Social Indicators Research

, Volume 106, Issue 2, pp 347–358 | Cite as

Health Care Service Needs and Correlates of Quality of Life: A Case Study of Elderly Chinese Immigrants in Canada

  • Henry P. H. ChowEmail author


This study explored the health care service needs and the major correlates of quality of life among 127 community-dwelling elderly Chinese immigrants in a western Canadian city. Participants were interviewed in their homes by trained, bilingual interviewers employing a structured questionnaire that covered a wide range of topics including health care service needs, living arrangements, health status, social network, life satisfaction, and socio-demographic information. Results demonstrated that ethnic nursing homes, senior centres that provide programs and services, and homemaker services were respondents’ major service needs. Multiple ordinary least-squares regression analysis revealed that respondents who emigrated from Mainland China and those who exhibited greater psychological well-being, reported being physically more mobile, perceived fewer service needs, and expressed satisfaction with the quality of their neighbourhood demonstrated higher levels of life satisfaction.


Health service needs Life satisfaction Service needs Elderly Chinese immigrants 



Financial support for this research was provided by the Chinese Christian Wing Kei Nursing Home Association in Calgary, Alberta. Appreciation is extended to Jules Dorval, Kelvin Wong, and Kathleen Ng for their research assistance, and to Chap Wong, Kwok Cheong, Jim Tsui, Thomson Yu, Angel Chow, Yau-tsang Chan, Yiu-joe Chow, Stephen Tam, Christopher Chow, Sutton Cheung, Simon Kwan, Vincent Ng, Eric Szeto, and She-weng Chow for their tenacious support. Gratitude is expressed to Paul Gingrich of the University of Regina for his helpful comments and suggestions on an earlier draft of this manuscript. An earlier version of this paper was presented at the 2009 annual meetings of the Canadian Sociological Association.


