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g and supporting community health
initiatives can be shared.
• Cultural awareness training is particularly important for providers of secondary care. As
the population ages, this will become important for long term and palliative care.
However, this study has also highlighted the importance of awareness of ethnic
differences in risk factors, genetic susceptibility and epidemiology. Ethnic awareness
should be promoted among primary care providers. They should also be aware that
Chinese have a tendency to combine Chinese and Western Medical systems.
• Cultural awareness in mental health care is also essential. Culturally- and linguisticallyappropriate
services should be made available. These services can be delivered by
outside organisations but promotion and referral systems need to be established so that
they can be accessed.
• Given the high proportion of Chinese students in Colleges, cultural awareness needs to
be promoted among College authorities so that guidelines and policies can be put in
place to accommodate culturally different health needs and behaviours.
• Ethnic monitoring must be introduced across the board so that equity of service provision
in relation to needs and population dynamics is ensured.
Acknowledgments
The author would like to thank:
Eddie Chan (CNHLC) for making the initial contacts and supervising the project
John Short, Lalita Patwardhan and Soma Moulik (Shropshire County PCT) for their
comments and contributions to the report
Divya Patel (Shropshire County PCT) for supplying the Census data
Maria Tighe for supplying information and References on traditional Chinese medicine
The Chinese Takeaway Association (UK) for supplying membership data
The Association of Traditional Chinese Medicine for supplying contacts
Vanessa Hawkins, Hilary Parker, Sharon Dellow, Hsiao Ying Tseng, Huili Townson and all
the participants of the study who contributed their time and experiences.
4
Contents
Executive Summary 2
Acknowledgments 3
Contents 4
1. Background 5
2. Chinese in Britain 5
2.1 A timeline 5
2.2 Population characteristics 6
3. Chinese in Shropshire and Telford & Wrekin 7
3.1 Shropshire County 7
3.1.1 Index of Multiple Deprivation 7
3.2 Borough of Telford & Wrekin 8
4. Methodology 11
4.1 Focus group 11
4.2 Interviews 12
4.3 Questionnaire survey 12
4.4 Advantages and limitations of the sample 12
5. Qualitative views of Chinese in Shropshire and Telford & Wrekin 14
5.1 Self-reported health and health beliefs 14
5.2 Language and cultural issues 14
5.3 GP registration 16
5.4 Access to information 16
5.5 Service provision 17
5.5.1 GP services 17
5.5.2 Other services 18
5.5.3 Social services 19
5.6 Attitudes, expectations and felt needs 19
5.7 Dependent children and young people 20
5.8 Overcrowding 20
5.9 Social support networks 21
5.10 Asylum seekers and irregular migrants 21
5.11 Traditional Chinese Medicine 21
5.12 Students in boarding colleges 22
5.12.1 Concord College 23
5.12.2 Ellesmere College 24
5.13 Disease patterns 24
6. GP Survey 25
7. Summary of recommendations 27
8. References 28
Appendix A 29
Appendix B 40
Appendix C 42
Appendix D 60
5
1. Background
In September 2005, Shropshire County Primary Care Trust (PCT) commissioned the
Chinese National Healthy Living Cen