When care doesn’t translate

When my grandmother was first diagnosed with diabetes, she was told to “watch her carbs.” But no one explained what that meant in the context of her daily meals – roti, rice, lentils and traditional sweets. Like many South Asian immigrants, she left the clinic more confused than reassured. It wasn’t that the advice was wrong – it just didn’t speak her language, in more ways than one.

South Asians are one of the fastest-growing demographics in Canada, making up more than seven percent of the Canadian population. They also experience some of the country’s highest rates of chronic illness – particularly Type 2 diabetes and cardiovascular disease. These conditions often appear earlier, progress faster and lead to more severe complications than in the general population. Left untreated, these illnesses eventually add cost and stress to our health-care system.

South Asians represent approximately 25 per cent of the world’s population – yet they account for 60 per cent of the world’s heart disease patients. The reasons are complex – a mix of genetics, migration-related stress, social determinants and limited access to culturally appropriate care. But one thing is clear: Current models of care don’t always reflect the lived realities of South Asian patients.

Medical education, for instance, may briefly mention South Asians as a high-risk group – but that’s often where the conversation ends. Information is rarely accompanied by guidance on how to adapt care meaningfully. Similarly, public health materials often assume a Western cultural and linguistic baseline, leaving many older adults and newcomers feeling excluded from the conversation altogether.

When patients can’t relate to the care they’re receiving – or don’t fully understand it – they often disengage.

How can we do better?

1. Educate health-care providers and medical learners on South Asian health.

This might mean introducing case studies in medical programs that reflect common health issues in South Asians, inviting community providers to share their insights, or teaching students how to build culturally sensitive care plans.

2. Ethnicity-specific national screening and treatment guidelines.

Screening and treatment guidelines should reflect differences in risk across various ethnicities. Further research is needed to determine the most appropriate age to initiate screening for each subgroup. These insights should inform the development of objective, evidence-based screening guidelines that can help practitioners identify and manage chronic diseases earlier in South Asians.

3. More accessible public health messaging.

Translating materials into South Asian languages is crucial and can be made more cost-friendly with the advent of AI-based translation tools such as DeepL and Google Translate. Messaging should also be culturally sensitive, such as through dietary advice rooted in traditional foods or community-based outreach in trusted spaces. Some programs, such as community-led diabetes education sessions in Punjabi, Hindi, Tamil and more, are already piloting these ideas.

4. Collaborate with South Asian health organizations.

These groups have established relationships within the community and are already providing health education, translation services and support for chronic disease management. The South Asian Canadian Health and Social Services (SACHSS), for instance, runs culturally tailored programs for mental health, addiction and chronic illness. Health systems can partner with organizations like SACHSS to co-deliver education sessions, translate public health materials, and connect patients to ongoing support they already trust and use.

For South Asian communities, improved care means earlier screening, culturally relevant guidance and meaningful language access. Without these changes, we risk continuing a pattern of preventable harm — not from lack of treatment, but from care that never quite fits.