  1. Abu-Bader, S. H., Rogers, A., & Barusch, A. S. (2002). Predictors of life satisfaction in frail elderly. Journal of Gerontological Social Work, 38(3), 3–17.CrossRefGoogle Scholar
  2. Bagley, C. R. (1993). Mental health and social adjustment of elderly Chinese immigrants in Canada. Canada’s Mental Health, 41(3), 6–10.Google Scholar
  3. Baker, F. M. (1994). Suicide among ethnic minority elderly: A statistical and psychosocial perspective. Journal of Geriatric Psychiatry, 27, 241–264.Google Scholar
  4. Balfour, J. L., & Kaplan, G. A. (2002). Neighborhood environments and loss of physical function in older adults: Evidence from the Alameda county study. American Journal of Epidemiology, 155(6), 507–515.CrossRefGoogle Scholar
  5. Beijing Review. (1997). Issues of most concern to urban workers. Beijing Review, 40, 21.Google Scholar
  6. Bowman, K. W., & Hui, E. C. (2000). Bioethics for clinicians: 20. Chinese bioethics. CMAJ, 163(11), 1481–1485.Google Scholar
  7. Breton, R. (1964). Institutional completeness of ethnic communities and the personal relations of immigrants. American Journal of Sociology, 70, 193–205.CrossRefGoogle Scholar
  8. Bromley, D. B. (1990). Behavioural gerontology: Central issues in the psychology of aging. New York: Wiley.Google Scholar
  9. Chan, K. B. (1983). Coping with aging and managing self-identity: The social world and managing self-identity: The social world of the elderly Chinese women. Canadian Ethnic Studies, 15(3), 36–50.Google Scholar
  10. Cheung, M. (1989). Elderly Chinese living in the United States: Assimilation or adjustment? Social Work, 34(5), 457–461.Google Scholar
  11. Chow, H. P. H. (2000). The health care needs of the Chinese seniors in Calgary: A community survey. Calgary, Alberta: Chinese Christian Wing Kei Nursing Home Association.Google Scholar
  12. Cornwell, E. Y., & Waite, L. J. (2009). Social disconnectedness, perceived isolation, and health among older adults. Journal of Health and Social Behavior, 50, 31–48.CrossRefGoogle Scholar
  13. Diener, E., Suh, E. M., Lucas, R. E., & Smith, H. L. (1999). Subjective well-being: Three decades of progress. Psychological Bulletin, 125, 276–302.CrossRefGoogle Scholar
  14. Gee, E. M. (1999). Ethnic identity among foreign-born Chinese Canadian elders. Canadian Journal on Aging, 18(4), 415–429.CrossRefGoogle Scholar
  15. Gee, A. (2000). Living arrangements and quality of life among Chinese Canadian elders. Social Indicators Research, 51, 309–329.CrossRefGoogle Scholar
  16. Gray, B. (2007). Psychological well-being and life satisfaction among older adults: Impact of living arrangements. California State University Long Beach, unpublished MSW thesis.Google Scholar
  17. Gui, S. X., Li, L. K., Shen, Z. N., Di, J. X., Gu, Q. Z., Chen, Y. M., et al. (1987). Status and needs of the elderly in urban Shanghai: Analysis of some preliminary statistics. Journal of Cross-Cultural Gerontology, 2, 171–186.CrossRefGoogle Scholar
  18. Herrick, C. A., & Brown, H. N. (1998). Underutilization of mental health services by Asian-Americans residing in the United States. Issues in Mental Health Nursing, 19, 225–240.CrossRefGoogle Scholar
  19. Hiskson, J., Housley, W. F., & Boyle, C. (1988). The relationship of locus of control, age, and sex to life satisfaction and death anxiety in older persons. International Journal of Aging and Human Development, 26(3), 191–199.CrossRefGoogle Scholar
  20. Ho, S. C., Woo, J., Lau, J., Chan, S. G., & Yuen, Y. K. (1995). Life satisfaction and associated factors in older Hong Kong Chinese. Journal of the American Geriatrics Society, 43, 252–255.Google Scholar
  21. Jang, M., Lee, E., & Woo, K. (1998). Income, language, and citizenship status: Factors affecting the health care access and utilization of Chinese Americans. Health and Social Work, 23(2), 136–145.CrossRefGoogle Scholar
  22. Jang, Y., Kim, G., & Chiriboga, D. A. (2006). Correlates of sense of control among older Korean-American immigrants, financial status, physical health constraints, and environmental challenges. International Journal of Aging and Human Development, 63(3), 173–186.CrossRefGoogle Scholar
  23. Kasl, S. V., & Rosenfeld, S. (1980). The residential environment and its impact on the mental health of the aged. In J. E. Birren & R. B. Sloan (Eds.), Handbook of mental health and aging (pp. 468–498). Englewood Cliffs: Prentice-Hall.Google Scholar
  24. Katz, R. (2009). Intergenerational family relations and life satisfaction among three elderly population groups in transition in the Israeli multicultural society. Journal of Cross-Cultural Gerontology, 24, 77–91.CrossRefGoogle Scholar
  25. Klatsky, A. L., & Armstrong, C. A. (1991). Cardiovascular risk factors among Asian Americans living in northern California. American Journal of Public Health, 81, 1423–1428.CrossRefGoogle Scholar
  26. Krause, N. (1993). Neighborhood deterioration and social isolation in later life. International Journal of Aging and Human Development, 36, 9–38.CrossRefGoogle Scholar
  27. Kuo, B. C. H., & Guan, J. (2006). Sociocultural predictors of depression for Chinese immigrant elderly in Canada: Acculturation, relationship with adult children, social support, and perceived services barriers. In D. Zinga (Ed.), Navigating multiculturalism: Negotiating change (pp. 373–392). Newcastle upon Tyne: Cambridge Scholars Publishing.Google Scholar
  28. Lai, D. W. L. (2004). Impact of culture on depressive symptoms of elderly Chinese immigrants. Canadian Journal of Psychiatry, 49(12), 820–827.Google Scholar
  29. Lai, D. W. L., & Chau, S. B. Y. (2007). Predictors of health service barriers for older Chinese immigrants in Canada. Health and Social Work, 32(1), 57–65.CrossRefGoogle Scholar
  30. Lai, D. W. L., & Kalyniak, S. (2005). Use of annual physical examinations by aging Chinese Canadians. Journal of Aging and Health, 17(5), 573–591.CrossRefGoogle Scholar
  31. Lam, L. (1994). Self-assessment of health status of aged Chinese-Canadians. Journal of Asian and African Studies, XXIX, 77–90.CrossRefGoogle Scholar
  32. Lam, R. E., Pacala, J. T., & Smith, S. L. (1997). Factors related to depressive symptoms in an elderly Chinese American sample. Clinical Gerontologist, 17(4), 57–70.CrossRefGoogle Scholar
