Aging and health among migrants in a European perspective

Abstract

Population aging and the associated changes in demographic structures and healthcare needs is a key challenge across Europe. Healthy aging strategies focus on ensuring the ability to maintain health, quality of life and independent living at old age. Concurrent to the process of population aging, the demographics of Europe are affected by increased migration resulting in substantial ethnic diversity. In this paper, we narratively review the health profile of the growing proportion of aging migrants in Europe, outline key factors shaping health among this diverse group and consider ways of addressing their healthcare needs.Although factors shaping aging processes are largely similar across populations, migrant-specific risk factors exist. These include exposure to health risks before and during migration; a more disadvantaged socioeconomic position; language barriers and low health literacy; cultural factors influencing health-seeking behaviours; and psychosocial vulnerability and discrimination affecting health and quality of life. Overall, migrants experience the same morbidity and mortality causes as the native populations, but with different relative importance, severity and age of onset and with substantial differences within and between migrant groups. Little is known regarding health behaviours among aging migrants, although differences in cancer screening behaviours have been identified. Indications of widening health differentials between migrants and native populations with age and informal barriers to quality healthcare for aging migrants are causes of concern.In conclusion, there is a need for attention to migration alongside other determinants of healthy aging. The diversity in individual characteristics, life course processes and contextual factors shaping aging processes among migrants point to the need for a sensitive and comprehensive approach to policies, practices and research within the field of healthy aging. This is important to accommodate for the needs of the growing number of aging migrants in Europe and counter inequities in health and well-being at old age.

The language barrier in migrant aging

“…Clearly, the social environment shapes language development and influences health status and psychological wellbeing at various levels, from the degree of integration to the degree and quality of interaction. Language development is further determined by other, individual factors such as low educational levels, limited literacy abilities and cognitive dispositions, which constrain the ability or willingness of migrants to take up Dutch language courses or, in the case of literacy, limit access to health care facilities (Kristiansen et al 2016).…”

Dignity of informal caregivers of migrant patients in the last phase of life. A qualitative study.

“…This is of growing importance in diverse patient populations, especially because of the aging of migrant populations across Europe. 26 Although most of the literature focuses on the burden of care among informal caregivers, 27,28,29 it is questionable whether this is the right angle of support for informal caregivers (of migrant patients), 30 because taking care of their loved ones is such a prominent part of informal caregivers' dignity. Healthcare professionals could support the dignity of informal caregivers (of migrant patients) by taking them seriously, building skills to provide good care, providing education about care and the disease, fully informing them, and, when appropriate, using a familial approach to share and manage the burden of care among family members.…”

For better or for worse mental health? The role of social networks for exogamous older couples

“…Health disparities between immigrants and non-immigrants have been extensively studied in the literature, with some studies pointing towards a health advantage for immigrants while others report a disadvantage (Carnein et al, 2015;de Valk et al, 2018;Kristiansen et al, 2016;Reus-Pons et al, 2018). While an immigrant health advantage is typically attributed to positive selection ("healthy immigrant effect", see, e.g., Constant et al, 2018), health disadvantages are often considered to be caused by differentials in immigrants' exposure to risk factors, such as experiences of discrimination (Schunck et al, 2015) or language barriers (Diwan, 2008).…”