How UK Chinese migrants from Hong Kong manage dual UK-HK social networks in ways that may affect their use of formal health and social care supports

Lead Research Organisation: University of Salford
Department Name: Nursing, Midwifery, Soc Work & Sciences


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Description What were the most significant achievements from the award?

The present study was an examination of the acculturation of Hong Kong (HK) Chinese migrants in the UK as reflected in their health and social care experiences, bicultural self development, and social networks. The study was in two parts, the first of which was conducted in the UK, where 272 HK Chinese migrants were recruited to complete a survey, of which a subset of 71 participants were interviewed. In the second part, a total of 67 friends or relatives of the UK interviewee were interviewed in HK.

The study demonstrated that Hong Kong Chinese migrants in the UK have the opportunity of developing three sets of social networks (UK Chinese, HK Chinese, and UK British) and acquiring a new British cultural self. The significance of the project lies in the unique study design of looking at all three social networks and relating them to their health and social care experiences as well as bicultural development. Ease of communication and relatively affordable airfares help to keep alive the UK-HK connection in the daily living of migrants. In general, the self-reported health status of UK migrants was good.

The Objectives of the study were:

1. Identify, using community based organisations, a sample of Chinese migrants in London and Manchester, and survey their local UK social networks as well as those in their country of family origin, with respect to network type and density, and strength.
2. From the survey results, recruit a subsample of first generation migrants from Hong Kong, both recent arrivals and long-term settlers, for in-depth interview to identify the extent to which they use formal and informal structures in the UK for health and social care, including social work.
3. Explore personal and UK factors that affect usage of health and social care systems in the UK.
4. Identify the usage of formal and informal structures in HK for health and social care.
5. Explore personal and HK factors that affect the usage of health and social care structures in HK.

These objectives were met in the following way
Objective 1
Of the three social support networks of respondents in the survey, the UK Chinese network was the most robust in terms of size and quality, followed by the Hong Kong Chinese and the UK British network, in descending order. These networks, in conjunction with respondents' age and length of residency in the UK, affected key aspects of their bicultural development (maintenance of Chinese cultural self, acquisition of British cultural self, and psychological integration of bicultural selves). These results were reported at an international conference held in Stellenbosch, and have subsequently been written up in a paper for submission to a journal by September 15 (paper attached: Ng, Rochelle, Shardlow, & Ng). They provide a useful background for understanding the other objectives.

Objective 2
The vast majority of respondents in the UK had no experience of using social care services there, implying that respondents used informal rather than formal social care structures. Many expressed negative views on the inaccessibility of information about social services. For health services, while many individuals acknowledged the availability of traditional Chinese medicine (TCM)) services dotted around local Chinatowns in the UK, only 14% of respondents reported consulting a TCM practitioner in past six months, choosing instead to make use of healthcare services in the NHS, which they found to be satisfactory. 59% of respondents reported consulting a GP within the previous six months, and another 28% of had experience of an outpatient hospital appointment, demonstrating good use of primary health services.

Objective 3
Around 40% of respondents rated their health as acceptable, and a further 36% rated their health as good. Older immigrants used TCM more, partly because of their greater Chinese cultural self and attachment to the Chinese way of life. Age also influenced attitudes towards Western medicine, with younger respondents possessing a more favourable attitude towards Western medicine than their older counterparts. Nevertheless, older respondents were just as likely to use Western medicine regardless of their attitude towards the medicine. As Western medicine was provided free of charge via the NHS, while TCM was user-pays, financial consideration also affected the different usage of Western medicine and TCM. In terms of giving voluntary help, the main reasons for giving help were a sense of filial piety, friendship, and problems related to old age, again highlighting the use of informal structures for help-giving among Chinese communities in the UK.

Objective 4
Similar to their pattern of services utilisation in the UK, respondents had little or no experience of using formal social care services in Hong Kong whereas usage of health services in Hong Kong was more frequent, especially the use of TCM.

Objective 5
Overall, respondents' usage of health and social care structures in Hong Kong differed according to their age and personal circumstances. Results based on the UK survey and interview of 67 friends and relatives in Hong Kong showed that communication between respondents and their social support network in Hong Kong played a key role in meeting respondents' socio-emotional needs as well as needs for information and tangible support. Some of the results were reported at an international conference held in the Netherlands.
Exploitation Route One area for exploration in future studies would be to examine how UK based Chinese people from mainland China maintain their social networks and how these networks reinforce or challenge their social identity.
Sectors Communities and Social Services/Policy,Healthcare