Disparities in home health-care service utilization and intensity among immigrant older adults

Abstract Population ageing, increased immigration and strained public resources will challenge the future provision of formal older-age care. Despite growing diversity in older populations across Western countries, evidence on health-care utilization among older immigrants remains limited. Using full-population registry data from Norway (2011–2016) for individuals aged 60+, we examined transitions into home health care (HHC) and intensity of use (hours/day) by immigrant background. Across all country-of-origin groups, immigrants had lower odds of transitioning into HHC than natives, with differences narrowing as duration of residence increased. A broad socio-demographic patterning to HHC transitions generally held across the country background groupings. Higher transition likelihoods were observed for individuals with lower education, lower income, living alone, and residing in less urban areas. Childlessness was linked to higher relative transition propensities among natives and Nordic immigrants, but lower relative propensities among Western-origin and Eastern European immigrants. Among non-Western immigrants, childlessness appeared to have little influence on transition propensities. For HHC intensity, only non-Western immigrants received significantly fewer hours of care than natives. Subsequent analysis indicated that this difference was entirely contingent on living alone: Only non-Western immigrants living alone had significantly fewer hours of care than natives (living alone or otherwise). These findings highlight clear variation in HHC utilization by immigrant background and socio-demographic characteristics. Future research should investigate whether lower HHC use among older immigrants reflects reduced need or barriers to access. It will also be important to assess how compositional changes in the immigrant population may influence future patterns of HHC utilization.