From shopping to eating: food safety practices among Chinese immigrants in Canada

Food safety is defined as the degree of confidence that food will not cause sickness or harm to people when it is prepared, served and eaten according to its intended use (FAO/WHO 2003).

Food can be mishandled at any number of stages during food preparation, handling and storage.

Contaminated raw foods, inadequate cooking, and consumption of food from an unsafe source were the factors most commonly associated with reported outbreaks of food-borne illness in homes (Medeiros et al. 2001). Food contamination creates an enormous social and economic burden on communities and their health system. It is estimated that in the last 20 years these economic losses amounted to nearly 1.0 to 1.2 billion dollars (Korel et al. 2003; Jevsnik et al. 2008). Study shows that between 50% and 87% of reported food-borne disease outbreaks have been associated with the home (Redmond and Griffith 2003).

Despite the importance of food safety to our health and economy, studies show that people have inadequate knowledge about measures needed to prevent food-borne illness in the home (Medeiros et al. 2001). Common mistakes identified include serving contaminated raw food, cooking/heating food inadequately, having infected persons handle implicated food and practice poor hygiene (Unusan 2007). Continued efforts are required to educate people on the hazards of improper food handling (Finch and Daniel 2005; Li-Cohen and Bruhn 2002; Mitakakis et al. 2004).

Food safety has been a top priority of the Canadian government. However, research on food safety practice in Canadian homes is lacking. A systematic literature review indicates that, of a total of 323 international publications related to consumer food safety knowledge, perceptions and food safety behaviours, only 26 were Canadian studies, which occurred between 1998 and 2011. The majority of the Canadian studies (n = 22) were classified as non-peer-reviewed public opinion reports (POR) and only four were peer-reviewed publications, of which three publications were based on one research project (Nesbitt et al. 2014).

For many immigrants, food is an essential component of culture and identity that they carry from their home country to the country of destination (Koc and Welsh 2002). Chinese food and approaches to eating are important parts of Chinese culture and are central to the Chinese way of life. Influenced by the yin-yang principle, an important concept in traditional Chinese medicine, Chinese food emphasizes a balance of both fan (e.g. rice, noodles, and steamed buns, dumplings) and ts’ai (e.g. stir-fried vegetable and meat dishes) (Chang 1977), a proper combination of “hot” and “cold” food. Unlike everyday thinking in the West, where foods are commonly organized according to principles of “good” and “bad” (Lupton and Chapman 1995), there is no “good” or “bad” food but only “right” or “wrong” food in the Chinese ideas and beliefs about food. If imbalanced, or improperly combined, food may cause illnesses. If carefully selected and properly administered, food may be used to strengthen health or cure diseases: “Food, therefore, is also medicine” (Chang 1977: 10).

There are wide knowledge gaps in the area of traditional foods and food safety such as information on traditional foods, food handling and preparation practices, educational needs of public health officials and newcomers (Dietrich et al. 2007; Papadopoulos et al. 2009). There is an urgent need for public health organizations to address issues such as determining the diverse needs, challenges and barriers of different ethnic communities in understanding and accessing food safety-related information and public services.

So far most studies on food safety focus mainly on food productions, food processing and food transportation as well as food sold in supermarkets and stores, or served in restaurants. There is little research on food safety among different ethnic groups in Canada. Chinese immigrants make up one of the largest immigrant groups to Canada in the past decade (Citizenship and Immigration Canada 2009) and over half of them settled in the Greater Toronto Area. However, little is known about food safety knowledge and practices among Chinese immigrants. Only a limited number of studies have looked at food safety risks in common Chinese dishes (e.g. Chinese barbecued meats, Chinese fried rice) sold in many Chinese restaurants in North America (McElroy et al. 1999; Ying 2000).

This study explores the knowledge and practices relevant to food safety among Chinese immigrant newcomers in the Greater Toronto Area, Canada. In particular, we will look at what they learn and how they learn in adapting to the changes in grocery shopping, food preparation, cooking, and food storage in order to keep their food safe in their host country. We will also explore the knowledge gaps as well as the educational and informational needs of the Chinese newcomers. This study contributes to our knowledge and understanding of food safety and diversity in Canada, which is of crucial importance for public health professionals and community health educators in developing effective health educational programs for ethnic minority groups in Canada.

Multiple methods were used in data collection. Two focus groups and a small-scale survey were conducted with Chinese immigrants, who had been in Canada for 10 years or less and who were residing in the Greater Toronto Area at the time of participation in our research. Three individual interviews were conducted with front-line community workers serving the Chinese community in the GTA: a Community Nutrition Educator (CNE), a dietitian, and a health program coordinator at a community centre. A consultation meeting was conducted with Toronto Public Health officials and professionals.

The focus groups were conducted in Mandarin among two groups of women (n = 6 for both groups): middle-aged women (35-50 years of age) and older women (55 years or older), who reported primary responsibility for food work in the home. Consideration of age, marital status, number of children, level of education, years in Canada, as well as types of food work (e.g. cooking, and grocery shopping) were also taken into account when selecting participants for the focus groups. All the participants in the focus groups were asked to complete a survey questionnaire distributed at the end of the focus groups. Electronic copies of the survey questionnaire were sent to two email lists of Chinese immigrants in the GTA. Hard copies of the questionnaires were also distributed to recent Chinese immigrants at workshops and seminars.

Twenty-two valid copies of survey questionnaires were returned, including 12 hard copies and 10 electronic copies from both women (86%) and men (14%) ranging in age between 23 and 74. Most of the respondents were married (68%), with at least one child in their family (59%). Eighty two percent of the participants had an educational level of college/university and above. Ninety percent of the respondents were in Canada for less than 10 years, and 45% of them were newcomers, who had been in Canada for less than 3 years.

Two of the individual interviews were conducted in English and one in Mandarin, and the consultation meeting was conducted in English. A consultation meeting was conducted in English with public health professionals working with different ethnic communities in the GTA. All the interviews, focus groups and the consultation meeting lasted about 1-2 hours and were recorded and transcribed.

This chapter examined a small sample of recent Chinese immigrants in Toronto, their concerns on food safety and health, their informational/educational needs, as well as their recommendations for improving immigrant food safety awareness and practices. This chapter also looked at recommendations by local community nutritionists and public health workers serving immigrant communities. It is clear that we need to recognize the diversity among newcomers in terms of social and cultural capital, level of knowledge, and life experiences. Meanwhile, age, level of education, years of Canadian residency, degree of fluency in English and socio-economic status, clearly can create barriers beyond an assumed ethnic origin. Programs targeting newcomer immigrant communities need to have flexibility in addressing such diversity. This, of course, comes down to availability of public health service workers who are not only informed about these communities but can serve as frontline workers in the knowledge translation and transfer. Further research is needed to explore intergenerational knowledge gaps and food safety risks posed by them.

We should also recognize that knowledge transfer must be seen as a mutual exchange and not a one-way transmission. This implies recognizing and benefitting from the indigenous knowledge and best practices of diverse global cultures, while at the same time informing newcomers about current Canadian safety and nutrition standards. Partnerships between communities, food safety professionals, practitioners and academics can create mutual learning opportunities and facilitate exchange of knowledge and experience to bridge these gaps, resulting in an increased understanding of traditional foods and food handling practices.