Table 2 Barriers and Facilitators of Health and Well-Being among Older Adult Immigrants in the United States
Barriers | Facilitators | |
|---|---|---|
Individual | - Lack of English language proficiency - Refugee status (as a proxy for trauma) - Loss of independence - Low health literacy - Loss of a spouse - Lack of SES resources - Loss of independence - Dementia/memory loss - Poor physical health - Depression - Chronic pain - Chronic conditions - Sleep issues/Insomnia | - Owning a personal vehicle/ability to drive - English language proficiency - Formal education in the U.S - Resilience - Positive emotions (ex: optimism, positive affect) and psychological well-being - Maintaining one’s native language and traditions - Traditional medicine/Holistic approaches to health - Life satisfaction - Proper nutrition - Leisure time - Sexual health knowledge |
Interpersonal | - Isolation - Social exclusion - Discrimination based on racial/ethnic/gender identity - Loss of previous social status - Financial abuse - Older adult abuse - Healthcare providers misinterpreting immigrants health service expectations and feeling unprepared to work with immigrants - Expectational role friction | - Social support - Culturally sensitive providers/culturally appropriate care - Receiving professional care -Provider and treatment trust - Opportunities for them to share their life experiences and knowledge with others, such as teaching cuisine/food - Liaisons, “helpers” from the immigrant community to aid other immigrants [48] - Social capital - Trust |
Organizational | - Discrimination based on racial/ethnic identity - Limited access to support services - Lack of preventative care - High cost of medical care/financial concerns - Issues accessing medical care | - Healthcare access - Translated materials—that are culturally relevant - Provision of culturally relevant information - Traditional medicine/Holistic approaches to health -Health education - Participation in activities (ex: social, cognitive, spiritual/religious, physical) - Culturally meaningful activities - Resource access (in addition to healthcare) - Group excursions, or “field trips”18 - Home health care services |
Community | - Lack of available, and inaccessible, transportation -The built environment – Lack of safety and walkability - Poverty - Discrimination based on racial/ethnic identity | - Neighborhood cohesiveness - The built environment - Available public transport - Healthcare access - Availability of care - Community trust |
Structural | - Discrimination based on racial/ethnic/gender identity - The 1996 Personal Responsibility and Work Opportunity Reconciliation Act - Lack of citizenship/temporary status - Lack of insurance | - Citizenship - Health insurance |