New Zealand is a country populated by migrants and the Asian population is the largest fastest growing cohort and are predicted to outnumber Māori (i.e. the indigenous people of New Zealand) by 2050. Due to the requirements of immigration to New Zealand the Asian community tends to be highly educated, with Asian ethnicities being more likely to have a university bachelors or post-graduate degree. Asian people are distributed more towards lower household income categories than Europeans, but the proportion of Asian people living in the lowest New Zealand deprivation quintile areas has declined in recent years. Migrants applying for residency are required to have, and thus can be expected to arrive in the country, with good health. The research on health care utilisation in geography has suffered by its tendency to neglect migration and culture as an influencing factor. In New Zealand this neglect is compounded by the near absence of a research focus on Asians and where they do appear it is in collated national surveys that have tended to group all sub-Asian ethnicities as one. This study explored the utilisation of health care from two directions. First, the response and perceptions of health care use from the view of the health services and, second, the perceptions of health care provision from the view of Asian migrants. For these reasons qualitative methods were utilised as they allow a focus on the everyday life situations of subjects.They provide opportunity to expand and flow with the research process.
In New Zealand, health services are available that specifically target Asian patients, but they are not uniformly available across New Zealand. This study identifies features of mainstream general practice services, as well as factors that migrants bring with them that act as barriers for Asian people accessing health services, including affordability, language and negative experiences that influence trust of the New Zealand health care system. In many cases affordability was linked to a perceived lack of value for money, where no treatment or tangible outcome was received through a visit to the doctor. Language was indicated to be the most pressing barrier to accessing health care and participants’ home country health experiences continued to influence perceptions and use of health care in New Zealand. The study also highlights some strategies that can be implemented into various stages of the Asian patient’s introduction into and then through the health system and health care to improve the availability and acceptability of these services.