Health Care Seeking Amongst Chinese Immigrant Women

Each year the health care system in the United States serves an increasingly diverse group of individuals; the fastest growing group being Chinese immigrants. Immigrants bring with them many different customs and traditions; therefore, it is vital to recognize the influence of culture on health in order to understand health care experiences and provide optimal care. One such difference is the medical system in China, where Western and Traditional Chinese Medicine (TCM) are practiced in tandem. Secondly, TCM contains drastically different beliefs and perceptions of illness causation than that of Western medicine. For example, the cultural context of “holism”; meaning that the mind, body, and spirit exist as an integrated whole. Not surprisingly, Chinese immigrants in the US utilize TCM in conjunction with Western medicine at high rates, particularly women. Western medical recommendations, presented in a conceptual framework incongruent with a patient’s cultural beliefs, decrease patient adherence. Further, patients dissatisfied with their Western care providers; have been found to delay health care seeking, which may prove detrimental to their health. This phenomenological study sought to understand Chinese immigrant women's health care seeking experiences in the US.

Inclusion criteria included being born in mainland China, residing in Los Angeles and currently using TCM and Western medicine. Sixteen participants between 24-86 years old were identified via purposive sampling methods. Between December 2013 - September 2014, in-depth semi-structured individual interviews were audio-recorded, transcribed and underwent phenomenological analysis. The aim was to explore how participants made sense of their personal and social world focusing on their own perceptions. It was found that participants used their combined cultural knowledge and personal experiences, both in China and the US, to determine which medical system to seek care from. This was influenced by factors such as their understanding of each medical system’s specific utility but also by their definition of health and therefore how to maintain it. Most interesting was how their knowledge of and belief in basic TCM concepts were acted out in their every day lives and how this ‘common knowledge’ or cultural understanding influenced their day to day health maintenance decisions.

Social workers hold unique positions both inside and outside of health care systems and routinely bridge the gap in knowledge, improve communication between patients and health care professionals and assist in teaching effective help-seeking behaviors for their patients. One focus of the Patient Protection and Affordable Care Act is of integrated care, meaning that health care professionals are encouraged to consider all health conditions when treating their patients, including behavioral health. As care in the US becomes more integrated, an increasing number of social workers will play a unique role in bridging the physical and behavioral health needs of their clients. It is therefore imperative that social workers become knowledgeable about TCM use amongst this large and growing population of women. Such knowledge can inform assessment and intervention efforts that might result in the development of more efficacious treatment planning, advocacy, education, and outreach when indicated.