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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]

Research points to a higher risk for social isolation and loneliness among new immigrant and refugee older adults. Our article draws from a research project that explored the everyday stories of ageing among 19 diverse immigrant older adults in Canada. To capture their experiences of loneliness and social isolation, we use four illustrative cases derived from a structural approach to life-story narrative. To these we apply the intersectional lifecourse analytical lens to examine how life events, timing and structural forces shape our participants' experiences of social isolation and loneliness. We further explore the global and linked lives of our participants as well as the categories of difference that influence their experiences along the continua of loneliness to belonging, isolation to connection. Finally, we discuss how an understanding of sources of domination and expressions of agency and resistance to these forces might lead us to solutions. [ABSTRACT FROM AUTHOR]

Much of the literature discusses filial piety in general and ambiguous terms. This study, in contrast, investigates specific perceptions of filial piety and parental expectations of filial duty among older Chinese immigrants in Canada. The study is based on thematic analysis of 46 Chinese immigrants in seven focus groups conducted in the Greater Toronto Area. Findings show the perceptions of filial piety varied, but almost all participants had reduced expectations of their children. Nevertheless, they still valued and expected emotional care from their children. The study argues that changes in institutional settings, social policies and welfare systems define parents' support needs and affect their expectations in the host society, while norms and institutional settings in the place of origin influence their perceptions of filial piety. [ABSTRACT FROM AUTHOR]