Top

BMC Health Services Research

Published in:

Open Access 01-12-2024 | Research

Self-identified barriers to health services among migrants 50 years of age or older: population-based survey study of Russian speakers in Finland

Authors: Nuriiar Safarov, Laura Kemppainen, Sirpa Wrede, Anne Kouvonen

Published in: BMC Health Services Research | Issue 1/2024

Abstract

Background

The compounded effect of a migratory background and ageing increases the risk of unequal medical treatment opportunities. The aim of this article is to investigate the social determinants of barriers to health services.

Methods

The study uses population-based survey data of Russian-speaking migrants (50 + years) residing in Finland (n = 1082, 57% of men, mean age 63 years). Multiple correspondence analysis was performed as a dimension reduction procedure on six barriers to health services. Multiple ordinary least-squares linear regression was used for the predicted score of the barriers as an outcome variable.

Results

Most of the sociodemographic characteristics were not associated with barriers to health services, except gender, as women tended to face more disadvantages. Migration-related factors, such as the need for interpreters for health services and experienced discrimination, were associated with an increased likelihood of reporting barriers to health services. Using the internet as a primary source of health information was associated with more access barriers to health services.

Conclusions

Migrants 50 years of age or older face multiple barriers to health services. Given that the healthcare needs increase with age, addressing this issue becomes crucial, necessitating improved access to health services for older migrants.

Brandenberger J, Tylleskär T, Sontag K, Peterhans B, Ritz N. A systematic literature review of reported challenges in health care delivery to migrants and refugees in high-income countries-the 3 C model. BMC Public Health. 2019;19(1):1–11. https://doi.org/10.1186/s12889-019-7049-x.CrossRef

Çilenti K et al. Use of Health Services and Unmet Need among Adults of Russian, Somali, and Kurdish Origin in Finland, International Journal of Environmental Research and Public Health 2021;(18):2229. https://doi.org/10.3390/IJERPH18052229.

Koponen P, Kuusio H, Keskimäki I, Mölsä M. Hoidon tarve, sen tyydyttyminen ja tyytyväisyys palveluun lääkärin vastaanotolla, in Maahanmuuttajien terveys ja hyvinvointi - Tutkimus venäläis-, somalialais- ja kurditaustaisista Suomessa, THL, 2012. Accessed: Oct. 07, 2022. Available: https://www.julkari.fi/handle/10024/90907.

Lebano A, et al. Migrants’ and refugees’ health status and healthcare in Europe: a scoping literature review. BMC Public Health. 2020;20(1). https://doi.org/10.1186/s12889-020-08749-8.

World Health Organization, World Report on Ageing and Health. Geneva: WHO Press, 2015. Accessed: Aug. 10, 2023. Available: https://books.google.fi/books?hl=en&lr=&id=n180DgAAQBAJ&oi=fnd&pg=PP1&ots=uTM1omMWk-&sig=om3XqhMQueEkb_92mqbjh39LmUU&redir_esc=y#v=onepage&q&f=false

Dowd JJ, Bengtson VL. Aging in minority populations an examination of the double Jeopardy Hypothesis. J Gerontol. 1978;33(3):427–36. https://doi.org/10.1093/geronj/33.3.427.

Wemrell M, Karlsson N, Perez Vicente R, Merlo J. An intersectional analysis providing more precise information on inequities in self-rated health. Int J Equity Health. 2021;20(1):1–10. https://doi.org/10.1186/S12939-020-01368-0/TABLES/3.

Ahmed S, Shommu NS, Rumana N, Barron GRS, Wicklum S, Turin TC. Barriers to Access of Primary Healthcare by immigrant populations in Canada: A literature review. J Immigr Minor Health. 2016;18(6):1522–40. https://doi.org/10.1007/s10903-015-0276-z.CrossRefPubMed

Arora S, Bergland A, Straiton M, Rechel B, Debesay J. Older migrants’ access to healthcare: a thematic synthesis. Int J Migr Health Soc Care. 2018;14(4):425–38. https://doi.org/10.1108/IJMHSC-05-2018-0032.CrossRef

10.

Qureshi SA, Kjøllesdal M, Gele A. Health disparities, and health behaviours of older immigrants & native population in Norway. PLoS ONE. 2022;17(1):e0263242. https://doi.org/10.1371/JOURNAL.PONE.0263242.

11.

Diaz E, Kumar BN. Differential utilization of primary health care services among older immigrants and norwegians: a register-based comparative study in Norway. BMC Health Serv Res. 2014;14(1):1–10. https://doi.org/10.1186/S12913-014-0623-0/TABLES/4.

