Growing Old as a Member of an Ethnic Minority in Hong Kong: Implications for an Inclusive Long-Term Care Policy Framework

Quality of Life of South Asian Older Adults in Hong Kong: Policy Implications for a Multicultural Active Aging Framework

In Hong Kong, the number of South Asian (Indian, Pakistani, and Nepalese) older adults is projected to increase. However, academic and policy research in Hong Kong exploring the aging experience among ethnic minority older adults remains scarce. Drawing on in-depth interviews with South Asian older adults in Hong Kong, this paper examines the challenges they face in the economic, health, and social domains to maintain their quality of life in old age. Our analysis illustrates the significant cultural values, family obligations, and ethnic networks that shape the quality of life of South Asians in Hong Kong. These findings can help advance active aging policy in Hong Kong as they examine how to enhance the quality of life and facilitate social integration among ethnic minority older adults in this multicultural society.

Access to Long-Term Care for Minority Populations: A Systematic Review

It has been shown that there is disparity in access to long-term care and other services for minority populations. This study assessed long-term care access among older individuals belonging to minority populations including visible, ethnocultural, linguistic, and sexual minorities. Barriers and facilitators influencing admission were identified and evaluated.A search for articles from 10 databases published between January 2000 and January 2021 was conducted. Included studies evaluated factors affecting minority populations' admission to long-term care, and non-residents' perceptions of future admission. This review was registered with PROSPERO: CRD42018038662. Sixty included quantitative and qualitative studies, ranging in quality from fair to excellent. Findings suggest minority status is associated with reduced admission to long-term care, controlling for confounding variables. Barriers identified include discordant language, fear of discrimination, lack of information, and family obligations. Findings suggest that minority populations experienced barriers accessing long-term care and had unmet cultural and language needs while receiving care in this setting.

A latent profile analysis of residents' knowledge, attitude, and practice toward common chronic diseases among ethnic minority area in China

Background

Health literacy plays an important role in preventing and managing chronic diseases, while low levels of health literacy among ethnic minorities are a major manifestation of health inequities. We believe that before effective health literacy intervention strategies, it is preferable to understand the features of health literacy among ethnic minorities. The present study firstly updated insights on health literacy among ethnic minorities by investigating the knowledge, attitude, and practice (KAP) profile of common chronic diseases in ethnic minority areas, and secondly discussed the KAP profiles in detail to inspire future health education interventions.

Methods

A cross-sectional, health-literacy-sensitive study was conducted in China's typical ethnic minority area. Participants included 801 adult residents who lived in the ethnic minority area. The primary outcome was participant scores on the KAP questionnaire of common chronic diseases, followed by latent profile analysis to identify participants with similar KAP score patterns and determine whether membership in specific groups was associated with demographic or clinical characteristics.

Results

The participants included 496 ethnic minorities (61.9%) and 305 Han Chinese (38.1%). Three-profile solution was determined after the latent profile analysis: incomplete transfer [I.T.] (n = 215), better practice [B.P.] (n = 301), and average [A.V.] (n = 285). IT group (26.84%) was characterized by the highest level of knowledge and attitude toward common chronic diseases and below average level for practice. Participants in B.P. group performed poorly in both knowledge and attitude toward common chronic diseases but had the highest level of practice. A.V. group reflected average knowledge, attitude, and practice toward common chronic diseases among three subgroups. Ethnic minorities were the dominant population in A.V. group (68.8%). Compared with other groups, the A.V. group contained the largest proportions of married participants (84.2%), participants with no formal education (46.7%), and high annual out-of-pocket medical expense (33.3%).

Conclusion

A more specific and nuanced understanding of minority health literacy can enable service providers to provide more effective health education to their recipients, thereby improving health inequities.

Equity in healthcare access and service coverage for older people: a scoping review of the conceptual literature

There is currently no global review of the conceptual literature on the equity of healthcare coverage (including access) for older people. It is important to understand the factors affecting access to health and social care for this group, so that policy and service actions can be taken to reduce potential inequities. A scoping review of published and grey literature was conducted with the aim of summarising how health and social care service access and coverage for older people has been conceptualised. PubMed, MEDLINE, PsycINFO, CINAHL, Web of Science, SciELO, LILACS, BIREME and Global Index Medicus were searched. Selection of sources and data charting were conducted independently by two reviewers. The database searches retrieved 10 517 citations; 32 relevant articles were identified for inclusion from a global evidence base. Data were summarised and a meta-framework and model produced listing concepts specific to equitable health and social care service coverage relating to older people. The meta-framework identified the following relevant factors: acceptability, affordability, appropriateness, availability and resources, awareness, capacity for decision-making, need, personal social and cultural circumstances, physical accessibility. This scoping review is relevant to the development and specification of policy for older people. It conceptualises those factors, such as acceptability and affordability, that affect an older person's ability and capacity to access integrated, person-centred health and social care services in a meaningful way. These factors should be taken into account when seeking to determine whether equity in service use or access is being achieved for older people.

OUP accepted manuscript

There is no theoretical framework to guide society to enhance social capital among older adults in the Decade of Healthy Aging. This article aims to advance scholarship by providing a theoretical framework for promoting social capital for healthy aging using timebanking as a case illustration. We provide an integrated theoretical framework to enhance social capital for healthy aging by incorporating 3 core elements: (a) facilitating emotional meaningfulness via social participation for older adults, (b) incorporating older adults as coproducers in community development, and (c) nurturing an inclusive and equitable society. We further demonstrate the utility of the integrated theoretical framework for gerontologists by conceptualizing timebanking as an intervention for enhancing social capital in an aging society.