Health care service use by Chinese seniors in British Columbia, Canada

Continuity of care: The ongoing use of "bush medicine" as a transnational therapeutic health practice in Guyanese immigrant communities

Using in-depth interviews with Guyanese immigrants in North America this paper argues their therapeutic landscapes are produced transnationally and these transnational therapeutic landscapes impact their ongoing health practices in the country of settlement. The results reveal that the historical use of traditional "bush medicine" provided a resilient response to inaccessible biomedical healthcare in Guyana. However, the continued use of bush medicine in the countries of settlement is not a result of barriers to healthcare. Instead, continued use constitutes a transnational therapeutic health practice that is tied to historical use, perceived efficacy of treatments, and participants' perceptions of Guyana as a therapeutic landscape.

Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward

The Mental Health Commission of Canada's (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Over two decades of relevant literature on immigrants' health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed.

Social Support Networks and Expectations for Aging in Place and Moving

This study investigated the relationship of social support networks with expectations for aging in place and moving in a sample of relatively healthy, community-dwelling adults ( N = 4,611). Results indicated that those with aging in place expectation and those with moving expectation were comparable in sociodemographics, self-rated health, and social support networks. Knowledge of home- and community-based services (HCBS) availability was associated with respondents reporting an older age at which they expected regular help and moving. When compared with those who did not offer an age prediction, knowledge of HCBS availability, information sources for personal care, and social activity engagement were important in understanding the choices of age ranges at which respondents expected to age in place and to move. Findings point to the importance of expanding social support networks, providing opportunities for social activity, and strengthening information networks with the emphasis on targeting older adults and their caregivers.

Medical Services Utilization Patterns by Seniors

Cette analyse documentaire vise à déterminer les principaux éléments du mode d'utilisation des soins médicaux chez les aînés dans le cadre du Consensus national sur la conception et la prestation d'une réforme des soins de santé visant à promouvoir l'autonomie des personnes âgées (Shapiro & Havens, 2000). On y présente une stratégie de recherche de la documentation pertinente depuis 1985 portant principalement sur des articles de revuses révisés par les pairs et on résume les conclusions de la recherche. On souligne les principaux articles, lesquels sont analysés et synthétisés à partir de modalités américaines ou canadiennes de fonctionnement institutionnel, de recours aux médecins, aux soin ambulatoires et sur des déterminants de l'utilisation de ces services.

Depression Among the Elderly Chinese in Canada

Cette recherche examine la prévalence de la dépression chez les Chinois(es) aîné(e)s du Canada. On a interrogé 96 Chinois(es) aîné(e)s choisi(e)s au hasard et vivant à Calgary. On a utilisé vine version chinoise en 15 points du Geriatric Depression Scale (échelle de l'évaluation de l'état dépressif des aîné(e)s) comme instrument de mesure. Les résultats indiquent que 9,4 pour 100 des personnes interrogées étaient légèrement déprimées et que 11,5 pour 100 étaient moyennement ou gravement déprimées. Le taux de prévalence général chez les Chinois(es) aîné(e)s est plus élevé que celui de l'ensemble de la population aînée du Canada et plus faible que celui des Chinois(es) aîné(e)s des États-Unis. Les résultats de l'analyse de régression font ressortir les principaux prédicteurs de la dépression de ce groupe de la population: la maladie, le fait d'habiter le Canada depuis longtemps, ne pas connaître l'anglais, être plus jeune, et avoir une mauvaise santé physique. Les résultats soulignent également les besoins du groupe sur le plan de la santé mentale. La recherche présente de plus d'autres éléments et les répercussions pratiques des résultats.

Health Behaviors and Use of Traditional Chinese Medicine Among the British Chinese

Health behaviors and use of traditional Chinese medicine among the British Chinese community were examined. One hundred and eighty-six British Chinese participants recruited from Chinese health and community centers across the United Kingdom completed the Cultural Health Belief and Value Survey. Results revealed that the majority of respondents used Western medicine. Respondents’ decisions to use Western medicine were influenced by cost of medicine and speed of recovery. Use of traditional Chinese medicine was significantly associated with a number of variables, including respondent speaking a Chinese dialect as his or her first language being, having a sense of cultural superiority, and believing that cultural values and religious beliefs influence health behavior. Concurrent use of traditional Chinese medicine and Western medicine was found to be common among respondents. Better understanding of the influence of traditional cultural and health beliefs could enable more culturally appropriate and effective health provision.

The use of complementary and alternative medicine among Chinese Canadians: results from a national survey

This study examines the relationship between Chinese Canadian ethnicity and the use of complementary and alternative medicine (CAM) and explores some of the factors that contribute to CAM use among this visible minority group. Using data from cycle 2.1 of the Canadian Community Health Survey (2003), we use multivariate logistic regression to investigate the extent to which CAM use varies among Chinese Canadians and non-Chinese Canadians. Two three-way interactions, which demonstrate how the combination of certain identity markers increases their predictive value within the model, are also examined. The use of CAM varies according to ethnicity, with Chinese Canadians being more likely to use than non-Chinese Canadians. The findings also indicate that cultural factors play a key role in establishing the necessary conditions for increasing the likelihood of CAM use for Chinese Canadians. Findings are discussed in terms of their implications for health care policy and program development.

