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1.
Objectives. Many older people in the UK require means-tested and health-related benefits to supplement low incomes in retirement and pay for additional resources required to cope with ill-health. Ethnic minority older people have lower uptake of welfare services than white older people. This study investigated routes to the service, barriers to claiming and explored the impact of additional financial resources among ethnic minority elders by evaluating a novel welfare rights advice service which facilitated access to state benefit entitlements.

Design. Qualitative study using data from one-to-one interviews with ethnic minority elders from Newcastle upon Tyne, UK analysed using the Framework method. Participants were recruited to this study from among ethnic minority elders attending a full benefits assessment offered by Newcastle Welfare Rights Service.

Results. Twenty-two South Asian participants aged between 50 and 81 were interviewed. Nineteen participants were above state retirement age, 15 of whom were on means-tested state benefits. Knowledge of state entitlements was extremely low. Sixteen qualified for non-means-tested health benefits; six qualified for further means-tested state benefits. Additional resources had a considerable impact on participants and their families. Participants could better afford essential items such as food, bills, shoes, clothes and ‘one off’ payments. Less stress, increased independence and better quality of life were reported. Welfare rights advice also had a positive impact on carers, none of whom knew what they or their relatives were entitled to.

Conclusions. As with older people of all backgrounds, facilitating access to state benefit entitlements with appropriate services is an important way of increasing the resources of ethnic minority older people on low incomes and/or in poor health. Such services can also significantly improve quality of life for carers. As the numbers of ethnic minority older people will rise over the next few decades, it is necessary to meet this need with linguistically and culturally appropriate welfare rights services. To do otherwise will exacerbate existing income and health inequalities.  相似文献   


2.
Older lesbian and gay people can face considerable marginalisation, which may affect their perceptions and experiences of accessing health and aged care services. To inform strategies promoting accessibility, this study aimed to investigate perceived barriers and facilitators to health and aged care service access among older lesbian and gay adults. A sample of 752 cisgender lesbian women and gay men aged 60 years and older living in Australia responded to questions on a broad range of potential barriers and facilitators to service access. Several barriers and facilitators were commonly reported, with some differences between the women and the men. LGBTI inclusiveness was among commonly reported concerns. A majority of participants reported a lack of LGBTI-inclusive service providers and professionals as a barrier. A majority also reported a perceived lack of professionals adequately trained and competent to work with LGBTI individuals, with significantly more women than men indicating this as a barrier. Almost all participants indicated LGBTI-inclusive mainstream services as a facilitator for access. In all, inclusiveness appears to be a key issue for service access among older lesbian and gay people, which may need to be further addressed by service providers and policy makers for improving service accessibility.  相似文献   

3.
The objective of the present paper is to explore levels of social service provision, the barriers to receiving these services and the experiences of social service provision amongst older people with heart failure. Five hundred and forty-two people aged over 60 years with heart failure were recruited from UK general practices in four areas of the UK, and these subjects completed quality-of-life and service-use questionnaires every 3 months for 24 months, or until death. Forty patients participated in in-depth interviews. Data collection was conducted between September 2003 and March 2006. Only 24% (n = 127) of the 460 participants who had provided information about social services contact reported having received social services during the past 24 months. Significant associations between the level of social services contact and participant characteristics were identified, with women, participants over 75 years of age, participants living alone, and those with two or more comorbidities being more likely to report receipt of social services. The qualitative data identified key barriers to using social services, including: access problems; not wanting additional help; the negative experiences of friends; and carers substituting for statutory services. The few participants interviewed who had received social services reported mixed experiences, including problems with inappropriate and insufficient services. This study indicates that only a minority of older people with heart failure have contact with social services. Improving provision for this group involves tackling the barriers to access identified above, as well as ensuring that their views influence service planning and delivery.  相似文献   

4.
Drawing on quantitative data from a large study, we explored service providers' perceptions of the care and support provided to older women from Black and minority ethnic backgrounds living in the UK. Analyzing 102 responses to a questionnaire, we found that the care needs of this group of older women were not adequately addressed, with ineffective communication being frequently reported. A number of information pathways and barriers to service provision were identified. More work is needed to explore not only how best to acknowledge diversity in care needs within older populations, but also to design and deliver responsive services accordingly.  相似文献   

5.
Sexual and/or gender minority young people who are also members of an ethnic minority can experience unique challenges. Limited research draws directly on the mental health experiences of these ‘double minority’ youth. This study focused on Chinese sexual/gender minority youth in New Zealand. It sought to explore features they found challenging for, or supportive of, their mental health and wellbeing. Semi-structured interviews were conducted with 11 Chinese sexual/gender minority participants aged between 19 and 29 years old and residing in Auckland, New Zealand. An inductive approach to qualitative data analysis was used. Two major domains of findings emerged. Firstly, participants described mental health challenges linked to racism, sexism, cis-heteronormativity and challenges in relation to intersecting identities. Secondly, Chinese culture and community connections, family and peer support and role models seemed to facilitate resiliency. However, the fear of ‘losing face’, unwillingness to disclose distress when unwell and mental health service providers’ lack of cultural and linguistic competency were described as barriers to effective mental health support. In conclusion, Chinese and sexual/gender minority identities were integral parts of participants’ sense of self, and this was associated with their mental health and wellbeing. Further research is required to explore ways to reduce barriers and promote resiliency.  相似文献   

