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

Abstract

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. Qualitative exploratory design. 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. 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. 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. 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. Referred by organizations serving ethnic minorities, the minority patients shared their lived experiences in health-seeking.