  33. Lee, E. (1997). Chinese American families. In E. Lee (Ed.), Working with Asian Americans: A guide for clinicians (pp. 46–78). New York: Guildford Press.Google Scholar
  34. Lee, Y. M. (2007). The immigration experience among elderly Korean immigrants. Journal of Psychiatric and Mental Health Nursing, 14, 403–410.CrossRefGoogle Scholar
  35. Litwin, H. (2005). Correlates of successful aging: Are they universal? International Journal of Aging and Human Development, 61(4), 313–333.CrossRefGoogle Scholar
  36. Litwin, H. (2009). Social networks and well-being: A comparison of older people in Mediterranean and Non-Mediterranean countries. Journal of Gerontology: Social Sciences, 65B(5), 599–608.CrossRefGoogle Scholar
  37. Loo, C. M. (1991). Chinatown: Most time, hard time. Westport, CT: Greenwood.Google Scholar
  38. Ma, G. X. (2000). Barriers to the use of health services by Chinese Americans. The Journal of Allied Health, 29, 64–70.Google Scholar
  39. Mackinnon, M. E., Gien, L., & Durst, D. (1996). Chinese elders speak out. Clinical Nursing Research, 5, 326–342.CrossRefGoogle Scholar
  40. Meng, X. (2008). Contextual factors influencing dietary practices of Chinese Canadian seniors: Elderly Chinese Canadians’ perspectives. University of Calgary, unpublished MN thesis.Google Scholar
  41. Millar, J. M. (1997). Use of alternative health care practitioners by Canadians. Canadian Journal of Public Health, 88, 154–158.Google Scholar
  42. Morioka-Douglas, N., & Yeo, G. (1990). Aging and health: Asian/Pacific Island American elders (Working paper series no. 3). Stanford, CA: Stanford Geriatric Education Center.Google Scholar
  43. Mui, A. C. (1996). Depression among elderly Chinese immigrants: An exploratory study. Social Work, 41, 633–645.Google Scholar
  44. Mui, A. C., Kang, S. Y., Kang, D., & Domanski, M. D. (2007). English language proficiency and health-related quality of life among Chinese and Korean elders. Health and Social Work, 32(2), 119–127.CrossRefGoogle Scholar
  45. Musa, D. (2005). Neighborhood environment and the functional health of older adults. University of Pittsburgh, unpublished DPH thesis.Google Scholar
  46. National Advisory Council on Aging. (2005). Seniors on the margins: Seniors from Ethnocultural minorities. Ottawa: Minister of Public Works and Government Services Canada.Google Scholar
  47. Ngo-Metzger, Q., Massagli, M. P., Clarridge, B. R., Manocchia, M., Davies, R. B., Iezzoni, L. I., et al. (2003). Linguistic and cultural barriers to care: Perspectives of Chinese and Vietnamese immigrants. Journal of General Internal Medicine, 18, 44–52.CrossRefGoogle Scholar
  48. Pacey, M. A. (2001). Living alone and living with children: Living arrangements of Canadian and Chinese Canadian seniors. Queen’s University, unpublished MA thesis.Google Scholar
  49. Rodin, J., Timko, C., & Harris, S. (1985). The construct of control: Biological and psychosocial correlates. In C. Eisdorfer, M. P. Lawton, & G. L. Maddox (Eds.), Annual review of gerontology and geriatrics (pp. 3–55). New York: Springer.Google Scholar
  50. Sadavoy, J., Meier, R., & Ong, A. Y. M. (2004). Barriers to access to mental health services for ethnic seniors: The Toronto study. Canadian Journal of Psychiatry, 49(3), 192–199.Google Scholar
  51. Schwirian, K. P., & Schwirian, P. M. (1993). Neighboring, residential satisfaction, and psychological well-being in urban elders. Journal of Community Psychology, 21, 285–299.CrossRefGoogle Scholar
  52. Shkolnik, T., Weiner, C., Malik, L., & Festinger, Y. (2001). The effect of Jewish religiosity elder Israelis on their life satisfaction, health, function, and activity. Journal of Cross-Cultural Gerontology, 16, 201–219.CrossRefGoogle Scholar
  53. Statistics Canada. (2007). A portrait of seniors in Canada 2006. Ottawa: Ministry of Industry.Google Scholar
  54. Statistics Canada. (2008). 2006 census: Ethnic origin, visible minorities, place of work and mode of transportation, The Daily. April 2.Google Scholar
  55. Stokes, S. C., Thompson, L. W., Murphy, S., & Gallagher-Thompson, D. (2001). Screening for depression in immigrant Chinese-American elders: Results of a pilot study. Journal of Gerontological Social Work, 36, 27–44.CrossRefGoogle Scholar
  56. Sun, R. (2004). Worry about medical care, family support, and depression of the elders in urban China. Research on Aging, 26(5), 559–585.CrossRefGoogle Scholar
  57. Tjam, E. Y., & Hirdes, J. P. (2002). Health, psycho-social and cultural determinates of medication use by Chinese-Canadian older persons. Canadian Journal of Aging, 21, 63–73.CrossRefGoogle Scholar
  58. Tong, B. (2000). The Chinese Americans. Westport, CT: Greenwood Press.Google Scholar
  59. Ujimoto, K., Victor, N., Harry, K., Wong, P. T. P., & Lam, L. (1995). Cultural factors affecting self-assessment of health satisfaction of Asian Canadian elderly. In R. Neugebauer-Visana (Ed.), Aging and inequality: Cultural constructions of differences (pp. 131–141). Toronto: Canadian Scholar’s Press.Google Scholar
  60. Valtonen, K. (2002). The ethnic neighbourhood: A locus of empowerment for elderly immigrants. International Social Work, 45(3), 315–323.CrossRefGoogle Scholar
  61. Varshney, S. (2007). Predictors of successful aging: Associations between social network patterns, life satisfaction, depression, subjective health and leisure time activity for older adults in India. University of North Texas, unpublished PhD thesis.Google Scholar
  62. Wu, B., Tran, T. V., & Amjad, Q.-A. (2004). Chronic illnesses and depression among Chinese immigrant elders. Journal of Gerontological Social Work, 43(2/3), 79–95.CrossRefGoogle Scholar
  63. Yanez, A. P. (2006). Character strengths and psychological well-being as predictors of life satisfaction among multicultural populations. University of Nevada, unpublished PhD thesis.Google Scholar
  64. Yu, E. (1986). Health of the Chinese elderly in America. Research on Aging, 8, 84–109.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Department of Sociology and Social StudiesUniversity of ReginaReginaCanada

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