for many expatriates, a new work environment brings stress not only to one’s career, but also to one’s health. In China, where air quality is poor and many lead fast-paced lifestyles, foreign professionals must keep an eye on a special set of health issues.
In fact, Dr Richard Saint Cyr, a US-trained physician based in Beijing and author of the My Health Beijing blog, has coined a term for the combined health tolls that he sees China taking on his foreign patients: "expatitis." The condition is characterized by stress, anxiety, exhaustion, alcohol abuse, smoking, risky sex, a sedentary lifestyle and poor diet – a route that many expatriates take to combat stress from demanding jobs and unfamiliar surroundings.
The cure to expatitis is moderation, Saint Cyr said. But that’s not as easy as it sounds, especially if people are ill prepared to deal with underlying issues.
The stress of moving to another country can spark first-time mental health problems, said Melinda Weber, director of counseling for the Community Center Shanghai. A new environment may also exacerbate issues that were more easily repressed in an expatriate’s home country. "A lot of expats experience culture shock and a sense of isolation before they make friends," Weber said.
This can lead to high levels of anxiety, which – if left untreated – potentially causes depression.
Up in the air
According to the UN Development Program’s 2010 Human Development Index, life expectancy among people in China is 73.5 years, well below that of many developed countries like France at 81.6 years and Singapore at 80.7 years.
The big difference between these countries that health professionals often highlight is air quality. Smog and pollution can be a big concern for expatriates, who only have to look outside their windows to know that something isn’t quite right.
Still, there is uncertainty on what poor air quality means for health in the long run. Various studies have linked prolonged pollution exposure to increased death rates, but it’s unclear how much time a foreigner needs to spend in a country with poor air quality before it begins to affect his or her health.
"People are still debating that," Saint Cyr said. "If you’re exposed to pollution, it’s most likely doing some kind of damage. The question is how much."
One can err on the side of caution, though. China provides reports on some pollutants in larger cities, while Saint Cyr adds that people with particular sensitivities to pollution – like asthmatics and children – consider staying indoors on particularly bad air quality days. If respiratory disease is a concern, or if commuting to work involves walking or biking in main ring roads – where pollution tends to be worst – wearing an N95 mask can help block 95% of harmful particulates.
But outdoor air isn’t the only issue. "Adults spend about 90% of their time indoors so you need to think about indoor air quality too," Saint Cyr said.
As such, using an indoor air purifier, or opening windows during the day and closing them at night, can help encourage ventilation and prevent pollutants from taking over.
To tackle health issues away from one’s home country, Weber emphasized the importance of seeking support from not only health professionals, but also the community. Support groups – like those for mothers with young children – can help people find others who are undergoing similar issues, which Weber said can be just as effective as therapy.
That said, after moving to a new country, it’s hard to distinguish what health issues are normal and what warrants medical attention. When Greg Mayer moved to Shanghai to teach English last year, he developed a persistent cough that wouldn’t go away. He chalked it up to pollution and didn’t think anything of it until he went for a routine check-up. His doctor told Mayer that he had acute bronchitis.
"[The doctor] told me that it wasn’t dangerous, and that it’s common for people to get bronchitis when they move to Shanghai," Mayer said. "I didn’t take anything for it… It went away on its own, I guess."