Healthy ageing in nomadic communities: addressing social inclusion and healthcare access

Purpose This paper aims to build a conceptual framework explaining how ageing unfolds among nomadic elderly populations, whose constant mobility, occupational informality and administrative invisibility set them apart from the settled, address-based populations around whom most gerontological theory has been written. It examines how these life conditions shape healthcare access, social inclusion and wellbeing once biological and occupational ageing set in. Design/methodology/approach The paper reviews interdisciplinary literature from gerontology, public health, migration studies and social policy, combining life-course theory, ecological systems theory, social exclusion theory and the Levesque model of healthcare access to build a multidimensional conceptual model. This model connects the antecedents of nomadic ageing to later-life wellbeing outcomes through a mediating pathway termed access vulnerability. Findings The major policy implication from this framework is that we need to break out of the passive stance that we have in our administrative and welfare systems. Nomadic older adults are frequently excluded from access to identity documents, social protection and health care services on the basis of proof of permanent residence, which includes nomadic and highly mobile older adults. Portable, location independent documentation and identification systems would lessen the invisibility of documentation, continuity of care and welfare services and the ageing trajectories of migrant elders would be healthier and more dignified. Practical implications The results emphasise that policies and services that are based on the address of the customer need to be adapted to the mobility context. Mobile ID, social protection coverage and interoperable health records can facilitate access to vital services for nomadic older persons. These would minimise administrative invisibility, improve continuity of care and facilitate better health and more ageing resilient journeys. Originality/value Gerontology is primarily built around stable, address-linked assumptions. This leaves nomadic elders almost entirely untheorised. This paper addresses that gap with an original integrative framework.