Les barrières au vieillissement en bonne santé des personnes âgées immigrées en France 

Posted on November 23rd, 2017 by Kate MacRae under Blog

Le vieillissement mondial de la population nécessite de prendre des mesures afin de s’assurer que les personnes âgées restent en bonne santé, pour continuer à vivre dignement. Mais ces mesures doivent prendre en compte la diversité de la population âgée pour éviter de creuser les inégalités au sein des personnes âgées. Par exemple, la France dispose d’un système de santé généreux mais complexe, et qui a tendance à bloquer l’accès aux soins aux immigrés.

La politique d’immigration française a connu un revirement à la fin des années 1970.  Ceci a mis fin à la politique volontariste d’après-guerre, qui encourageait l’arrivée de travailleurs immigrés, venant surtout du Maghreb, afin d’augmenter l’offre de main d’œuvre1. Ces restrictions ont été accompagnées d’une discrimination envers les immigrés, vus comme une force de travail, ce qui remet en cause leur présence sur le sol français en cas de chômage ou de retraite2. Les personnes âgées immigrées font donc face à des difficultés pour atteindre une égalité de traitement avec celles nées en France. Ils représentent pourtant 9% de la population nationale, dont un tiers a plus de 55 ans3.

Les difficultés d’accès aux soins semblent être davantage liées à l’appartenance à une fraction basse des classes populaires qu’au statut d’immigré. Les personnes âgées immigrées ont plus tendance à avoir un travail faiblement rémunéré et éprouvant, ainsi qu’une carrière complexe et discontinue, ce qui affecte leur santé et leur accès aux soins4. Le statut de migrant empire cette situation : la mauvaise maitrise de la langue et le manque de renseignements sur les procédures administratives complexes les empêche souvent de comprendre leurs droits. De plus grandes ressources en interprétariat sont nécessaires pour pallier cette incompréhension.

Les immigrés sont aussi exposés à la complexité du droit des étrangers, surtout s’ils font des allers-retours avec leur pays natal5. Les conséquences sur l’accès aux soins sont directes : les personnes âgées immigrées sont nombreuses à signaler un manque de complémentaire santé, d’informations sur les aides financières de l’Etat, et à renoncer aux soins de spécialistes6.

Le renoncement aux soins est un obstacle considérable pour le vieillissement en bonne santé des migrants. Il est 2 à 3 fois plus fort chez les hommes immigrés du Maghreb que chez ceux nés en France. Cela est dû à la complexité de l’accès aux soins, ainsi qu’à la culture maghrébine de la famille. Les enfants d’immigrés maghrébins tendent à vouloir apporter eux-mêmes l’intégralité des soins corporels à leurs parents, dans un renversement des rôles parents/enfants. L’introversion des familles maghrébines est aussi due à la stigmatisation dont elles sont victimes. Cela crée parmi elles une culture d’après immigration, basée sur l’indépendance et le soutien intrafamilial, qui les dissuade de chercher de l’aide médicale ou de placer un proche malade en EHPAD (Etablissement d’Hébergement pour Personnes Agées Dépendantes)7.

Les migrants âgés font donc face à une double discrimination, du fait de leur âge et de leur statut d’immigré. Cette discrimination a des conséquences sur leur capacité à vieillir en bonne santé, et sur de nombreux autres aspects de leur vie. C’est pourquoi la Federation Internationale sur le Vieillissement (IFA) a fait des inégalités au sein des personnes âgées une de ses priorités. Ce thème sera débattu lors de la Conférence sur le Vieillissement de l’IFA, qui sera tenue du 8 au 10 aout à Toronto, au Canada. Pour plus d’informations sur la Conférence, rendez-vous sur le site ifa2018.com.

1 http://www.vie-publique.fr/politiques-publiques/politique-immigration/chronologie-immigration/

2 Madoui Mohamed, Jaeger Marcel, « ‪Les migrants face aux défis du vieillissement ‪ », Hommes & Migrations, 2015/1 (n° 1309), p. 6-7. URL : https://www-cairn-info.lama.univ-amu.fr/revue-hommes-et-migrations-2015-1-page-6.htm

3 INSEE, ‘’Population étrangère et immigrée par sexe et âge en 2013’’, Tableaux de l’économie française

4 Karine Meslin, Kedhidja Benelhadj, « Présentation des études de l’Asamla », Le Vieillissement des populations immigrées, Nantes, Asamla/ResO Villes 2014

5 Anaïk Pian, « De l’accès aux soins aux ‘trajectoires du mourir’. Les étrangers atteints de cancer face aux contraintes administratives », Revue européenne des migrations internationales, n° 28, 2012, pp. 101-127.

