IMMIGRANTS AND

REFUGEES: AGING

ISSUES & CHALLENGE

S

Muthoni Imungi, Assistant ProfessorSchool of Social Work

Grand Valley State University

DEFINITIONS

• Who is a “REFUGEE”

• 1951 Convention Relating to the Status of Refugees (28 July, 1951) defines a refugee as

• Any person who is outside their country of origin and unable or unwilling to return there or to avail themselves of its protection, on account of a well-founded fear of persecution for reasons of race, religion, nationality, membership of a particular group, or political opinion.

DEFINITION

• Who is an “IMMIGRANT”

• An immigrant is anyone who moves from one country to another with the intention of settling there permanently

DIFFERENCE BETWEEN THE TWO

• IMMIGRANT• Makes the decision

to migrate

• Often safe journey

• Is able to return to their home country

• 37.9 million in 2007

• REFUGEE

• Is forced to migrate

• Arduous and dangerous journey taking days, months.

• Most often do not have the ability to return home

• 48,281 in 2007

U.S. IMMIGRATION POLICY

• Three sets rules:

1 Govern legal migration, mainly family reunification or employment. U.S. citizens 21 or older could sponsor the immigration of their PARENT’S, as well as spouses and minor children. [IMMIGRANTS]

2 Govern humanitarian reasons for entering the U.S. i.e. those fleeing oppressive political regimes, parolees and those admitted during emergency situations [REFUGEES AND ASSYLUM SEEKERS].

3 Govern illegal immigration [UNDOCUMENTED IMMIGRANTS]

WELFARE POLICY INFLUENCE

• Type of entry governs social welfare entitlements

• REFUGEES

• Are entitled to special assistance similar to those of U.S. citizens i.e. SSI, AFDC, TANF, Medicaid, food stamps (Refugee Act of 1980)

• IMMIGRANTS

• Are excluded from federally funded program for the first 5 years (PROWRA Act of 1996)

WHY FOCUS ON OLDER ADULTS

• In 1900s older adults comprised 5% of the population

• According to a recent census older adults comprised 12.7% of the population or 33 million people

• Trend towards a growing older adult population is expected to continue to rise as more adults live into late life

OTHER CHANGES IN THE OLDER ADULT POPULATION• The older adult population will increase in diversity

• Between 1990 and 2050 the non-white older adult population in the U.S. is projected to double from 10.2% to 21.3% (0thers 16% to 32.6%)

• Between 1990 and 2050 the Asian population over the age of 65 increase by 625% followed by Hipsanic, Native American and African Americans at the rate of 150%

• At the turn of the century, the non-Hispanic-white population will account for approximately 72% of the U.S. Population, by 2050 they will account for less than 53% of that same populatin

REASON FOR DIVERSITY

• Older adults resettled as refugees and immigrants

• Aging of younger cohorts of immigrants

• Immigration• Over the past 40 years immigration

streams have shifted towards Africa, Asia and Latin America

• Family reunification, enable older parents immigrate

KNOWLEDGE GAPS

• Little research on older adults in general because the comprise a small percentage of the population

• Event less is known of the health or health trajectories in older immigrants and refugees

• Increase in number of older immigrants and refugees in the U.S. presents a new challenge to practitioners and policy makers concerned with promoting healthy aging.

AGING CHALLENGE

SIMMIGRANTS AND REFUGEES

LANGUAGE

• Many older adults who immigrate later in life from non-English speaking countries do not speak English

• For example, in 20001• 4.5% of older adult Asian Immigrants spoke English

well• 42.8 spoke English less than very well• 18.6 had graduate/professional degrees

• No research evidence suggests that older adults cannot successfully learn another language, however, evidence finds that it is easier for pre-pubescent children to acquire language faster and speak it without an accent

ACCULTURATION

• LANGUAGE• Lack of language hampers acculturation.

• MOBILITY• Older adults may also be more home-bound

resulting in less interaction with mainstream culture, thereby hampering acculturation

• Older age at immigration is associated with lower levels of acculturation, acculturative stress and depression.

• DIFFERING RATES OF ACCUTURATION• Differential rates of acculturation within families

are source of distress• It is near impossible for older immigrants to

achieve complete assimilation to a new culture

LOSS

• LOSS OF FAMILIARITY AND NETWORKS• Older adults had previously established roots,

relationships and a familiar way of life in their home country

• Moving to a new culture where they have few if any network and no established way of life can lead to feelings of loss

• Feelings of loss and isolation are common

• VIEW OF OLDER ADULTS• Many come from cultures where old age is equated

with wisdom and privilege to a culture where it is associated with loss of productivity

• Loss of status is experienced

LIVING ARRANGEMENTS

• MULTIGENERATIONAL LIVING ARRANGEMENTS

• Most immigrants who arrive as older adults are sponsored by their adult children through family unification

• Older adults are unlikely find employment or may not able to work. Without a source of income they often live with their children’s families

• Having to share space with their young children is often a radically different living arrangement that can be a source of distress and depression

• Multiple generation households can also lead to strained relationships

• According to the 2000 U.S. census approx. 50% of immigrants 65 years and older lived in the homes of their children compared to 4% of older U.S. born immigrants

LIVING ARRANGEMENTS

• POOR HOUSING

• Older adults immigrating in the past 20 years are likely to live in the inner city in substandard and overcrowded housing which sometimes lacks basic necessities

• The living conditions have implications for

• Physical health

• Mental health

• Safety

HEALTH• PROWRA (1996)

• Barred legal immigrants admitted after September 1996 from many federal and state benefits. States can also bar legal permanent resident aliens from TANF, AFDC and Medicaid.

• This waiver is especially aimed at baring sponsored immigrants from becoming a public charge

• Public welfare and immigration policy place responsibility for taking care of older adults solely on family members

• Taking care of older adults can be especially burdensome to immigrants and refugees with limited social support and knowledge of resources

• A study in Canada found that recent older adult immigrants, had poorer health than longer-domiciled immigrants or Canadian citizens

HEALTH

• Older adults may suffer poor health because

• They are not be able to see health practitioners due to high cost and lack of insurance

• Older adults may not mention their poor health for fear of further burdening the family

• Lack of understanding of the health system and cultural norms may prevent their seeking health care

MENTAL HEALTH

• Isolation, limited language ability, loss, poor health can be a source of depression and anxiety among older adults

• Refugees may especially be prone to poorer health and PTSD

• Older adult immigrants however may not seek mental health services for these problems because they may not be familiar with the disorders or symptomatology

ELDER ABUSE

• The limited acculturation, language ability and income of older adults immigrants means that many of them will depend on family member for financial support, transport, language an cultural brokering.

• This sense of responsibility can be overwhelming for family members that can lead to elder abuse

• Physical Abuse

• Financial abuse

• Emotional abuse

INTERVENTIONS

INTERVENTIONS

1 Language classes tailored for older adult

2 Acculturation and adaptation services

3 Sensitization about mental health disorders

4 Access to culturally competent mental health and health practitioners

5 Funding for mental health and health care services

6 Adult day care services/friendship classes

7 Family preservation programs

8 Advocate for policy changes

Research Interventions

• To provide appropriate services to older immigrants from diverse backgrounds service providers need to understand their race/ethnicity, culture, immigration history, acculturation level and family relationships.

• Need to understand health status and health behaviors

Research

• Little research looking at within group diversity

• Asian immigrants constitute people from over 20 different nations

• Most research aggregates cultural groups as one thereby masking important health disparities