Healthy ageing among immigrants

The number of older people is rising rapidly; in the Netherlands, it is expected to increase more among immigrants (by 163%) than among natives (by 44%) between 2009 and 2025. Most immigrants live in large cities, with Turks, Surinamese, and Moroccans comprising the largest groups in the Netherlands. Poor health, chronic diseases, and functional limitations are much more prevalent among these immigrant populations than among natives. Health behaviours, such as smoking, eating habits, and physical activity, play a crucial role in these health problems and differ between immigrants and natives. For example, in the Netherlands, the prevalence of overweight is much higher among immigrants and the prevalence of smoking is especially high among Turks. These differences in health and health behaviour can be attributed only partly to differences in socio-economic status.            

Sociocultural differences make it especially difficult for healthcare organisations to reach older immigrants effectively. Immigrant-sensitive healthcare interventions are needed, requiring insight into underlying sociocultural mechanisms explaining differences in health and health behaviour between older natives and immigrants. These insights will likely have important implications for preventive and curative healthcare delivery. Social influence, for example, is known to be related to smoking and eating and likely differs among cultures. Food consumption is embedded in cultural norms, such as hospitality and politeness, which are greatly valued in most immigrant groups. Cultural norms may be incongruent with lifestyle advice, which likely results in negative, rather than positive, effects of the social environment through negative role models and peer pressure to adhere to these norms, rather than by supporting family members to engage in healthy behaviours. Another sociocultural mechanism that may explain health differences between older Dutch natives and immigrant community-dwellers is the perception of ageing among older immigrants (e.g. beliefs about the health impacts of ageing, personal management of one's ageing experience). Perceptions of ageing are known to affect health and health behaviour, and are expected to vary among cultures.            

Inadequate understanding of the role of sociocultural mechanisms in health and health behaviour compromises the design and implementation of effective healthcare delivery and health promotion strategies for older immigrants. To improve (preventive) healthcare delivery quality and effectiveness for older immigrants, and to deliver care tailored to their needs, research on the sociocultural mechanisms leading to their poorer health and health behaviours is needed. Thus, this study aims to:

  1. Validate instruments assessing perceptions of ageing and social influence on health behaviours among older Dutch natives and immigrants (Turks, Surinamese, and Moroccans).
  2. Identify differences in perceptions of ageing between older Dutch natives and immigrants.
  3. Identify differences in the influence of the social environment on health behaviour between older Dutch natives and immigrants.
  4. Identify differences in health and health behaviours between older Dutch natives and immigrants.
  5. Identify and compare the relationships between the influences of the social environment and perceptions of ageing on health and health behaviours between older Dutch natives and immigrants over time.

This study will increase our understanding of the interplay between the influences of perceptions of ageing and the social environment on health and health behaviours among older Dutch natives and immigrants. These insights will support the effective tailoring of services and interventions aiming to promote healthy ageing among older immigrants, and lead to recommendations for the implementation of immigrant-sensitive healthcare delivery. Interventions aiming to encourage a more positive perception of ageing, for example, may influence health and health behaviours. Positive perceptions of ageing and perceived control over ageing-related experiences enhance older people’s abilities to cope with challenges and demands as they age. Understanding the role of social influence on health behaviours in certain groups/networks can inform the development of interventions targeting such social networks.

Publications from this project

Slotman, A., Cramm, J.M., Nieboer, A.P. (2015). The Ageing Perceptions Questionnaire (APQ): an Examination of its Psychometric Properties and Development of the Shortened APQ among Dutch Community-dwelling Elders. Health and Quality of Life Outcomes. 13:54 doi:10.1186/s12955-015-0248-y.