6 Elise Chiron, Prise en compte des immigrés vieillissants. Enquête auprès des migrants vieillissants et d’agglomération nantaise, Nantes, DRAS, ASAMLA, 2005

7 Duchier Jenny, Mantovani Jean, « ‪Les familles face à la maladie d’Alzheimer‪. Le parcours du combattant des aidants », Hommes & Migrations, 2015/1 (n° 1309), p. 87-94. URL : https://www-cairn-info.lama.univ-amu.fr/revue-hommes-et-migrations-2015-1-page-87.htm

Unequal Ageing: Older Prisoners Ageing in Place

Posted on November 17th, 2017 by Kate MacRae under Blog

Tags:

In managing the growing wave of older offenders, it would be wise to avoid some of the mistakes we have already made along the way in regards to the mentally ill. Just as prisons today have become the new asylums, we do not want the prisons of tomorrow to become the new geriatric facilities.” – Mr. Howard Sapers, former Correctional Investigator of Canada.

In early 2015, the IFA featured Ms. Margaret Easton as a guest blogger who discussed Canada’s ageing prison population and highlighted the need to prioritize the health and well-being of these older prisoners. Despite the pronounced need to tailor services to address this growing ageing population, little has been done worldwide to alleviate the inequalities older people in prison experience.

Globally, two billion people will be 60 years or older by 2050, making up over 20% of the world’s population. Prison populations around the world are no exception to this general population trend. A greater number people are being sentenced later in life due to advances in technology, an increase in mandatory minimum sentences and reduced access to parole and compassionate release combined with a general increase in life expectancy, have all contributed to the rapid ageing of prison populations globally.

As a consequence, correctional services are struggling to meet the basic needs of older prisoners which in turn, accelerates their ageing processes. There are a number of specific issues and emerging trends that require the urgent attention of policymakers.

Older prisoners are in the unique position within society where their autonomy in accessing health and social care is restricted. In an era where the World Health Organization together with 194 member states are working to promote healthy ageing, it is necessary and timely to respond to the specific individual and environmental needs of older prisoners.

This blog post is part of an ongoing series of blogs on addressing inequalities amongst older people. To read the other blogs in the series, please click here.

Addressing Inequalities is one of the four themes of the 14th Global Conference on Ageing, which will be taking place in Toronto from 8-10 August 2018.

To learn more about the theme of Addressing Inequalities, and the 14th Global Conference on Ageing, click here.

Income security of older people in Mexico

Posted on November 10th, 2017 by Kate MacRae under Blog

The number and proportion of older people is increasing globally, which makes it even more important to ensure that the rights of older people are both protected and respected, and inclusion is the norm. However, the countries facing the biggest growth in the number older adults do not appear to be equipped with appropriate agencies and subsequent policies to respond to the demographic change. For example, people aged 60 years and over make up 10% of Mexico’s population, and that proportion should reach 15% in 2025.

The rapid ageing of population is especially challenging for the country, which is facing a very high poverty rate – almost one-half of the population (46%) lives in poverty. While the proportion of people facing poverty is lower in those 60 years and over (44%) compared with the total population, older people are often more vulnerable. Guaranteeing basic income security for older persons is essential to enabling them to continue to contribute to society.

Poverty in older age exists for a multitude of reasons but one of the main contributors to this situation in Mexico is the lack of formal income. More than 50% of the workers are in the informal sector, which does not necessarily provide a retirement pension1. The consequence is that three in every four older adults do not have a retirement or pension plan.

In Mexico, there are two types of pensions: contributory and non-contributory2. The contributory pensions are handled by the States and the municipalities, and are distributed to people who have worked in the formal sector and paid into a pension plan. Non-contributory pensions, on the other hand, were created by the federal government in 2013 in order to cover a wider percentage of the population. The average monthly income with a non-contributory pension is 585 pesos ($30), as opposed to 6,169 pesos ($323) with a contributory pension3. So in most cases, the income from a pension is not sufficient to live securely.

Because of the insufficient amount of formal income, a large proportion of older people have to gain income from another source. For example more than one-third of older people are working well into their later years. As it is more difficult for older people to find a “declared job” in large this sub population becomes the informal workforce, and not well compensated4. Reports show that 32% of older people in Mexico are paid less than the minimum wage. Others often depend on their families, usually their spouse or children. Over one-half (53%) of older people received money transfers from their children during the last two years, a source of income which is often not reliable 5.
Women are especially affected by poverty in older age, because many have not formally worked enough, or at all, to receive any kind of pension. For instance, women comprise 58% of those who do not receive a pension. Moreover, 59% of older women are dependent on their families for income for a longer period of time as they likely live longer than their husbands5.

As long as poverty is not addressed, perhaps even seen as “the norm”, inequalities within the age group of adults aged 60 years or more will continue to exist. Income security is essential for older persons to live a dignified life and contribute to family and society in general. That is why the International Federation on Ageing (IFA) advocates for Income security, which will be addressed as a way to combat ageism at the IFA 14th Global Conference on Ageing, taking place 8 – 10 August 2018 in Toronto, Canada.

References:
1
2
3
4
5 E. Aguila, C. Díaz, M. Manqing Fu, A. Pierson; Envejecer en México: Condiciones de Vida y Salud, 2011

Older »