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What is wellness? And how is it affected by living in another country?

This short article is part of the What is Wellness? Expat Family Wellness Survey 2018, in which we spoke to 32 families living around the world to explore what ‘wellness’ means to expats.

The families that contributed to the research varied in almost every way, from their locations and lifestyles to their attitudes and beliefs. We did however see a uniting thread: none seriously regret the decision to move and all have a will to make things work. Every family recommended moving abroad to live, but with the proviso that you need to be willing to make sacrifices to achieve the benefits. Things like time with friends and family, security (sometimes in more than one sense) and familiarity all have to be put to one side. You have to accept that it won’t always be an easy transition initially and that it takes time to settle.

Although some of our families happily use words like ‘paradise’ and ‘dream’, they recognise that real life isn’t all like that. All the more so if you have a family with you: “the focus isn’t on the individual, it’s on the family unit”  — Leung (Hong Kongers in Singapore)

Family wellbeing: highest rated countries
Source: The Expat Insider 2017 survey report published by InterNations

  1. Finland
  2. Netherlands
  3. Norway
  4. Singapore
  5. Israel
  6. Costa Rica
  7. Czech Republic
  8. Sweden
  9. Japan
  10. New Zealand


The novelty of a move to a new country only lasts a few weeks, then the transition from vacation to a new reality happens. That’s not to say that the reality is bad, it’s mostly positive, but it’s not a ‘holiday’.

“If you move thinking that ‘we had a great month there before’ or ‘it was the best time for a week’, then you’re quickly going to be disappointed. You don’t maintain the glow for long, you can’t. Relocating isn’t a trip. Treat it like it’s forever.”  — Anonymous

Globally mobile

Nearly half of the people we spoke to had lived in multiple countries before settling where they are now and many of them self-identify as ‘global citizens’: “I’m not Nicaraguan, Canadian or Mexican, it doesn’t matter what’s on my passport, I’m not defined as any of those”  — Astacio (Canadians in Mexico)

“If a job came up in any part of the world, we’d consider the move there because we’re not really ‘from’ anywhere. We’re a mix of several nationalities and a bit of where we’re living. But the dog is definitely British!”  — Mortleman (Australians in Spain)

Career versus lifestyle

  • 63% of expats are individual workers
  • 14% Students
  • 8% retired expats
  • 3% corporate transferees
  • 12% remaining expat groups 

Source: Finaccord

Most of our families moved due to career opportunities — although even this hasn’t been a simple case of relocating with the same employer. The definition of a career opportunity for some included the ability to pursue “greater possibilities and realise my potential, not just more money and a better role.”

Money versus experience

In fact, for the majority, relocating wasn’t primarily about money, it was about the experience and the lifestyle — and this clearly reflects in their views of wellness and overall family wellbeing.

Those who moved for the money seem most likely to be disenchanted with more aspects of life away from home and see the experience as part of “a short-term stage in a long-term plan.”

The Leung family (Hong Kongers in Singapore) might fall into this category. They moved with all of the relocation support and back-up that comes with a fixed assignment but explained that:

“It was very difficult initially and we weren’t too happy, but the second year has been better than the first.”

Career move

Regional differences come into play to an extent here, with those moving to destinations like Hong Kong and Dubai being much more likely to be completing a specific assignment and for a fixed period.

This can dictate their attitude to all aspects of life:

“I’m not putting down roots or planning a future here, so if I can make things as easy as possible for the short-term I will. It’s all about the money and I know it’s just a two-year contract. It’s not that it’s bad here — in some ways I feel very lucky, but in others I would rather have stayed at home”  —Cherry in Hong Kong

There were some exceptions to this widely defined sense of moving for ‘career’. These included the Sharma and Agbo families, both of whom moved to allow one of the parents to study:

“It will open up a new set of possibilities for me and then I’ll move again maybe to complete a PhD. Maybe Europe and particularly Denmark because the education system there, for our child, is very good”  — Sharma (Nepalese in India)

62% of expat students say they believe their time abroad will improve their future job prospects
Source: HSBC Expat Explorer survey 2016

Emotional ties

The Hargreaves family (U.S.) moved to India for both nostalgic and financial reasons because Mrs Hargreaves had lived in that part of India as a child and wanted to give her children the same experience. This is one specific example of a recurring theme of parents moving to expose their children to other cultures and situations as a means of shaping them for the future. A strong desire to give the family the broadest possible horizons.

