Faculty of Social Sciences, University of Helsinki, P.O. Box 4, Yliopistonkatu 3, 00014, Finland.
Centre for Public Health, Institute of Clinical Science, Queen's University Belfast, Royal Victoria Hospital, Block A, Belfast, BT12 6BA, Northern Ireland.
J Med Syst. 2023 Apr 1;47(1):45. doi: 10.1007/s10916-023-01940-5.
As digital technologies continue to transform health care and health systems, they will continue to have a lasting impact on health services. Many health and social care services have rapidly become 'digital by default'. The electronic identification (e-ID) technology is needed for secure authentication to digital services. Recent studies have shown that the 'digital divide' is prominent between ethnic minorities and the majority populations and between older and younger adults. Inequalities related to not having an e-ID, which is in many countries required to access digital health services, remain under-researched. Moreover, there is a lack of knowledge of the use of digital services among older migrants. This study analyses general socio-demographic as well as migration specific factors that may be associated with not having an e-ID among older migrants. We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥ 50 years living in Finland (N = 1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Our results showed that 21% of older Russian-speakers did not have an e-ID. Our regression analysis showed that older age and poorer economic situation were associated with a lower probability of having an e-ID. In addition, we found an association between not speaking local languages and not having an e-ID. This may relate to private banks regulating the requirements for obtaining the most common e-ID method, online banking ID. We argue that for individuals who are already in vulnerable positions, current e-ID practices might pose yet another obstacle to obtaining the health services they need and are entitled to.
随着数字技术继续改变医疗保健和医疗系统，它们将继续对医疗服务产生持久影响。许多医疗和社会保健服务已经迅速成为“默认数字化”。电子身份识别 (e-ID) 技术是安全访问数字服务所需的。最近的研究表明，少数民族和多数人群之间以及老年人和年轻人之间存在明显的“数字鸿沟”。在许多国家，无法获得电子身份证以访问数字健康服务的不平等现象仍然没有得到充分研究。此外，老年人移民对数字服务的使用知之甚少。本研究分析了可能与老年移民没有电子身份证相关的一般社会人口统计学因素以及移民特定因素。我们使用了 Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) 研究，该研究是一项针对居住在芬兰的 50 岁及以上讲俄语的成年人（N=1082，57%为男性，平均年龄 63.2 岁，标准差 8.4 岁，应答率为 36%）的全国代表性调查。我们的结果表明，21%的老年俄语使用者没有电子身份证。我们的回归分析表明，年龄较大和经济状况较差与获得电子身份证的可能性较低有关。此外，我们发现不使用当地语言与没有电子身份证之间存在关联。这可能与私人银行监管获得最常见的电子身份证方法，即在线银行 ID 的要求有关。我们认为，对于已经处于弱势地位的个人来说，当前的电子身份证实践可能会对他们获得所需和应得的医疗服务构成又一障碍。
