Access to health care among racialised immigrants to Canada in later life: a theoretical and empirical synthesis
Ageing and Society
; 42(8):1735-1759, 2022.
Article
in English
| ProQuest Central | ID: covidwho-1947117
ABSTRACT
Evidence that immigrants tend to be underserved by the health-care system in the hosting country is well documented. While the impacts of im/migration on health-care utilisation patterns have been addressed to some extent in the existing literature, the conventional approach tends to homogenise the experience of racialised and White immigrants, and the intersecting power axes of racialisation, immigration and old age have been largely overlooked. This paper aims to consolidate three macro theories of health/behaviours, including Bronfenbrenner's ecological theory, the World Health Organization's paradigm of social determinants of health and Andersen's Behavioral Model of Health Service Use, to develop and validate an integrated multilevel framework of health-care access tailored for racialised older immigrants. Guided by this framework, a narrative review of 35 Canadian studies was conducted. Findings reveal that racial minority immigrants’ vulnerability in accessing health services are intrinsically linked to a complex interplay between racial-nativity status with numerous markers of power differences. These multilevel parameters range from socio-economic challenges, cross-cultural differences, labour and capital adequacy in the health sector, organisational accessibility and sensitivity, inter-sectoral policies, to societal values and ideology as forms of oppression. This review suggests that, counteracting a prevailing discourse of personal and cultural barriers to care, the multilevel framework is useful to inform upstream structural solutions to address power imbalances and to empower racialised immigrants in later life.
Gerontology And Geriatrics; health-care equity; social determinants of health; minority ageing; immigration; race and ethnicity; Health care access; Behavior; Oppression; Immigrants; Racial differences; System theory; COVID-19; Synthesis; Minority & ethnic groups; Aging; Social factors; Health behavior; Minority groups; Medical research; Immigration policy; Race; Capital; Medical screening; Coronaviruses; Underserved populations; Cultural differences; Health services; Organization theory; Cultural capital; Birth place; Socioeconomic factors; Canadian literature; Labor migration; Age; Migration; Power; Parameters; Canada Health Act; Health services utilization; Systematic review; Canada; United Kingdom--UK; United States--US
Full text:
Available
Collection:
Databases of international organizations
Database:
ProQuest Central
Language:
English
Journal:
Ageing and Society
Year:
2022
Document Type:
Article
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