Search

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. [ABSTRACT FROM AUTHOR]

The majority of refugees are children and youth and their integration and life-course transitions are a research priority. This paper examines the timing of refugee children and youths' entrance into the labour market and family formation (marriage/common law union and parenthood). It does so by examining how admission category, knowledge of a host country's official languages, and age at arrival shape their transition to adulthood. Using data from the Canadian Longitudinal Immigration Database and Heckman selection estimation, the paper finds minimal variation in refugee children and youths' entry into the labour market compared to children of other immigrant streams. It also finds that refugee children and youth start forming families at a younger age than children of economic class immigrants, but at an older age than family class children. The analysis also shows limited effects of knowledge of official language prior to arrival while age at arrival has a robust impact on their adulthood transitions. These findings shed light on the unique patterns of life-course transition among refugee children and youth and contribute to a better conceptualization of their experiences relative to children and youth of other immigrants. [ABSTRACT FROM AUTHOR]