6.
Objective: To evaluate the parents’ perceived unmet needs in early childhood healthcare services among Indigenous, non‐English‐speaking background (NESB) and English‐speaking background (ESB) children and the related barriers. Method: Data was from the Longitudinal Study of Australian Children (LSAC). Rao‐Scott chi‐square was used to examine the level of parents’ perceived unmet needs in three ethnic groups in early childhood healthcare services over a 12 month period. Survey logistic regression was used to assess the association between the groups of infants and the barriers to utilisation. Results: Ten per cent of Australian infants have at least one parents’ perceived unmet need in early childhood healthcare services. NESB (15.3%) and Indigenous (15.1%) infants were more likely than ESB infants (9.9%, p<0.001) to have parents’ perceived unmet needs in health care services. The barriers to service access include cost, transport problems, child care difficulties, service availability and family reasons. Parents of ESB infants were more likely to cite operating hours as the major barrier to accessing services. Conclusion: There were parents’ perceived unmet needs in a number of health services for all Australian infants, but at different levels by Indigenous, NESB and ESB groups. The most common barrier to services utilisation related to cost or private health insurance, availability and accessibility of service provision and other socioeconomic issues. Implications: Policy attention and operational changes are required to improve equity in accessing early childhood services, as well as to improve the overall access to healthcare services for all Australian infants.  相似文献   

7.
《Global public health》2013,8(8):869-881
Abstract

Low maternal health service utilisation amongst minority ethnic women in Vietnam is often attributed to ‘traditional customs’. Drawing on secondary data and original, qualitative research amongst Hmong and Thai communities, this paper analyses minority behaviour related to childbirth. The informed selectivity in service attendance identified can be considered, in part, a rejection of current medicalised approaches at health facilities, where supine delivery is compulsory and family members are prohibited from attending women in labour. The paper reveals how conventional analyses of barriers to minority maternal health service utilisation inhibit scrutiny of the ways services fail to engage with or accommodate local preferences. Participatory identification of mutually acceptable delivery methods by maternal health staff and local women is recommended to enable the development of culturally inclusive services.  相似文献   

8.
As far as Britain’s black and South Asian minority communities are concerned, the development of health and social care in the community is often perceived to be problematic. For some minority groups (or for some sections of particular communities) this view is justified. Firstly, significant numbers of people in minority ethnic communities are socially and economically disadvantaged and might lack the resources (income, satisfactory housing, access to transport, family support) to provide care to the level that is needed. Secondly, the planning and delivery of care services for people in minority communities can leave much to be desired. Among other problems, racism and institutional discrimination can result in services which neglect the needs of minority communities. However, the argument remains that to a degree the issue of community care in minority ethnic communities is an over‐problematized one. Are the problems faced by particular groups in the minority population experienced widely in every minority community? This paper examines the argument by focusing on the care of older people. It accepts that problems of racism in the planning and delivery of health and social services are serious and lead to limited access to, and under‐use of, social services by some. However, it is evident that some minority communities are in a much better position than others to meet the care needs of older people.  相似文献   

9.
This study investigates the relationship between unmet long‐term care needs and depressive symptoms among community‐dwelling older people in China. The data come from a nationally representative sample of 1,324 disabled older people from the China Health and Retirement Longitudinal Survey (CHARLS) collected between 2013 and 2014. Regression analyses were conducted to examine the factors associated with unmet needs and the impacts of unmet needs on people’s depressive symptoms. We found that disabled older people living in rural communities have a higher level of unmet needs than those in urban communities. Unmet needs cause more severe depressive symptoms among rural older people, but they do not have a significant impact among urban older people. Depressive symptoms are also affected by people’s health conditions in rural China and by household income in urban China. We argue that older people living in rural communities face a double disadvantage. The first disadvantage relating to unmet needs reinforces the second one relating to mental health. These findings highlight the urgent need for more investment by the Chinese central government in formal social care services and support for carers in rural areas.  相似文献   

10.
Living with a chronic or mental health condition can be challenging and requires considerable adjustment. As ways of coping are culturally influenced, it is important to understand how minority ethnic populations cope, to inform appropriate services. This review aimed to explore the coping strategies used by UK residents from an African Caribbean or Irish background between 1960 and 2020. A systematic literature search on strategies used to cope with chronic health conditions in both populations living in the United Kingdom identified 26 relevant studies. Data were extracted, quality of papers was appraised and critical interpretive synthesis was applied. Two major foci of the studies were coping strategies and barriers to coping. The main coping strategies were denial/scepticism, self-management, spirituality and religion. Within each population, there was variation in ways of coping. The review highlights the complex role of religion in influencing coping strategies. It demonstrates how personal and minority ethnic populations’ experiences of service use are connected with stigma, fear and mistrust, which also act as barriers to seeking help and to coping. Coping with a chronic or mental health condition in the Irish and African Caribbean populations is under-researched. Stigma, fear and mistrust in services act as key barriers to help-seeking and religion is a prominent coping strategy. However, few detailed examples were given on how it was used to assist individuals when managing a chronic or mental health condition. Also due to a lack of research, firm conclusions cannot be drawn for the Irish population.  相似文献   

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