12.

Devaux M, de Looper M. Income-related inequalities in Health Service Utilisation in 19 OECD Countries, 2008–2009. OECD Health Working Papers. 2012;58. https://doi.org/10.1787/5k95xd6stnxt-en.

13.

Blomgren J, Virta LJ. Socioeconomic differences in use of public, occupational and private health care: a register-linkage study of a working-age population in Finland. PLoS ONE. 2020;15(4). https://doi.org/10.1371/JOURNAL.PONE.0231792.

14.

Graetz V, Rechel B, Groot W, Norredam M, Pavlova M. Utilization of health care services by migrants in Europe - A systematic literature review. Br Med Bull. 2017;121(1):5–18. https://doi.org/10.1093/bmb/ldw057.CrossRefPubMed

15.

Lai DWL, Chau SB. Effects of service barriers on health status of older Chinese immigrants in Canada. Soc Work. 2007;52(3):261–9. https://doi.org/10.1093/sw/52.3.261.CrossRefPubMed

16.

Gil-Gonzalez D, Carrasco-Portinõ M, Vives-Cases C, Agudelo-Suarez AA, Castejon Bolea R, Ronda-Perez E. Is health a right for all? An umbrella review of the barriers to health care access faced by migrants. Ethn Health. 2015;20(5):523–41. https://doi.org/10.1080/13557858.2014.946473.CrossRefPubMed

17.

Vignier N, et al. Access to health insurance coverage among sub-saharan African migrants living in France: results of the ANRS-PARCOURS study. PLoS ONE. 2018;13(2):e0192916. https://doi.org/10.1371/JOURNAL.PONE.0192916.

18.

Nielsen SS, Waldorff FB, Kreiner S, Krasnik A, Hempler NF. Is there equity in use of healthcare services among immigrants, their descendents, and ethnic Danes? Scand J Public Health. 2012;40(3):260–70. https://doi.org/10.1177/1403494812443602/ASSET/IMAGES/LARGE/10.1177_1403494812443602-FIG1.JPEG.CrossRefPubMed

19.

Schouten BC et al. Dec., Mitigating language and cultural barriers in healthcare communication: Toward a holistic approach, Patient Educ Couns. 2020:103(12):2604–2608. https://doi.org/10.1016/J.PEC.2020.05.001.

20.

Kieseppä V, García Velázquez R, Vehko T, Kuusio H. Satisfaction with access to health services among foreign-born population in Finland: a survey-based study. BMC Health Serv Res. 2022;22(1):1–11. https://doi.org/10.1186/s12913-022-08155-3.CrossRef

21.

Bécares L, Das-Munshi J. Ethnic density, health care seeking behaviour and expected discrimination from health services among ethnic minority people in England. Health Place. 2013;22:48–55. https://doi.org/10.1016/J.HEALTHPLACE.2013.03.005.

22.

Gil-Salmerón A, Katsas K, Riza E, Karnaki P, Linos A. Access to healthcare for migrant patients in europe: Healthcare discrimination and translation services. Int J Environ Res Public Health. 2021;18(15):7901. https://doi.org/10.3390/ijerph18157901.

23.

Ndumbi P et al. Jun., Barriers to health care services for migrants living with HIV in Spain, Eur J Public Health. 2018:28(3):451–457. https://doi.org/10.1093/EURPUB/CKX225.

24.

Ahmadinia H, Eriksson-Backa K, Nikou S. Health-seeking behaviours of immigrants, asylum seekers and refugees in Europe: a systematic review of peer-reviewed articles, Journal of Documentation. 2021:78(7):18–41. https://doi.org/10.1108/JD-10-2020-0168/FULL/PDF.

25.

Berens EM, Ganahl K, Vogt D, Schaeffer D. Health literacy in the domain of healthcare among older migrants in Germany (North Rhine-Westphalia). Findings from a cross-sectional survey. Int J Migr Health Soc Care. 2021;17(1):62–74. https://doi.org/10.1108/IJMHSC-09-2019-0078.CrossRef

26.

Heponiemi T, Gluschkoff K, Leemann L, Manderbacka K, Aalto AM, Hyppönen H. Digital inequality in Finland: Access, skills and attitudes as social impact mediators:, New Media Soc, 2021. https://doi.org/10.1177/14614448211023007.

27.

Vehko T, Lilja E, Parikka S, Aalto A-M, Kuusio H. Self-reported strong electronic identification varies between population groups in Finland. Finnish J eHealth eWelfare. 2020;12(3):187–97. https://doi.org/10.23996/fjhw.91512.CrossRef

28.

