Negative Consequences of Acculturation on Health Behaviour, Social Support and Stress among Pregnant Southeast Asian Immigrant Women in Montreal: An Exploratory Study
Hyman, Ilene, Dussault, Gilles, Canadian Journal of Public Health
It is frequently assumed that migrant status constitutes a health risk because migration is inevitably associated with a period of significant adjustments and stress. This paper describes the role of acculturation in understanding the relationship between migration and low birthweight (LBW). Psychosocial and behavioural risk factors for LBW were explored using semi-structured interviews with 17 pregnant southeast Asian women who represented different levels of acculturation. Findings suggested that acculturation had negative consequences for immigrant women. Higher levels of acculturation were associated with dieting during pregnancy, inadequate social support and stressful life experiences.
(Bell & Howell Information and Learning Foreign Text omitted)
Acculturation, the process of incorporating new values, attitudes and behaviours, provides a conceptual bridge for understanding the relationship between migration and changes in health.' Acculturation has been implicated in immigrant adoption of 'bad' North American health habits, such as smoking,2- high fat diets,5-9 and substance abuse.10,11 In the area of perinatal health, several studies have reported that more acculturated women experience higher rates of low birthweight than less acculturated counterparts 3,12,13>>z.ts However, explanations for these occurrences have been inadequately researched.","
Low birthweight (LBW can be due to a short gestation (prematurity), an intra-uterine growth retardation, or a combination of both. The causes of term low birthweight are multifactorial and include race/ethnicity, maternal height and weight, general morbidity, and health behaviours such as gestational weight gain and caloric intake, cigarette smoking and alcohol consumption. 16-21 Other researchers have examined the role of social support22-25 and stress26-29 to explain differences in pregnancy outcome.
Few studies have examined the consequences of acculturation in terms of psychosocial and behavioural risk factors that impact on term LBW. The purpose of the current study is to explore health behaviours (e.g., smoking, alcohol, diet), social support and stress, in a group of pregnant Southeast Asian immigrant women displaying different levels of acculturation.
The study population consisted of a group of 17 pregnant Southeast Asian women (Vietnamese, Cambodian, Laotian) living in Montreal, Canada. Southeast Asian women were selected because this group experienced a significantly higher rate of term LBW than native Quebecers (4.0% vs. 3.4%), particularly among the more acculturated members of this group.' Subjects were identified from an interpretation and orientation agency serving the Southeast Asian community of Montreal (SIARI), community health departments (CLSCs), obstetricians, Southeast Asian cultural and religious organizations, Southeast Asian health professionals and word of mouth. Informed consent was obtained prior to the interview sessions.
Qualitative techniques were used to identify the range of health and migration experiences encountered by the study population. Data collection, in the form of semi-structured interviews, lasted between one and two and a half hours. Vietnamese, Cambodian and Laotian interpreters were used in cases where the subject's comprehension of English or French was poor. During each interview, subjects were asked about their migration history and resettlement experiences in Canada as well as about their current pregnancy. Acculturation was assessed using two proxy variables, length of stay"3' and host country language fluency.32'33 Pregnancy-related questions focussed on health behaviours, social support and stress. All of the interviews were recorded with the permission of the participants. The transcripts were subsequently reviewed and coded into predetermined study themes: acculturation, health behaviour, social support and stress. …