Interaction between Pre- and Post-migration Factors on
Depression among New Migrants to Hong Kong from
Mainland China
Funding source: RGC Public Policy Research
Funding Scheme (HKU 7004-PPR20051). Dr. Kee-lee Chou & Prof. Nelson Chow
Introduction
• Immigration in Hong Kong
– Under One Way Permit (OWP):
• 150 quotas for new immigrants (NI) from Mainland daily
• 55,000 NI annually
• Over 800,000 NI (1985 – 2004)
= 11.7% population in 2004
= Main contributor to population growth
Introduction
• Pre- and Post Migration Factors with Depression in Refugee literature (Birman & Tran, 2008; Fenta et al., 2004; Lindencrona et al., 2008; Silove et al., 1997),
• Pre-migration factor: Pre-migration preparation (Chou, 2009)
Introduction
• Moderated by social support (Chou, 2009)
• Limitation 1: cross –section data• Limitation 2: stayed in Hong Kong
Less than six months• Limitation 3: no examination of
post-migration factors
Objectives
• 1: examine the long-term effect of pre-migration planning on depressive symptoms
• 2: interaction effect of pre-migration with acculturation stress and quality of life on depressive symptoms
Method
• Participants:
– New arrivals aged 18 or above
– From Mainland on OWP
– Resided in HK for 3–6 months
– Baseline 449 respondents (Response rate = 78.9%)
– One-year follow-up: 347 respondents (dropout rate = 20%)
Method
• Measures
– Depressive symptomatology
• Chinese version of 20-item CES-D
– Preparation for migration
• 8 items used in Ryan et al.’s study (2006)
Method
• Measures
– Acculturation Stress
• 26-item Social, Attitudinal, Familial, and Environment (SAFE) Acculturation Stress Scale (Hovey & Magana, 2009; Wong et al., 2004)
Method
• Measures
– Quality of Life
• 28-item Hong Kong Chinese version of the World Health Organization Quality of Life (WHOQOL) Scale – Brief Version (WHOQOL, 1998; Chan et al., 2006)
Method
• Measures
– Demographic variables
• Sex, age, marital status, education, household income
Method
• Statistical Analyses
– Descriptive statistics (Table 1)
– Regression tests (Table 2)
• Base model
CES-D + All independent variables
• Moderating effects of Pre-migration planning with stress and quality of life
Results: Table 1
Demographic
Age 34.1 (8.7)
Female 87.3%
Married 90.2%
Years of Education 3.4 (0.9)
Household Income (range 1-18)
7.9 (0.9)
Results: Table 1
Independent & Dependent Variables
Poorly planned migration (range 0-5) 1.9 (0.9)
Stress (range 0-128) 30.5(19.7)
Quality of life (range 60 – 137) 99.3 (13.3)
CES-D scores at baseline (range 0=48) 11.4 (10.0)
CES-D scores at 1-year follow-up (range 0-42)
5.8 (7.6)
Results: Table 2 (a)
Independent Variable Beta (t)
Poorly planned migration
-0.084 (-1.719)
Stress 0.301***(5.413)
Quality of life -0.182**(-2.889)
Results: Table 2 (b)
Independent Variable Beta (t)
Poorly planned migration -0.080 (-1.655)
Stress 0.276***(5.021)
Quality of life -0.180**(-2.907)
Poorly planned migration x Stress
0.172*** (3.732)
Results: Table 2 (c)
Independent Variable Beta (t)
Poorly planned migration -0.093 (-1.898)
Stress0.299***(5.395)
Quality of life -0.173**(-2.745)
Poorly planned migration x Quality of life -0.097* (-2.068)
Discussion
• Important findings:
– Poor planning predicted depressive symptoms at baseline assessment only and its direct impact disappeared after one year of stay in Hong Kong
– But it has a moderating effect with two post-migration factors, namely acculturation stress and quality of life on depressive symptoms
Discussion
• Important findings:
– Acculturation stress and quality of life predict depressive symptoms
– Depressive symptoms dropped significantly after one year of stay in Hong Kong
Limitations
• Based upon one-year Longitudinal data: longer period of follow-up time needed
• Potentially important variables may not be included: childhood traumatic experiences, social support or life events before migration.
• Sample predominantly female• Measure of depression based on self-report
Conclusion
• Mental health of New Arrivals is worrying during their first year of stay in Hong Kong
• Depression associated with poor migration planning, acculutration stress, and quality of life
• Preventive measures needed
• Pre-migration planning as effective intervening factor
The End