Social Inequalities and Health among Older Immigrant Women in the Nordic Countries: An Integrative Review.

Introduction: The Nordic countries have a surprisingly strong relative socioeconomic health inequality. Immigrants seem to be disproportionately affected due to their social economic position in the host countries. Healthcare professionals, including nurses, have a professional obligation to adhere to fairness and social equity in healthcare. The aim of this review was to identify and synthesize research on health status and the impact of social inequalities in older immigrant women in the Nordic countries. Methods: We conducted an integrative review guided by the Whittemore and Knafl integrative review method. We searched multiple research databases using the keywords immigrant, older, women, socioeconomic inequality, health inequality, and Nordic countries. The results were limited to research published between 1990 and 2021. The retrieved articles were screened and assessed by two independent reviewers. Results: Based on the few studies on older immigrant women in the Nordic countries, the review findings indicate that they fare worse in many health indicators compared to immigrant men and the majority population. These differences are related to various health issues, such as anxiety, depression, diabetes, multimorbidity, sedentary lifestyle, and quality of life. Lower participation in cancer screening programs is also a distinctive feature among immigrant women, which could be related to the immigrant women's help-seeking behavior. Transnational family obligations and responsibilities locally leave little room for prioritizing self-care, but differing views of health conditions might also contribute to avoidance of healthcare services. Conclusion: This integrative review shows that there is a paucity of studies on the impact of social inequalities on the health status of older immigrant women in the Nordic countries. There is a need for not only research focused on the experiences of health status and inequality but also larger studies mapping the connection between older immigrant women's economic and health status and access to healthcare services.