Older immigrants: language competencies and mental health

Pathways of aging in migration and their association with the quality of life

This study adopted a life course approach in exploring the quality of life of old migrants based on the experiences of Korean Australians aged 60 years and over. Pathways of aging were considered as related to the aging progress in migration, and three different groups were identified: aged with a migrant background (those who migrated when they were younger and had grown old in the destination country), family migrants (those who accompanied/were invited by their children), and retirement migrants (those who chose to migrate in later life independent of their children). The study identified elements of quality of life particularly meaningful to specific groups. The findings of this study may help in broadening the knowledge base of the diverse aging experiences of migrants and to inform policy and the development of programs to support elderly migrants.

Competing challenges for immigrant seniors: Social isolation and the pandemic

The pandemic has exposed and amplified complex and complicated health and societal challenges while offering immense opportunities to transform societies to improve health for all. Social isolation is a challenging and persistent issue experienced by many older adults, especially among immigrant and refugee seniors. Unique risk factors such as racism, discrimination, language barriers, weak social networks, and separation from friends and family predispose immigrant and refugee seniors to a higher risk of social isolation. The pandemic has magnified the unique risks and has highlighted the differential health and economic impacts. This article examines social isolation among immigrant and refugee seniors in Canada by focusing on the policy context, available programs and services to reduce social isolation, and the conceptualization and measurement considerations for advancing research to address social isolation among this growing population. Drawing on specific examples, we discuss immigration, aging, and social isolation within the context of Canada. While our article focuses on Canada as a case study, our discussion has relevancy and implications for other high-income countries with aging immigrant and refugee populations. In moving forward, we argue that a more complete and targeted understanding of social isolation is essential to informing program and policy development to support immigrant and refugee seniors in Canada and beyond. The transformation needed in our societies to create health for all requires strong equity and determinants of health perspective and a systems approach beyond health to ensure lasting change.

Primary Care and Access to Mental Health Consultations among Immigrants and Nonimmigrants with Mood or Anxiety Disorders: Soins de première ligne et accès aux consultations en santé mentale chez les immigrants et les non-immigrants souffrant de troubles de l'humeur ou anxieux

OBJECTIVE

To examine the association between usual place of primary care and mental health consultation among those with self-reported mood or anxiety disorders. We also describe access to mental health services among people who are recent immigrants, longer-term immigrants, and nonimmigrants and determine whether the association with place of primary care differs by immigration group.

METHODS

We used data from the Canadian Community Health Survey (2015 to 2016) to identify a representative sample of individuals with self-reported mood or anxiety disorders. We used logistic regression, with models stratified by immigration group (recent, longer-term, nonimmigrant), to examine the association between usual place of primary care and receiving a mental health consultation in the previous 12 months.

RESULTS

Higher percentages of recent and longer-term immigrants see a doctor in solo practice, and a higher percentage of recent immigrants use walk-in clinics as a usual place of care. Compared with people whose usual place of care was a community health center or interdisciplinary team, adjusted odds of a mental health consultation were significantly lower for people whose usual place of care was a solo practice doctor's office (AOR = 0.71; 95% CI, 0.62 to 0.82), a walk-in clinic (AOR = 0.75; 95% CI, 0.66 to 0.85), outpatient clinic/other place (AOR = 0.72 95% CI, 0.59 to 0.88), and lowest among people reporting no usual place other than the emergency room (AOR = 0.59; 95% CI, 0.51 to 0.67). Differences in access to mental health consultations by usual place of primary care were greatest among immigrants, especially recent immigrants.

CONCLUSIONS

People with mood or anxiety disorders who have access to team-based primary care are more likely to report mental health consultations, and this is especially true for immigrants. Expanded access to team-based primary health care may help reduce barriers to mental health services, especially among immigrants.

Social isolation and loneliness among immigrant and refugee seniors in Canada: a scoping review

Purpose

Social isolation and loneliness are global issues experienced by many seniors, especially immigrant and refugee seniors. Guided by the five-stage methodological framework proposed by Arksey and O’Malley and more recently Levac, Colquhoun and O’Brien, the purpose of this paper is to explore the existing literature on social isolation and loneliness among immigrant and refugee seniors in Canada.

Design/methodology/approach

The authors conducted a literature search of several databases including: PubMed; MEDLINE; CINAHL; Web of Science; HealthStar Ovid; PschyInfo Ovid; Social Services Abstracts; AgeLine; Public Health Database, Google Scholar and Cochrane Library. In total, 17 articles met the inclusion criteria.

Findings

Based on the current literature five themes related to social isolation and loneliness emerged: loss; living arrangements; dependency; barriers and challenges; and family conflict.

Research limitations/implications

Given the increasing demographic of aging immigrants in Canada, it is useful to highlight existing knowledge on social isolation and loneliness to facilitate research, policy and programs to support this growing population.

Practical implications

The population is aging around the world and it is also becoming increasingly diverse particularly in the high-income country context. Understanding and addressing social isolation is important for immigrant and refugee seniors, given the sociocultural and other differences.

Social implications

Social isolation is a waste of human resource and value created by seniors in the communities.

