“We (Tong) Chinese”: Contemporary identity positioning through health management among Cantonese Chinese Americans

ABSTRACT

This paper explores discursive ways Chinese American older adults with type 2 diabetes mellitus (T2DM) take ownership of their health management. Fifteen patient stakeholders with T2DM took part in four focus group interviews. We used qualitiative discourse analysis to examine how participants used the phrase, “We (Tong) Chinese,” and variants, to index models of Chinese-living-in-the-U.S. personhoods, to incorporate “Chinese” and “western” ways of doing health management, to be Chinese American, and to interact with medical practitioners. We show how terms like “Tong” distinguish transnational boundaries and position participants in claiming “Chinese-in-America-ness” in relevant ways. Findings have implications for healthcare providers, health education, and intercultural communication.

KEYWORDS:

• Health communication
• Cantonese
• Chinese American
• identity
• integrative medicine

Acknowledgements

We wish to thank our research participants for generously sharing their time and their stories with us and UCSF’s Asian Health Institute and USF’s Faculty Development Fund for sponsoring this project. The funding sources had no role or involvement in the design and conduct of the study; the collection, management, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript. Contents are solely the responsibility of the authors and do not necessarily represent the official views of the funders.

Notes

1 In this paper, for all instances of Cantonese words and phrases, we follow the Jyutping Cantonese Romanization Scheme, designed by the Linguistic Society of Hong Kong: https://www.lshk.org/jyutping. For all instances of Standard Written Chinese and Mandarin Chinese, we follow Hanyu pinyin.

2 We recognize that 唐 is conventionally Romanized as “Tang,” which is how the character is rendered in Hanyu pinyin and how the Dynasty is usually spelled Romanized. “Tong” is how the character is rendered in Cantonese (Jyutping). Part of what we are articulating in this paper is a specific sense of Cantonese-speaking, Chinese-in-America-ness, so we feel it is appropriate to Romanize this character and phrases with this character using Cantonese whenever it is being used to refer to this sense of identity. We understand this breaks from common convention.

3 The INC guide itself and more on the project can be found at www.INCguide.org

4 Traditional characters were chosen to reflect the particularly longstanding, Cantonese-speaking, immigrant community in this area. The local safety net hospital also uses traditional characters to solicit research participants and for patient outreach and this was the way we approved all materials with our Institutional Review Board.

5 Scholars, including Snow (2004) and Peyraube (1991), have noted the diglossic nature of Hong Kong and diglossia that exists in the realities of speakers of Cantonese. We use the term vernacular Cantonese to refer to the written form of spoken Cantonese, and we use the term written Standard Chinese to refer to the standard written form writing as well as the national spoken standard of mainland China and Taiwan (Snow, 2010).

6 All transcripts shown will have the speech verbatim (noted as either Cantonese or Mandarin) as well as the English translation.

7 This participant was the only one who used this plural pronoun zanmen, and she used it in two other instances in the focus group. Once was: 這不是咱們可解決的, 全世界的難題 (“This is not just for us [Chinese] to resolve, it’s a problem affecting the whole world”) and the other was: 在咱們這代還有他們這個 … 全世界都不可能實現的 (“In the time and place we are living now  …  plus they, this, the whole world cannot achieve it”). In both of these instances, it seems this participant is using collective “we” [Chinese] to contrast with [the rest of] the world.

Additional information

Funding

This work was supported by University of California, San Francisco (Asian Health Institute Funding) and USF Faculty Development Funds.