However, the reality isn’t always that simple as the host country culture is sometimes seen to be less ‘developed’ than the home country:

The Mortelmans in Spain say, “It’s 20 years behind in its social perspectives, even environmentally it’s a bit behind.” Meanwhile the Hargreaves in India say, “You have to fight for whatever is yours here.”

Benefits of expat living

Most expat families living in most places find some aspects challenging while others bring welcome benefits — especially the climate.

There is a long list of potential benefits of living away from home — but not all expats would enjoy all of them. Just as one man’s trash is another man’s treasure, so too are aspects of expat living a benefit or disadvantage depending on who you ask.

Our respondents reflected what reports, articles and surveys reveal: the list includes everything from culture and climate to career and lifestyle. Our families help describe how these things affect their wellness while living away from home.

A total of 69% of expats declared their health as good, or even very good, compared with only 58% of people who had only lived one country.
Source: The Guardian

Best countries for family life
Source: The Expat Insider 2017 survey report published by InterNations

  1. Finland
  2. Sweden
  3. Czech Republic
  4. Denmark
  5. Norway
  6. Costa Rica
  7. Singapore
  8. Spain
  9. Netherlands
  10. Bahrain

Access the outdoors

Some say it can be a challenge, but without question, climate plays an integral role for many families and warm weather can be the essence of healthy living. Overall wellness is cited as being better in warmer countries because it allows people to be outdoors more. Simply having access to parks and outside spaces is beneficial to many of those we spoke to.

Even in built up cities (such as Pune, Dubai and Hong Kong (Island)) the ability to access facilities for fitness and recreation is seen as both easy and critically important.

For the children especially, being in a warm climate means they are able to enjoy playing more sports, stay outside longer and generally be more active.

Spain and Nigeria (and to an extent Hong Kong and Singapore) were the countries where this was most evident:

“We live outside. The kids can run and hike and swim until 9pm or later and it makes such a difference to us as family.”  — Mortleman (Australians in Spain)

Hotter (and drier) climates also deliver benefits for other reasons. Of living in Spain, Ennio (17) says:

“My skin is so much better now, I don’t have to use Clearasil or anything harsh, the sun just clears it up for me.”


Exposure to cultural diversity is a fundamental benefit. Parents particularly like the fact that their children are growing up in a global environment and living an ‘international lifestyle’. As a major benefit it is viewed as connected to a sense of wellbeing through wider horizons and a more positive self-image.

The fact that families — and children in particular — could be bilingual (trilingual in some cases) is a major benefit for future employability and wider emotional wellbeing.

“My kids will be growing up speaking two, three or even four languages.”

The Lagnado’s moved to Canada not only because of quality of life, finances etc. but they both have different heritages from the country they were born (Italian and Japanese), and they felt more culturally included in Canada than Sao Paolo, Brazil.

If you make the effort to absorb the culture of your host country and assimilate wherever you can it makes living away from home seem much more likely to be beneficial in the immediate and longer term. We heard many people say that if you’re going to go to another country then appreciate that it’s not your own and mingle with the locals. Get a feel for how to communicate and appreciate their culture and language:

“We love being able to travel around. You’re only ever a couple of hours away from cool places on a plane.

“I love being able to immerse yourself fully into the culture. Whenever friends come to visit there’s always something new to do and explore. Hong Kong is only as big as London so it only takes 1.5 hours max to ever get anywhere. One minute you’re mountain climbing, the next you’re at the seaside or paragliding. But you can still see skyscrapers in the distance. It’s very diverse.”  — Shiroi (Brits in Hong Kong)

“It’s great to get different perspectives on how people live their lives - it makes you a better person,” explains Bibhuti Prusty — an Indian in Canada.  You have to be careful not to offend different cultures by giving the wrong signs, or using the wrong language etc. That’s a challenge in itself.”

Quality of life

  • 52% expats agree that their quality of life improved since moving
  • 61% say they are integrating well with the local people and culture

(HSBC Expat Explorer Survey 2016)

Quality of life generally improves for expats, but some acknowledge that settling can take some time. It usually takes no less than six months before people start to feel settled in their environments and can begin enjoying their new lives.

