What are the socio-cultural and religious influences on the health beliefs of tri-generational Pakistani women in the UK?

Problem

South Asian community members, specifically Pakistanis, living in areas of high socio-economic deprivation in the UK have an elevated risk of cardiovascular disease (CVD) and associated illnesses. Furthermore, minority ethnic groups may not have the appropriate social or familial support to prevent health conditions, where Social Capital (social networks, trust, cultural norms) could influence health and well-being. Primary care practitioners may have an insufficient understanding of the socio-cultural contexts within which healthcare decisions are being made. The aim of this research was to explore how members of the Pakistani community use their social networks to access healthcare information and support when making lifestyle choices associated with CVD prevention.

Approach

Semi-structured qualitative interviews were undertaken using a piloted interview guide and the convoy model diagram to elicit responses from participants on social networks, interactions, as well as health behaviours (diet and exercise). We used a novel approach to recruitment, asking business owners in community settings to act as research advocates to recruit participants. Interviews lasted between 45 and 120 minutes and were conducted in English and Urdu, translated and transcribed verbatim. Transcripts were analysed using framework approach. Social capital was used as an interpretive lens during analysis, with input from social psychology theories such as goal instrumentality to understand participant decision making in relation to lifestyle choices.

Findings

22 tri-generational women (1st, 2nd, and 3rd) aged 18 and above from diverse educational and occupational backgrounds reported their views on health and lifestyle. Women formed unique networks within and outside of the Pakistani community for seeking healthcare advice, support and information. It became evident that female participants were influenced by religion, culture and post-migration identities in forming lifestyle choices. For women across all three generations, health behaviours such as exercising in public or including non-traditional meal (Western) items into their diet were often affected by culturally embedded patriarchal structures in their community. However, cultural trends are shifting as a result of female empowerment as women are becoming better educated, in paid employment, thus expanding their social networks and access to different sources of health information.

Consequences

Recommendations can be made about the potential benefits of engagement for individuals from minority-ethnic groups, such as the Pakistani community. Engagement outside of familiar contexts and exposure to different cultural norms (e.g. British context) could provide greater sources of support and information when making healthier lifestyle choices. Understanding the shifting perceptions of health in relation to religious and cultural identity could provide primary care practitioners with a greater understanding of the context within which their health care decisions are being made and shed light on individual preferences regarding the nature of support required to achieve a healthy quality of life.