deficits or problems, specifically those who have less power in society, that group can be more marginalised and stigmatised,” Pourmarzi argues.

A less helpful term 

On the other hand, the overly broad stroke of CALD collapses enormous diversity within the labelled population.  

In Victoria, for example people categorised as CALD hail from more than 300 ancestries and speak over 290 languages a highly heterogeneous group itself.

When healthcare planning or policy targets people from CALD backgrounds as a single entity, the distinct needs of different communities are easily overlooked. 

That’s why Pourmarzi and colleagues at the ANU National Centre for Epidemiology and Population Health (NCEPH) have urged public health practitioners and researchers to stop using the term ‘CALD’ in a recent paper on Public Health Research & Practice. 

“With new risks being identified, it’s both our ethical and professional responsibility to make sure that we don’t use language that may perpetuate harm to individuals or society,” Pourmarzi says. 

Pourmarzi stresses that many studies that used the term CALD have contributed to improving health equity. Still, researchers should exercise caution regarding how and why they apply such labels to minimise potential harm. 

A power imbalance 

If CALD is flawed and the phrase should be retired, should we simply coin a better term?  

Over the years, researchers have proposed several alternatives, such as Culturally, Ethnically and Linguistically Diverse (CEALD), Culturally and Racially Marginalised (CARM), and Australians Ethnically Diverse and Different from the Majority (AEDDM). 

But to Pourmarzi, the problem lies deeper, in the act of labelling populations under unequal power structures. Being labelled CALD, NESB or something else gives those people little say in how they are defined. 

“Attaching labels to those seen as different can reinforce that power imbalance,” he explains. 

“Unfortunately, CALD is not empowering people, nor would any other othering term.” 

Beyond the broad stroke label  

Pourmarzi says instead of chasing the perfect term to categorise people, we should be asking sharper questions. 

“What is problematic is when researchers uncritically label a group of the Australian population and then use it as a proxy to measure factors of interest,” he explains. 

“If you are studying how language influences access to health services, for example, CALD is just not a variable more helpful than spoken English proficiency.” 

As they advocate retiring the term CALD, Pourmarzi and his colleagues urge peers to think more critically about the outcomes they seek to achieve from using certain variables. 

“What specific variables and factors are affecting people’s interaction with the health system?” he asks. 

“By focusing on such details, we may be able to see health inequities that labels like CALD often obscure.” 

According to Pourmarzi co-designing research with communities would help identify those variables and more empowering to the populations that public health practitioners and researchers are trying to serve.

Since the publication of their paper, Pourmarzi and co-authors have received a flood of comments. 

“Some agree with us, some disagree – all are great,” he says. “I’m really happy that this conversation is happening, because it’s how change starts.”