Predictors of Health Service Barriers for Older Chinese Immigrants in Canada

Abstract

Elderly people from ethnic minority groups often experience different barriers in accessing health services. Earlier studies on access usually focused on types and frequency but failed to address the predictors of service barriers. This study examined access barriers to health services faced by older Chinese immigrants in Canada. Factor analysis results indicated that service barriers were related to administrative problems in delivery, cultural incompatibility, personal attitudes, and circumstantial challenges. Stepwise multiple regression showed that predictors of barriers include female gender, being single, being an immigrant from Hong Kong, shorter length of residency in Canada, less adequate fmancial status, not having someone to trust and confide in, stronger identification With Chinese health beliefs, and not self-identified as Canadian. Social work interventions should strengthen support and resources for the vulnerable groups identified in the findings. Service providers should adjust service delivery to better serve elderly immigrants who still maintain strong Chinese cultural values and beliefs.

Immigration, Participation in Health Services and Social Occupations: A Literature Review

“…33,34 For women in particular, their spouses' attitudes or permission were important factors, which may help or hinder participation. 35 A stable life situation after immigration was an enabling factor for participating in more social occupations and health-related services, 34 as was having financial support or the time available. 35 Free access to services such as cancer screening, 32 and accessibility in terms of transport and language support services were all considered as enabling factors.…”

“…35 A stable life situation after immigration was an enabling factor for participating in more social occupations and health-related services, 34 as was having financial support or the time available. 35 Free access to services such as cancer screening, 32 and accessibility in terms of transport and language support services were all considered as enabling factors. 36 Understanding the language and having cultural familiarity were important in recognising opportunities for activity, 33,37 as were people's exposure to positive experiences suggested by others, particularly other immigrants.…”

“…Blocking, Inhibiting, Demanding, Restricting Factors Environmental factors such as complicated transport systems, travel distances to facilities, the climate and lack of supportive services were the restricting factors in relation to participation. 34,35,38 Lack of support from family was a common barrier, especially for women. 33,39 Personal factors such as a lack of confidence in the ability to use the language, or to understand the government or health system of the host country acted as inhibiting factors.…”

“…33,39 Personal factors such as a lack of confidence in the ability to use the language, or to understand the government or health system of the host country acted as inhibiting factors. 33,35,40 Perceived rejection and isolation by host communities was another obstacle to participation, in particular with regard to taking part in community activities. Immigrants' personal values and beliefs attributed to certain activities could be an inhibiting factor to their participation.…”

“…33,42 Other studies explored or measured participation via interview or questionnaire. [30][31][32]35,40,42,43 Other kinds of participation involved attendance at a social event, doing something with others or attending an activity that may include another person. 29,34,36,37,39,44 Almost all the health-related service participation studies had considered participation through an objective method of attendance and dropouts.…”