43 Health, identity, and citizenship: a realist-informed scoping review of healthcare access among aging Filipino migrant workers in Japan and Belgium

Abstract EP1.4, e-Poster Terminal 1, September 4, 2025, 11:35 - 13:00 Aim The increasing number of aging migrant workers presents challenges for healthcare systems, particularly in host countries with legal, social, and cultural barriers. This realist-informed scoping review investigates the structural and systemic factors influencing healthcare access for aging Filipino migrant workers in Japan and Belgium, focusing on the intersection of citizenship status, healthcare policies, and social determinants. Using the Context-Mechanism-Outcome (CMO) framework, this scoping review explores how migrant identities and entitlements influence their healthcare experiences and well-being. Methods Following a realist-informed scoping review methodology, this study systematically analyzed literature from 2004 to 2024 using databases such as Google Scholar and JSTOR, along with manual searches. A total of 268 sources were initially identified, with 143 screened and 63 full-text articles included for final review. The Context-Mechanism-Outcome (CMO) framework was applied to assess (1) Contexts—the socio-political and healthcare environments in Japan and Belgium, (2) Mechanisms—processes such as citizenship policies, healthcare infrastructures, and social networks, and (3) Outcomes—healthcare access, equity, and well-being. Results Findings highlight significant barriers to healthcare access, including language barriers, legal precarity, and employment-related exclusions. In Japan, the national health insurance system ensures universal coverage, but bureaucratic and linguistic hurdles restrict accessibility for Filipino migrants. In Belgium, legal migrant workers benefit from a publicly funded healthcare system, while undocumented migrant workers face administrative and financial constraints, limiting healthcare access. This illustrates how migrants’ legal status influences their access to healthcare services, shaping their health-seeking behaviors and well-being. Conclusion This scoping review underscores the need for migrant-sensitive healthcare policies, culturally competent services, and stronger social?support networks to address healthcare disparities among aging Filipino migrant workers. Targeted policy interventions, including legal protections and culturally competent healthcare models, are essential to improving healthcare equity for this vulnerable population.