Kemppainen L, Wrede S, Kouvonen A. Migrants face barriers to Obtaining Electronic Identification: a population-based study among older russian-speakers in Finland. J Med Syst. 2023;47(1):1–7. https://doi.org/10.1007/S10916-023-01940-5/TABLES/2.

29.

Tynkkynen LK, Pulkki J, Tervonen-Gonçalves L, Schön P, Burström B, Keskimäki I. Health system reforms and the needs of the ageing population—an analysis of recent policy paths and reform trends in Finland and Sweden, Eur J Ageing. 2022;19(2):221–232. https://doi.org/10.1007/S10433-022-00699-X/TABLES/4.

30.

Tuomisto K, Tiittala P, Keskimäki I, Helve O. Refugee crisis in Finland: Challenges to safeguarding the right to health for asylum seekers, Health Policy (New York). 2019;123(9):825–832. https://doi.org/10.1016/J.HEALTHPOL.2019.07.014.

31.

Keskimaki I, et al. Finland: Health System Review. Health Syst Transit. 2019;21(2):1–166.PubMed

32.

Huotari T, Antikainen H, Keistinen T, Rusanen J. Accessibility of tertiary hospitals in Finland: a comparison of administrative and normative catchment areas. Soc Sci Med. 2017;182:60–7. https://doi.org/10.1016/J.SOCSCIMED.2017.04.015.

33.

Ilmarinen K, Aalto A-M, Palvelujen saavutettavuus. 2023. Accessed: Jan. 23, 2024. Available: https://www.thl.fi/tervesuomi_verkkoraportit/ilmioraportit_2023/palvelujen_saavutettavuus.html.

34.

Kuusio H, Seppänen A, Jokela S, Somersalo L, Lilja E. Ulkomaalaistaustaisten terveys ja hyvinvointi Suomessa: FinMonik-tutkimus 2018–2019, 2020. Available: http://urn.fi/URN:ISBN978-952-343-034-1.

35.

Finland S. Population by language and age. Accessed: Aug. 07, 2023. Available: https://pxdata.stat.fi/PxWeb/pxweb/fi/StatFin/StatFin__vaerak/statfin_vaerak_pxt_11rl.px/table/tableViewLayout1/.

36.

Kouvonen A, Kemppainen L, Ketonen EL, Kemppainen T, Olakivi A, Wrede S. Digital information technology use, self-rated health, and depression: population-based analysis of a survey study on older migrants. J Med Internet Res. 2021;23(6). https://doi.org/10.2196/20988.

37.

Kouvonen A, Kemppainen T, Taipale S, Olakivi A, Wrede S, Kemppainen L. Health and self-perceived barriers to internet use among older migrants: a population-based study. BMC Public Health. 2022;22(1):1–12. https://doi.org/10.1186/s12889-022-12874-x.CrossRef

38.

Bombak AE. Self-rated health and public health: A critical perspective, Front Public Health. 2013;1; p. 15. https://doi.org/10.3389/FPUBH.2013.00015/BIBTEX.

39.

DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P. Mortality prediction with a single general self-rated health question: a meta-analysis. J Gen Intern Med. 2006;21(3):267–75. https://doi.org/10.1111/J.1525-1497.2005.00291.X/METRICS.

40.

Kela. Social assistance. Accessed: Sep. 28, 2022. Available: https://www.kela.fi/web/en/social-assistance.

41.

Buchert U, Kemppainen L, Olakivi A, Wrede S, Kouvonen A. Jul., Is digitalisation of public health and social welfare services reinforcing social exclusion? The case of Russian-speaking older migrants in Finland:, https://doi.org/10.1177/02610183221105035, p. 026101832211050; 2022.

42.

Greenacre MJ. Theory and applications of correspondence analysis. Academic Press, 1984. Accessed: Aug. 10, 2023. Available: https://cir.nii.ac.jp/crid/1130282272721844480.

43.

Jobson JD. Principal Components, factors and correspondence analysis. In: Jobson JD, editor. in Applied Multivariate Data Analysis. New York, NY: Springer; 1992. pp. 345–482. https://doi.org/10.1007/978-1-4612-0921-8_4.CrossRef

44.

Dalmau-Bueno A, García-Altés A, Vela E, Clèries M, Pérez CV, Argimon JM. Frequency of health-care service use and severity of illness in undocumented migrants in Catalonia, Spain: a population-based, cross-sectional study. Lancet Planet Health. 2021;5(5):e286–96. https://doi.org/10.1016/S2542-5196(21)00036-X.

45.

