Rance P. L. Lee

Perceptions and uses of Chinese medicine among the chinese in Hong Kong

The present paper was based on both qualitative observations and quantitative survey data. Major findings are as follows: (1) The sacred or magical-religious tradition of Chinese medicine is accepted by a relatively small portion (roughly one-fifth) of the ordinary Chinese people in urban Hong Kong, and is relatively more popular among women or less educated people. (2) Both the classical-professional and the local-empirical traditions of secular medicine are resorted to by many Chinese people (over one half) either for treating diseases or for strengthening their constitution. The acceptance of secular Chinese medicine does not vary significantly among different sex, age, education, or income groups. It should be noted that secular Chinese medicine is often used in addition to or in combination with modern Western medicine. (3) It appears that most people are more confident in the Chinese medical tradition than in Chinese-style practitioners in Hong Kong, and that peoples confidence in secular Chinese medicine has been increasing in recent years. (4) There are reasons for the confidence in secular Chinese medicine. Chinese medicine is generally perceived to be better than or as good as Western, scientific medicine in some ways, such as for tonic care, for fewer side effects, for curing the cause (not symptoms) of diseases, and for treating certain diseases. Therefore, to ordinary Chinese people, Chinese and Western medicine may perform either equivalent or complementary functions. (5) As regards the process of seeking medical care, most people seem to follow the pattern of moving from self-medication, using Chinese and/or Western home remedies, to Western-style doctors, to Chinese-style practitioners, and finally to a Western medical hospital. Policy and theoretical implications of these findings are discussed.

Social Structure and Support Networks in Beijing and Hong Kong

Abstract This study examines personal support networks in Beijing and Hong Kong, based on survey data collected in 2000. It was found that these two Chinese cities, which share a common Confucian cultural heritage, are similar in many aspects of social support. The supportive roles of spouse or partner are prominent and diffuse. Other close relatives are more involved in instrumental than emotional support. Non-kin primary ties specialize in emotional support. Neither extended kin support nor institutional support is significant. Nonetheless, the two cities differ in certain aspects of social support, reflecting their differences in such macro social-structural forces as economic modernization, urbanization and the social organization of work. Compared to the Hong Kong Chinese, the Beijing Chinese are more likely to seek support from close kin or coworkers, but less likely to rely on institutional help. Sources of support in both cities are also affected by the micro social-structural positions people occupy, particularly marital status and household income. It is noted that about 10% of the respondents in both cities reported “no one” to turn to for support. Among the various types of support, emotional comfort is the most difficult to find.

Comparative studies of health care systems.

This paper reveals the dynamics of hierarchical medical pluralism through a comparative analysis of the health care systems in three Chinese societies (the China mainland, Taiwan and Hong Kong). It is argued that the hierarchical relationships among medical traditions within a national society should be studied in terms of structural superiority (power, prestige and wealth) and functional strength (distribution and utilization) and should be understood in the context of modernization. The world-wide movement of modernization through science has made scientific biomedicine become structurally superior to other medical traditions in virtually every contemporary society but its functional strength varies with the societys political-organizational and economic development. The national will to modernize through science has also resulted in many alternative traditions being increasingly absorbed into the scientific biomedical sector. The various efforts to revive alternative remedies may turn out to facilitate the process of both technical and organizational absorption by scientific biomedicine.

Social life and development in Hong Kong

The papers in this volume, prepared by social scientists with different specializations, address selected aspects of Hong Kongs post-War development.

Market Reforms and Psychological Distress in Urban Beijing

This article examines the change in psychological well-being among urban residents in Beijing, China, over a 10-year period of rapid social change. The findings suggest that urban reforms generate economic gains at the expense of urban residents’ psychological well-being. Results from two community surveys conducted in 1991 and 2000 reveal that urban Beijing residents have experienced greater life stress and a rise in depressive symptoms during the 10-year period. The decline in psychological well-being between 1991 and 2000 can be partly explained by greater exposure of Beijing residents to life stressors in the course of rapid social changes associated with the urban reforms. The survey results also lend support to the social adjustment and stress explanation, but not the social relations and support explanation. Changes in social relations only marginally affect the change in depressive symptomatology, and the protective function of social relations, particularly relations with family and co-workers, has gained importance over the years.

