‘Silence is gratitude’: social support and female empowerment to improve health and well-being in the Pakistani community, UK

Background South Asian migrants living in high income countries have an increased risk for developing cardiovascular disease (CVD), but there is limited research exploring the underlying socio-cultural causes and specifically as they impact women. Methods Social capital was used as an interpretive lens to analyse of in-depth qualitative interviews across three generations of at-risk migrant Pakistani women living in the West Midlands, UK. Perceptions of trust, cultural norms and social networks were the primary areas of exploration. Results Findings highlighted the importance of educational and occupational opportunities to seek healthcare related support outside of the Pakistani community. Appearance played a key role as there were varying ideals for younger or older women depending on how participants perceived their role in society. Women were often navigating pluralistic identities depending on whether they were at home or outside of their community setting. There were limited social spaces for women to seek support or information for their health as local sites, such as gyms, felt were prioritised for men. Conclusions There were age-based and generational differences in how women in the Pakistani community perceived the role of their social networks and community spaces in helping them to develop healthier lifestyle behaviours. The pursuit of a healthier lifestyle varied across the diverse migrant community, and efforts are needed to promote wider integration between communities and locations with the potential needed to improve to health.