Originality/value

The paper makes a unique contribution by focusing on immigrant and refugee seniors.

Mental Health and Service Issues Faced by Older Immigrants in Canada: A Scoping Review

Une population vieillissante et la croissance de la population sur la base de l’immigration nécessitent que la recherche, la pratique et la politique doivent se concentrer sur la santé mentale des immigrants âgés, surtout parce que leur santé mentale semble se détériorer au fil du temps. Cette revue se concentre sur: Qu’est-ce que l’on sait sur les déterminants sociaux de la santé mentale chez les immigrants âgés, et quels sont les obstacles à l’accès aux services de santé mentale confrontés par les immigrants âgés? Les résultats révèlent que (1) les déterminants sociaux décisifs de la santé mentale sont la culture, le sexe et les services de santé; (2) que les immigrants plus âgés utilisent les services de santé mentale de moins que leurs homologues nés au Canada à cause des obstacles tels que, par exemple, les croyances et les valeurs culturelles, un manque de services culturellement et linguistiquement appropriées, des difficultés financières, et l’âgisme; et (3) quelles que soient les sous-catégories dans cette population, les immigrants âgés éprouvent des inégalités en matière de la santé mentale. La preuve des recherches disponibles indique que de combler les lacunes des service de santé mentale devrait devenir une priorité pour la politique et la pratique du système de soins de santé au Canada.

Social support, social conflict, and immigrant women's mental health in a Canadian context: a scoping review

ACCESSIBLE SUMMARY

Social support has positive and negative dimensions, each of which has been associated with mental health outcomes. Social networks can also serve as sources of distress and conflict. This paper reviews journal articles published during the last 24 years to provide a consolidated summary of the role of social support and social conflict on immigrant women's mental health. The review reveals that social support can help immigrant women adjust to the new country, prevent depression and psychological distress, and access care and services. When social support is lacking or social networks act as a source of conflict, it can have negative effects on immigrant women's mental health. It is crucial that interventions, programmes, and services incorporate strategies to both enhance social support as well as reduce social conflict, in order to improve mental health and well-being of immigrant women.

ABSTRACT

Researchers have documented the protective role of social support and the harmful consequences of social conflict on physical and mental health. However, consolidated information about social support, social conflict, and mental health of immigrant women in Canada is not available. This scoping review examined literature from the last 24 years to understand how social support and social conflict affect the mental health of immigrant women in Canada. We searched MEDLINE, PsycINFO, CINAHL, Healthstar, and EMBASE for peer-reviewed publications focusing on mental health among immigrant women in Canada. Thirty-four articles that met our inclusion criteria were reviewed, and are summarized under the following four headings: settlement challenges and the need for social support; social support and mental health outcomes; social conflict and reciprocity; and social support, social conflict, and mental health service use. The results revealed that social support can have a positive effect on immigrant women's mental health and well-being, and facilitate social inclusion and the use of health services. When social support is lacking or social networks act as a source of conflict, it can have negative effects on immigrant women's mental health. The results also highlighted the need for health services to be linguistically-appropriate and culturally-safe, and provide appropriate types of care and support in a timely manner in order to be helpful to immigrant women.

Immigrant Mental Health, A Public Health Issue: Looking Back and Moving Forward

The Mental Health Commission of Canada's (MHCC) strategy calls for promoting the health and wellbeing of all Canadians and to improve mental health outcomes. Each year, one in every five Canadians experiences one or more mental health problems, creating a significant cost to the health system. Mental health is pivotal to holistic health and wellbeing. This paper presents the key findings of a comprehensive literature review of Canadian research on the relationship between settlement experiences and the mental health and well-being of immigrants and refugees. A scoping review was conducted following a framework provided by Arskey and O'Malley (Int J Soc Res Methodol 8:19-32, 2005). Over two decades of relevant literature on immigrants' health in Canada was searched. These included English language peer-reviewed publications from relevant online databases Medline, Embase, PsycInfo, Healthstar, ERIC and CINAHL between 1990 and 2015. The findings revealed three important ways in which settlement affects the mental health of immigrants and refugees: through acculturation related stressors, economic uncertainty and ethnic discrimination. The recommendations for public health practice and policy are discussed.

Inequalities in the use of health services between immigrants and the native population in Spain: what is driving the differences?

In Spain, a growing body of literature has drawn attention to analysing the differences in health and health resource utilisation of immigrants relative to the autochthonous population. The results of these studies generally find substantial variations in health-related patterns between both population groups. In this study, we use the Oaxaca-Blinder decomposition technique to explore to what extent disparities in the probability of using medical care use can be attributed to differences in the determinants of use due to, e.g. a different demographic structure of the immigrant collective, rather than to a different effect of health care use determinants by nationality, holding all other factors equal. Our findings show that unexplained factors associated to immigrant status determine to a great extent disparities in the probability of using hospital, specialist and emergency services of immigrants relative to Spaniards, while individual characteristics, in particular self-reported health and chronic conditions, are much more important in explaining the differences in the probability of using general practitioner services between immigrants and Spaniards.