The Causal Priority Between Socioeconomic Status and Psychiatric Disorder: a Prospective Study

We found that socioeconomic status was more likely to have causal priority over psychiatric disorder than the reverse. This finding held separately among men and among women. It is suggested that the social causation hypothesis may be more plausible than the social drift hypothesis. Over the last few decades, sociologists and psychiatrists have been greatly interested in the relationship between mental illness and social environment. There exists, however, a controversial issue : do social-structural forces predispose to mental illness? Or do mental disorders cause changes in social-structural characteri-

Sex Roles, Social Status, and Psychiatric Symptoms in Urban Hong Kong

Mental health researchers have identified a number of social factors that may be associated with the prevalence of functional psychiatric illness. Some of the empirical findings are contradictory among studies using different methodologies or conducted in different times and places (Mishler and Scotch 1965; Turner 1972; and Dohrenwend 1975). It is recognized, however, that two of the highly consistent findings are the relationships of psychiatric illness to sex roles and social class. In general, the overall rates of psychiatric illness are higher among women than men (e.g., Davis 1962; Langner and Michael 1963; Phillips 1966; Phillips and Segal 1969; Gove and Tudor 1973; and Clancy and Gove 1974), and higher among members of lower socioeconomic groups (Faris and Dunham 1939; Hollingshead and Redlich 1958; Langner and Michael 1963; Leighton, et al. 1963;Kohn 1968; Dunham 1970; and Hodge 1970).

Chinese and Western medical care in China's rural commune: a case study☆

Abstract This paper examines the structure and functioning of both the traditional Chinese and the modern Western medical care services in the rural areas of the Peoples Republic of China. Data were drawn from the in-depth interviews and non-participant observations during a field visit to the Toushan Commune of Kwangtung Province in May 1978. It was found that a variety of Chinese and Western medical services were systematically organized in terms of the three-level principle of administration, and were made available for use by the peasants living in different regions of the commune. There is a constant flow of patients and health resources among the three levels, i.e. the commune health clinic, the brigade medical stations, and the auxiliary health workers of the production teams. It is argued that (a) some organizational principles of the rural commune have facilitated the mobilization and organization not only of the Western but also of the Chinese medical resources in the rural areas, and (b) the incorporation of Chinese medical care into the organized health system has political as well as technical, cultural and economic implications.

Problems of primary health care in a newly developed society: Reflections on the Hong Kong experience

Hong Kong has emerged as a newly developed society in Asia and its modern scientific health care system has had a substantial expansion. Recently, the rise of medical costs has made the health authority come to stress the development of PHC. This paper focuses on three major aspects of the PHC development in Hong Kong: (1) public health and preventive care; (2) food supply and nutrition; and (3) first-contact medical care and referral network. It is argued that in a newly developed society, the emphasis on developing both the quality and the quantity of PHC in the scientific biomedical stream is justifiable. However, at least two kinds of problems need to be taken into consideration, i.e. the prevalence of traditional beliefs and practices and the ever-rising demands of the public for health services.

Ethical Challenges of the Market for Health Care

The introduction of market mechanisms to the system of health-care services has emerged as a major trend in many countries around the world. This is mainly due to the steeply rising cost of health care in recent decades. Progress in medical technology and the growth in health-care demand are key factors in the escalation of medical costs, which has far outrun the general increase in cost of living (Coe, 1970, Chapter 13). In many countries, the ever-rising cost of health care has made an increasing number of people unable to obtain adequate care for their health needs. It has also made it increasingly difficult for governments to finance public sector health-care services.