Health-seeking, intercultural health communication, and health outcomes: An intersectional study of ethnic minorities' lived experiences.

AIMS: To explore ethnic minorities' lived experiences of health-seeking and healthcare utilization in Hong Kong, and to examine the impact of intersectionality of sociocultural identities on intercultural health communication. DESIGN: Qualitative exploratory design. METHODS: Data collection methods were semi-structured interviews, unstructured observations, and unstructured informal group discussions. Twenty-five informants, including eight Pakistanis, seven Nepalese, five Indians, four Bangladeshis and one Sri Lankan, were recruited using the snowball sampling method and individually interviewed between 25th June and 23rd September 2019. RESULTS: Sixteen females and nine males, aged 21-76 years, were in the study. Two-thirds could communicate in English, but eight required interpreters. Thematic analysis reveals four factors affecting intercultural health communication: healthcare professionals' cultural insensitivity, red-tapism and ethnic minorities' language improficiency and/or deficiency in medical knowledge. Health professionals' workplace stress and cultural insensitivity prompt ineffective intercultural communication, making ethnic minority patients feel disrespected despite having adopted the Hong Kong culture. The intersectionality of sociocultural identities plus health professionals' blocking behaviours results in health inequalities. CONCLUSION: The unequal power relationship between health professionals and ethnic minority patients may lead to dehumanizing and depersonalized experiences for patients, as humanity is the heart and soul of medicine. Therefore, the government should raise healthcare providers' cultural sensitivity and diversity awareness, and offer ethno-specific care and more interpretation services. IMPACT: The study addresses health inequalities among Hong Kong ethnic minority patients with different sociocultural identities. About the impact of ineffective intercultural health communication on health inclusion and health outcomes, policies and practices should ameliorate health professionals' cultural sensitivity, awareness of the unequal power relationship and respect for diversity. PATIENT OR PUBLIC CONTRIBUTION: Referred by organizations serving ethnic minorities, the minority patients shared their lived experiences in health-seeking.

Elderly people as "apocalyptic demography"? A study of the life stories of older people in Hong Kong born in the 1930s.

In Hong Kong, the general view still follows the biomedical discourse to define aging. The government and leading gerontologists follow the prevailing representation of elderly and describe growing old as a process of becoming "frail, infirm, and vulnerable" (Fealy et al., 2012: 91). Discussions of demographic trends often focus on the drastic effects of an aging society on economic development. Our research indicates that Hong Kong's construction of aging is a product of its market-driven economy. Drawing from the life stories of eight participants born in the 1930s, we examine the meaning of aging and the formation of character in a specific historical context, adopting the life-course perspective. We wish to understand how larger movements in the social and political world shaped the experiences of the participants and the strategies they developed to maintain agency and control in life. The participants in our study struggled for survival through unprecedented political disasters and social turmoil in their youth. When they reached maturity in the 1960s and 1970s, they devoted themselves to bettering their lives and contributed to the economic boom of the city. We maintain that the biomedical model offers a reductive and unjust means of viewing the people in this cohort, who are often seen as a problem and a burden. Challenging the prevailing ageist attitude, we set the life stories of the participants against the dominant biomedical model of aging. Our work aims to establish a just description of the life experiences of Hong Kong people.