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