Family time

Family time is hugely improved and the family unit is much closer together. The absence of other social distractions and a sense of a shared experience go a long way towards bringing the family together:

“We do so much more together now and lean on each other because the usual support and the rest of family isn’t there.”  — Mortleman (Australians in Spain)

Work/life balance

Work/life balance is generally felt to be better in the new country, even where at least one adult is working long hours or travelling for work. There is a sense that actively choosing how one lives their life helps them settle into their job — as opposed to feeling like their lifestyle was forced on to them.

Expats on assignments for fixed periods were more likely to see work/life balance issues:

“We work hard and put the time in but it’s different because there are so many more aspects to our life here” — Anonymous in Hong Kong

“People — mainly women — are more sociable and less stressed in Hong Kong because they have ‘helpers’ — someone to cook, clean, look after the kids etc. so they have more time to socialise” —Kirwans (Australians in Hong Kong)

Best countries for working life
(HSBC Expat Explorer Survey 2016)

  1. Germany
  2. Norway
  3. Sweden
  4. Switzerland
  5. Austria
  6. Netherlands
  7. New Zealand
  8. UK
  9. Canada
  10. Australia

Cost of living

A lower cost of living can be a benefit but, as explained, financial benefit isn’t the defining factor for most considering a move. If finances become stretched, it can create huge pressure on the whole family and potentially generate health and wellness issues. For most of our families, this has not been an issue.

Challenges to wellness away from home

Knowing how to set up and sustain wellness abroad is only half of the battle. You also need to be able to access the products, services and people to maintain it. 

Every family recognises that there are challenges to living away from home — whether practical or emotional. There are some consistent issues across the globally mobile audience, felt by all to a greater or lesser extent. But there are many other features of expat life that are a challenge for some while being a benefit for others.

One area that poses a challenge across the board is increased bureaucracy and administration —particularly in the early stages of relocating but to some extent throughout the period away from home. While Hong Kong and Singapore are seen as forward-thinking places — ahead of the curve in terms of technology and infrastructure — they can be immensely challenging places to live when it comes to sorting out domestic necessities such as banking and utilities.

In Singapore, you have to pay deposits on utilities, childcare and bank accounts — the Brown family (Finns in Singapore) told us they set aside $20,000 to set themselves up and this only lasted six months. These concerns can have a detrimental impact on overall wellbeing if they start to build.

For others, the challenge is ‘navigating the system’, which can be a problem, even before you factor in language barriers:

“There was nobody to tell us what to do or where to go to register with a doctor or get the children into a school. You have to work things out… but quickly”  — Anonymous

Most common expat problems
Source: The Expat Insider 2015 survey report published by InterNations

  1. Missing friends and family
  2. I am single and the expat lifestyle makes having a relationship difficult” is not listed here
  3. Worried about future finances
  4. I still need to adjust to work environment
  5. No professional network
  6. Loss in personal income
  7. Trouble making friends
  8. Culture shock
  9. Tired of expat life
  10. Language barrier
  11. My partner/family aren’t happy here
  12. Bad for psychological/mental health

Settling in

Some families, like the Lagnados (Brazilians in Toronto), took a while to settle into their new home. The first few weeks of a move can be busy but can be a honeymoon period, which then declines into a tricky settling-in period before becoming an established lifestyle and a better place. They said: “It took us nine months or more but now we’re finally settled and it’s good.”

Similarly, the Zamureuvs, who have moved from Russia to Spain, felt that “we’re two years in and it finally feels as though we’re straight after some difficult times.”

Red tape

The Astacio family (Canadians in Mexico) experienced a whole new level of bureaucracy after moving to Mexico when the dad had to leave the country and come back in again in order to generate the right circumstances to be recognised in some public systems:

“I had to get in the car and drive out of Mexico, across the border into McAllen, Texas, and turn straight back round again and come back to get the right paperwork.”

The Kirwan-Elliot family (Australians living in Hong Kong) has their own story of administrative pain, seen from the perspective of Wendi:

“Most of the forms here require me to identify myself as a housewife, not a teacher, a housewife! That’s such an alien thing to me and culturally not what we’re about. Not only that, if I need to go to the bank, my husband has to countersign everything, I can’t do anything individually. He thinks it’s hilarious.”

