Suchergebnisse

Governments are rapidly digitalising public services to increase cost-effectiveness of the public sector. This study examines older migrants' use of digital public health and social welfare services from the perspective of social exclusion. The study uses a mixed methods approach, drawing on representative survey data of Russian-speaking migrants in Finland and qualitative interviews with third-sector representatives who assist Russian-speaking migrants with digital service use. Our quantitative results show that a sizeable proportion of Russian-speaking older adults are excluded from digital services. In particular, those with lower socio-economic status, poor local language skills and without Finnish education are at higher risk of exclusion. Our qualitative results describe the multiple ways the exclusion from digital services intersects with other disadvantages in the everyday lives of Russian-speaking older adults. We argue that digitalisation of these services may foster social exclusion and endanger the realisation of these people's social rights.

In lay terms, childbirth is regarded as a purely biological event: what is more natural than birth and death? On the other hand, social scientists have long understood that 'natural' events are socially structured. In the case of birth, sociologists have examined the social and cultural shaping of its timing, outcome, and the organization of care throughout the perinatal period. Continuing in this tradition, we examine the peculiar social design of birth in the United States of America, contrasting this design with the ways birth is organised in Europe. We begin by showing how several key characteristics of the US health care system – including its inherent social inequality, its high level of medicalisation, and the substantial influence of private medical practice and insurance companies – influence the organization of maternity care there. We then explore how cultural characteristics of American society – its emphasis on individuality, the influence of moral conservatism in US politics, and the ease with which ordinary people take court action (the so-called 'litigation culture') – shape the delivery of care at birth. We conclude with a consideration of the implications of US maternity care exceptionalism for comparative sociological analysis.

Tutkimme Suomessa asuvien ikääntyvien venäjänkielisten ylirajaista terveyspalvelujen käyttöä ja käytön syitä. Analysoimme vuonna 2019 kerättyä CHARM-kyselyaineistoa ja syvennämme tuloksia haastatteluaineiston temaattisen analyysin avulla. Lähes 30 prosenttia yli 50-vuotiaista Suomessa asuvista venäjänkielisistä oli käynyt kyselyä edeltävän vuoden aikana Suomen ulkopuolella lääkärissä. Ulkomailla lääkärissä käynti oli yleisempää naisilla, työttömillä, korkeasti koulutetuilla sekä vastaajilla, joiden kotitalouden nettotulot olivat yli 2 500 euroa kuukaudessa. Kansalaisuus jossain muussa maassa kuin Suomessa lisäsi käytön todennäköisyyttä ja pidempi asumisaika Suomessa puolestaan vähensi sitä. Eläminen kroonisen sairauden kanssa sekä täyttämätön hoidontarve olivat yhteydessä ylirajaiseen palveluiden käyttöön. Kyselyaineistossa tärkeimmiksi syiksi palveluiden ylirajaiselle käytölle nousivat halvempi hinta, nopeampi hoitoon pääsy ja omankieliset palvelut. Haastatteluaineistossa esiintyivät nämä samat syyt, mutta esiin nousivat myös koetut pettymykset suomalaisessa terveydenhuollossa. Tulokset osoittavat, että ikääntyvät venäjänkieliset kohtaavat monenlaisia esteitä hoitoon pääsylle ja toimivalle hoidolle Suomessa. Sivuutetuksi tulemisen kokemukset ja väärinymmärrykset voivat johtaa avun hakemiseen Suomen ulkopuolelta. Terveyspalvelujen laatua ja saavutettavuutta tulisi kehittää vastaamaan moninaistuvan ikääntyvän väestön tarpeita.

In this article, we examine the transnational use of health services and the reasons given for their use by older Russian-speaking migrants living in Finland. We analyse the CHARM survey data collected in 2019, and elaborate the results with thematic analysis of the interview data. Almost 30 per cent of Russian-speakers over the age of 50 living in Finland had seen a doctor outside Finland in the year before the survey. Visiting a doctor abroad was more common among women, the unemployed, the highly educated and respondents with a net household income of more than 2,500 euros per month. Having citizenship in a country other than Finland increased the likelihood of use and having a longer period of residence in Finland reduced it. People living with a chronic illness and those who had an unmet need for care used more health services abroad. In the survey data, the main reasons for the cross-border use of services were cheaper prices, faster access to treatment and the delivery of services in one's own language. These same reasons appeared in the interview material, but the interviewees also mentioned perceived disappointments with Finnish health care. The results show that older Russian-speakers face a variety of barriers to accessing and navigating care in Finland. Experiences of misunderstanding and of being ignored can lead to seeking help from outside Finland. The quality and accessibility of health services should be developed to meet the needs of a diversifying ageing population.

The editorial team introduces the journal.

This original and innovative book opens up new perspectives in health policy debate, examining the emerging international trends in the governance of health professions and the significance of national contexts for the changing health workforce. In bringing together research from a wide range of continental European countries as well as the United Kingdom, Canada and Australia, the contributors highlight different arenas of governance, as well as the various players involved in the policy process. They expand the public debate on professional governance - hitherto mainly limited to medical self-regulation - to encompass a broad span of health care providers, from nurses and midwives to alternative therapists and health support workers. The book provides new data and geopolitical perspectives in the debate over how to govern health care. It helps to better understand both the enabling conditions for, and the barriers to, making professionals more accountable to the interests of a changing public. This book will be a valuable resource for students at an undergraduate and postgraduate level, particularly for health programmes, sociology of professions and comparative health policy, but also for academics, researchers and managers working in health care.