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 Age34.1 (8.7) Female87.3% Married90.2% Years of Education3.4 (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 VariableBeta (t) Poorly planned migration (-1.719) Stress0.301***(5.413) Quality of life-0.182**(-2.889)

Results: Table 2 (b) Independent VariableBeta (t) Poorly planned migration (-1.655) Stress0.276***(5.021) Quality of life-0.180**(-2.907) Poorly planned migration x Stress 0.172*** (3.732)

Results: Table 2 (c) Independent VariableBeta (t) Poorly planned migration (-1.898) Stress 0.299***(5.395) Quality of life **(-2.745) Poorly planned migration x Quality of life * (-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