This is a good example of the overlap between aspects of culture and administrative challenges.

Our families’ experiences support the need for best practice: if you’re moving abroad with a company or even under your own steam, the more you do to understand where you’re going, the more you’ll understand what support systems you need to sort before you arrive, and so the more you’ll be able to organise in advance — and make your move a success.

Staying in touch

Leaving friends and family behind is one of the biggest challenges faced by expat families — one that has a big effect on wellness. Access to social media to stay in contact is vital to and the biggest tool used by most of our families. Although, for some the distance is a blessing as well as a curse: some stating they enjoyed not being judged on the way they live their lives by other family members (particularly older parents) is a welcome by-product of living away. Those from cultures where the extended family is a major influence, particularly saw this as a double-edged sword — with the wrench of being outside the family group being offset by the freedom to live their lives by their own rules:

“Although we would like more support, one of the main advantages is being able to raise children without useless advice or ‘family standards’ to uphold”  — Sharma (Nepalese in India)


Both parents and children say that being so far away from loved ones is a big issue and is cited as one of the biggest influencers on overall wellness. The social aspect is undoubtedly lacking for most, which can then turn into feelings of isolation and sometimes depression.

While children don’t express the impact in such clear emotional terms, the distance from their family and friends is the number one downside and the biggest reason to return home:

“If I could wave a wand and change one thing, it would be to bring my friends and family here too,” said nine-year-old Alysia Witter (Brit in Nigeria).

Family life is almost always enhanced by moving to a new country, but it can bring challenges and complications too.

“We have more family time together, but, in a way that’s because we have to - there isn’t anyone else. It’s good for me, but I don’t know if the children think it’s all that great”  — anonymous in Canada

The support network

There is a practical aspect raised in this area too, beyond the emotional impact of family distance. The lack of a support network to help with childcare and having no-one to fall back on is felt by many we spoke to.

In addition to the views of the Sharmas (above) families from almost all countries have similar issues — not just in relation to social lives but daily working lives too. The family set-up has to be flexible enough to adapt to changing circumstances and developing plans. If one parent works, it generally means that the other can’t if there’s no childcare available.

We had a mix of stay-at-home mums and dads whose life was dominated by childcare: “My wife is the one working now and, although that was never the plan, I’m enjoying the time with the children, but it’s limiting and it’s really all I do”  — Zamuruev (Russians in Spain)


Moving near

Intra-regional movement (within Asia or the Middle East for example) is least likely to present problems related to climate, culture or language, but that doesn’t mean that there aren’t meaningful problems even with relatively short distance relocations:

“Some things have been easy because of the open border. The TV is in the same language and the culture is Hindu, so it’s all very similar. But it has been a challenge to make new friends and the people are very different. We don’t meet many like-minded people and that’s difficult.”  — Sharmas (Nepalese in India)

Moving far

Those moving further afield or to different cultural areas felt the challenge of the move more, partly because of a self-identification as an ‘alien’:

“I didn’t realise just how German I was until I moved to Mexico! Things happen slowly here and that’s not what I’m used to. I found myself getting really stressed when people don’t turn up as promised or things are delivered late. Then I thought, ‘oh, I’m like a typical German’.”  — Julia Vogt (Germans in Mexico)

Cost of living

The cost of living can be higher but with earnings (or potential earnings) that are much higher. Higher costs of living and higher pay can often leave some families roughly neutral.

There were few examples of families who benefited from a win/win of significantly higher incomes alongside a move to countries with a noticeably lower cost of living:

“You come to a country and think, ‘this is great, everything is much cheaper and we can afford much more’. The cost of living here is much lower — healthy food and drink prices -— but salaries are lower too so it works out about even. Spain is not a place for entrepreneurs.”  — Mortleman (Australians in Spain)

  • 62% expat parents say it is more expensive overall to raise their children abroad
  • 88% of expat parents rate their children’s quality of life as the same or better Source: HSBC Expat Explorer Survey 2016

Click on the links below to read what our families said about various topics:

Click here to view the full What is Wellness? Expat Family Wellness Survey 2018

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