Intention of use of long-term care facilities and home support services by Chinese-Canadian family caregivers

One common myth about ethno-cultural minority family caregivers is that they do not use formal services. This study examined the intention of using home support and long-term care facilities by a random sample of 339 Chinese-Canadian family caregivers, using a modified version of the Andersen-Newman service utilization model. Filial piety, caregiving burden, care receivers, and health conditions are the common predictors identified. Filial obligation is most likely manifested through facilitating the care receivers to make use of the services needed, particularly for caregivers who reported a high level of caregiving burden.

The gendered nature of filial piety--a study among Chinese Canadians

This paper examines the modern face of filial piety enactment among Chinese families living away from their homeland. It empirically assesses filial piety practices among a random sample of diasporic Chinese Canadians, by studying the role of sons, daughters and spouses in providing assistance with basic activities of daily living, instrumental activities of daily living and perceptions of support; the relative contribution of the traditional Chinese caring unit (son plus daughter-in-law) with assistance provided; whether source of assistance changes when amount of care is taken into account, when the gendered nature of tasks is taken into account and when controlling for other factors in multivariate analyses. N = 2,272 Chinese seniors (age 55+) living in seven cities across Canada. The findings reveal that, among these diasporic Chinese, patterns found in other Chinese societies are evident in their tendency to live with children, even when the spouse is still living, and the involvement of sons and the son/daughter-in-law unit in providing care. However, similar to recent findings for China, daughters and spouses are involved in all 3 areas of support examined and importantly, their involvement increases as more assistance is provided while that from sons decreases, notably in terms of IADL. The participation of daughters-in-law tends to be lower than that of either sons or daughters. The involvement of spouses increases for perceived or emotional support. The findings suggest a blending of Chinese and Canadian patterns of care and are discussed in terms of the changing but still gendered nature of care.

Use of Home Care Services by Elderly Chinese Immigrants

Using the Anderson Service model, this study examined the level and predictors of using selected home care services by elderly Chinese immigrants in Canada. Data from 1,537 randomly selected Chinese immigrants aged 65 years and older were used. Only 5.2% of participants reported using home care services. Being older, living alone, having a post-secondary education, immigrating from Hong Kong or Southeast Asia, having a higher level of agreement with Chinese health beliefs, higher social support, and poorer physical and mental health were predictors for home care service use among elderly Chinese. The probability of using homecare services lessens with increased self-rated financial adequacy. These findings point to the need for service providers to address the gap in use of home care between elderly Chinese immigrants and overall elderly Canadians through promoting appropriate use of home care among elderly Chinese immigrants.

Health status of older Chinese in Canada: findings from the SF-36 health survey

BACKGROUND

Despite the fact that the Chinese belong to the largest visible minority group in Canada, there is little research findings on their health status, particularly the aging adults. This research aimed at bridging the knowledge gap by examining the health status of this population and comparing the health status between the Chinese aging population and the general aging population in Canada.

METHODS

Secondary data analysis of data obtained from a multi-site study, Health and Well Being of Older Chinese in Canada, and from the Medical Outcomes Study 36-item Short Form (SF-36). The SF-36 published scores obtained from the same age cohorts in the Canadian Multicentre Osteoporosis Study were used for comparison purposes. Independent samples t-tests were used to compare the statistical significance of the two groups.

RESULTS

Overall, older Chinese-Canadians reported better physical health than all older adults in the Canadian population. However, the older Chinese in all age and gender groups scored lower in the mental component summary (MCS). Despite the age differences, Chinese women reported statistically poorer health than the Chinese men in all of the 8 health domains.

CONCLUSION

The data are useful for forming baselines for monitoring the effectiveness of future health interventions for this population. Efforts by service providers to address the health needs of older Chinese-Canadian women, the most vulnerable subgroup in this study, are essential. Interventions are also needed to address the poor mental health status in this ethnic minority group.

Correcting cross-cultural stereotypes: aging in Shanghai and Canada

This paper challenges common belief that the aging experience is primarily different for seniors in Asia and those in western cultures. The examination reveals that there are many differences in the life situation of seniors living in mainland China and those living in Canada, with Shanghais seniors living in much greater poverty, with much less education and typically not alone when compared to Canadian seniors whether they be of Chinese origin or not. The Shanghais are also in worse health and perceive themselves to be in worse health. However, when examining the predictors of subjective quality of life, life satisfaction, in both cultures it is social support and health that predict life satisfaction. The form that social support takes (the importance of sons is clearly evident in Shanghai, whereas spouses are more important in Canada) and the particular physical health problems that one might suffer from differ across cultures but it is social support and health that appear to be universal in their affects on our subjective quality of life. Similarly when examining caregivers there are many differences evident across the cultures but when examining subjective burden in both cultures it is the deteriorated health of the care receiver that is the major predictor of burden. The data suggest that there are cross-cultural universals, with particularistic forms.