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从欧洲视角看移民中的老龄化与健康问题。

Aging and health among migrants in a European perspective.

作者信息

Kristiansen Maria, Razum Oliver, Tezcan-Güntekin Hürrem, Krasnik Allan

机构信息

1Center for Healthy Aging (CEHA), Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

2Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany.

出版信息

Public Health Rev. 2016 Oct 26;37:20. doi: 10.1186/s40985-016-0036-1. eCollection 2016.

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.

摘要

人口老龄化以及相关的人口结构变化和医疗保健需求是整个欧洲面临的一项关键挑战。健康老龄化战略侧重于确保老年人维持健康、生活质量和独立生活的能力。在人口老龄化进程的同时,欧洲的人口结构受到移民增加的影响,导致了显著的种族多样性。在本文中,我们对欧洲日益增多的老年移民的健康状况进行了叙述性综述,概述了影响这一多样化群体健康的关键因素,并探讨了满足他们医疗保健需求的方法。尽管影响老龄化进程的因素在不同人群中大致相似,但存在特定于移民的风险因素。这些因素包括移民前和移民期间接触健康风险;社会经济地位更为不利;语言障碍和健康素养低下;影响就医行为的文化因素;以及影响健康和生活质量的心理社会脆弱性和歧视。总体而言,移民与本地人口经历相同的发病和死亡原因,但相对重要性、严重程度和发病年龄不同,而且移民群体内部和群体之间存在很大差异。尽管已发现癌症筛查行为存在差异,但对于老年移民的健康行为知之甚少。随着年龄增长,移民与本地人口之间健康差距不断扩大以及老年移民获得高质量医疗保健存在非正式障碍,这些迹象令人担忧。总之,除了健康老龄化的其他决定因素外,还需要关注移民问题。移民个体特征、生命历程过程和影响老龄化进程的背景因素的多样性表明,在健康老龄化领域,需要采取敏感且全面的政策、实践和研究方法。这对于满足欧洲日益增多的老年移民的需求以及消除老年健康和福祉方面的不平等现象至关重要。

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