Wulkotte E, Bozorgmehr K. Trends and Changes in Socio-Economic Inequality in Self-Rated Health among Migrants and Non-Migrants: Repeated Cross-Sectional Analysis of National Survey Data in Germany, 1995–2017, Int J Environ Res Public Health. 2022;19(14):8304. https://doi.org/10.3390/IJERPH19148304/S1.

46.

Debesay J, Nortvedt L, Langhammer B. Social Inequalities and Health among older immigrant women in the nordic Countries: an integrative review. SAGE Open Nurs. 2022;8. https://doi.org/10.1177/23779608221084962/ASSET/IMAGES/LARGE/10.1177_23779608221084962-FIG1.JPEG.

47.

Le M, Hofvind S, Tsuruda K, Braaten T, Bhargava S. Lower attendance rates in BreastScreen Norway among immigrants across all levels of socio-demographic factors: a population-based study. J Public Health (Bangkok). 2019;27(2):229–40. https://doi.org/10.1007/S10389-018-0937-1/TABLES/4.

48.

Kalich A, Heinemann L, Ghahari S. A scoping review of immigrant experience of Health Care Access barriers in Canada. J Immigr Minor Health. 2016;18(3):697–709. https://doi.org/10.1007/s10903-015-0237-6.CrossRefPubMed

49.

Terveydenhuoltolaki 1326/2010.

50.

Eklöf N, Hupli M, Leino-Kilpi H. Nurses’ perceptions of working with immigrant patients and interpreters in Finland, Public Health Nurs. 2015;32(2):143–150. https://doi.org/10.1111/PHN.12120.

51.

Eklöf N, Hupli M, Leino-Kilpi H. Factors related to privacy of Somali refugees in health care. Nurs Ethics. 2020;27(2):514–26. https://doi.org/10.1177/0969733019855748/ASSET/IMAGES/LARGE/10.1177_0969733019855748-FIG1.JPEG.

52.

Gustafsson K, Norström E, Höglund P. Language interpreting and brokering in Swedish public service institutions: the use of children for multilingual communication. Revista De Llengua i Dret. no. 2019;71:13–26. https://doi.org/10.2436/RLD.I71.2019.3260.CrossRef

53.

Kyytsönen M, Aalto A-M, Vehko T. Sosiaali- Ja terveydenhuollon sähköinen asiointi 2020–2021: Väestön Kokemukset. THL; 2021.

54.

Samkange-Zeeb F et al. Aug., Superdiversity, migration and use of internet-based health information - Results of a cross-sectional survey conducted in 4 European countries, BMC Public Health. 2020;20(1):1–12. https://doi.org/10.1186/s12889-020-09329-6.

55.

Bergman L, Nilsson U, Dahlberg K, Jaensson M, Wångdahl J. Health literacy and e-health literacy among arabic-speaking migrants in Sweden: a cross-sectional study. BMC Public Health. 2021;21(1):1–12. https://doi.org/10.1186/S12889-021-12187-5/TABLES/6.

56.

Tan SSL, Goonawardene N. Internet Health Information Seeking and the Patient-Physician Relationship: A Systematic Review, J Med Internet Res 2017;19(1):e9 https://www.jmir.org/2017/1/e9

57.

Mathijsen A, Mathijsen FP. Diasporic medical tourism: a scoping review of quantitative and qualitative evidence. Global Health. 2020;16(1):1–15. https://doi.org/10.1186/S12992-020-00550-X/FIGURES/2.

58.

Shin YK, et al. Digital Information Technology Use and transnational Healthcare: a Population-based study on older russian-speaking migrants in Finland. J Immigr Minor Health. 2022;24(1):125–35. https://doi.org/10.1007/s10903-021-01301-9.CrossRefPubMed

Title: Self-identified barriers to health services among migrants 50 years of age or older: population-based survey study of Russian speakers in Finland
Authors: Nuriiar Safarov
Laura Kemppainen
Sirpa Wrede
Anne Kouvonen
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-024-10728-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Self-identified barriers to health services among migrants 50 years of age or older: population-based survey study of Russian speakers in Finland

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2024

Unfinished nursing care in healthcare settings during the COVID-19 pandemic: a systematic review

Physician resilience and perceived quality of care among medical doctors with training in psychosomatic medicine during the COVID-19 pandemic: a quantitative and qualitative analysis

Strategies to improve care for older adults who present to the emergency department: a systematic review

Hospital length of stay and readmission after elective surgery: a comparison of current and former smokers with non-smokers

Modelling cost-effectiveness of replacement strategies for ambulance services in the Ministry of Health Malaysia

‘It’s about time’: policymakers’ and health practitioners’ perspectives on implementing fertility care in the Gambian health system