Section I - Introduction and background

The Asian adage that a flowing river cannot be appreciated by scooping up water and examining what has been collected, is a reminder that we cannot truly understand anyone outside of their cultural and psychosocial context (Uba, 2003). Understanding how a person may think, feel, and behave requires some understanding about their cultural values, practices and behaviours, how these differ within the culture, and how they differ from our own. However, the river's true nature cannot be revealed by looking at it either; experience through practice and relationship only, can grow an understanding of the river. Clinicians will need to integrate formal research with practice and experience. This document goes some way towards creating a bridge.

Demographics and diversity

Population

The term 'Asian' is used in New Zealand to describe culturally diverse communities with origins from the Asian continent. The Auckland Asian population currently represents 22% of the total population in the Auckland region, and is projected to increase more than 60% by 2026 (Statistics NZ, 2010; Mehta, 2012). The Asian population includes migrant as well as New Zealand born Asians. Chinese are the largest ethnic group within the Asian population (44%), followed by Indian (26%) and Korean (8%). As well as immigrants, over 10,000 refugees from Southeast Asia came to New Zealand between 1977 and 1992. The largest groups are Cambodian, Vietnamese and Laotian, with Burmese arriving in recent years, as well as some Bhutanese peoples of Nepalese origin (also called Lhotsampas). By 2021, the Asian population in the WDHB region will increase by 61,200 (from 75,090 to 136,290). In the Auckland District Health Board (ADHB) region the Asian population will increase by approximately 67,000 (from 106,960 in 2006 to 173,840 in 2021) (Wang, 2012).1

The Asian share of the population of WDHB will increase from about 15 percent in 2006 to 22 percent in 2021. In central Auckland (ADHB), one-third (33 percent) of residents will identify with an Asian ethnicity by 2021, up from one-quarter (25 percent) in 2006 (SNZ, 2010). The Asian population including Chinese, Indian and Other Asian peoples across Auckland region (three metro Auckland DHBs) is expected to double by 2026.

Diverse values

Whilst general guidelines and information about health beliefs, practices and principles are offered, viewers are reminded that Asians are not a homogenous group, and that there are no real typical 'Asian' or 'Asian family' values; these vary across contexts, ethnicities, cultures and countries. The tremendous diversity of values and practices across Asian countries, as well as significant variations in degrees of acculturation of migrants render the term 'Asian' barely meaningful. In mainland China alone, there are over 50 official ethnic groups with multiple dialects and cultural heritages.

In addition to diversity issues across the different Asian countries, urbanization, modernisation and cross-migration also have an impact on traditional values. The transition from a production to a consumption economy, as well as the low fertility rates in many of the big Asian cities has changed the family dynamics, and more nuclear families are emerging. Differentiating between a traditional family and one that has become more westernized will aid the clinician to tailor treatments appropriately.

While there are some commonalities among Asian groups, it is important to refer to contemporary studies of specific Asian groups rather than attempt to generalise about Asian values across all Asian groups (Yang et al, 2006). There is now a substantial and growing body of New Zealand Asian health and social research available. Further information can be found on the Te Pou, CAHRE, CALD, Asian NZ, Massey New Settlers, and School of Population Health websites.

Implications for practice

Whilst we emphasize the heterogeneity of Asian groups, there are cultural similarities amongst the various ethnicities. The generalisations about similarities in values and practices provided in this resource can be used as a platform for further exploring the unique perspective and context of each individual or family.