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Abstract Background The compounded effect of a migratory background and ageing increases the risk of unequal medical treatment opportunities. The aim of this article is to investigate the social determinants of barriers to health services. Methods The study uses population-based survey data of Russian-speaking migrants (50 + years) residing in Finland (n = 1082, 57% of men, mean age 63 years). Multiple correspondence analysis was performed as a dimension reduction procedure on six barriers to health services. Multiple ordinary least-squares linear regression was used for the predicted score of the barriers as an outcome variable. Results Most of the sociodemographic characteristics were not associated with barriers to health services, except gender, as women tended to face more disadvantages. Migration-related factors, such as the need for interpreters for health services and experienced discrimination, were associated with an increased likelihood of reporting barriers to health services. Using the internet as a primary source of health information was associated with more access barriers to health services. Conclusions Migrants 50 years of age or older face multiple barriers to health services. Given that the healthcare needs increase with age, addressing this issue becomes crucial, necessitating improved access to health services for older migrants.

Abstract Background In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants. Methods 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%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response. Results After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p

BackgroundPrevious studies have found that in general, poor health is associated with a lower likelihood of internet use in older adults, but it is not well known how different indicators of health are associated with different types of digital information technology (DIT) use. Moreover, little is known about the relationship between health and the types of DIT use in older ethnic minority and migrant populations. ObjectiveThe aim of this study is to examine the associations among depressive symptoms and self-rated health (SRH) with different dimensions of DIT use in older migrants. MethodsWe analyzed data from the Care, Health and Ageing of Russian-speaking Minority (CHARM) study, which is based on a nationally representative sample of community-dwelling, Russian-speaking adults aged 50 years or older residing permanently in Finland (men: 616/1082, 56.93%; age: mean 63.2 years, SD 8.4 years; response rate: 1082/3000, 36.07%). Data were collected in 2019 using a postal survey. Health was measured using depressive symptoms (measured using the Center for Epidemiologic Studies Depression Scale) and SRH. Binary logistic regression analyses were used to investigate the associations between the two health indicators and the following six outcomes: daily internet use, smartphone ownership, the use of the internet for messages and calls, social media use, the use of the internet for personal health data, and obtaining health information from the internet. A number of sociodemographic and socioeconomic factors were controlled for in the logistic regression regression analysis. Analyses were performed with weights accounting for the survey design and nonresponse. ResultsAfter adjusting for sociodemographic and socioeconomic factors, depressive symptoms (odds ratio [OR] 2.68, 95% CI 1.37-5.24; P=.004) and poor SRH (OR 7.90, 95% CI 1.88-33.11; P=.005) were associated with a higher likelihood of not using the internet daily. Depressive symptoms (OR 1.88, 95% CI 1.06-3.35; P=.03) and poor SRH (OR 5.05, 95% CI 1.58-16.19; P=.006) also increased the likelihood of smartphone nonuse. Depressive symptoms were additionally associated with a lower likelihood of social media use, and poor SRH was associated with a lower likelihood of using the internet for messaging and calling. ConclusionsPoor SRH and depressive symptoms are associated with a lower likelihood of DIT use in older adults. Longitudinal studies are required to determine the directions of these relationships.

The editorial team introduces the journal.

Diaconal workers of the Evangelical Lutheran Church of Finland have traditionally worked on the borderline between parish work and public welfare services. However, the role of parish diaconal workers in social services and nursing services has diminished as the Finnish welfare state has expanded. In conjunction with this downsizing, the so-called intra-church diaconate process has re-demarcated parish diaconal work. Andrew Abbott’s theory of how professional jurisdictions are negotiated in the societal arenas in which different actors are engaged inspired the analysis in this article. Using Thomas F. Gieryn’s concept of boundary work, the jurisdictional settlements that reshape professional parish diaconal work are examined. It is argued that institutional boundary work and disputes over whether the culture of diaconal work is secular or spiritual, serve to renew its cultural jurisdiction.