Ageing across borders: psychological wellbeing, health and healthcare access among Latvian migrants in Europe

Abstract

Population ageing is increasingly occurring in societies shaped by migration. Older migrants differ substantially in migration cohort, duration of residence, labour-market histories, language proficiency, pension rights, social networks and access to welfare institutions. For ageing migrants, healthcare access is not only a service-use outcome but also an indicator of welfare anchorage, institutional trust and the practical capacity to translate formal rights into effective care. This study examines health outcomes and healthcare-access patterns among Latvian migrants aged 45 years and older. It asks whether mobility pattern is associated with poor psychological and physical health, and whether healthcare use is organised locally, transnationally or across multiple countries. The analysis draws on the 2019 wave of the Latvian emigrant survey. The analytical focus is on respondents aged 45+. Mobility pattern/place of residence was classified as living outside Latvia, living mostly outside Latvia, or alternating between Latvia and another country. Health outcomes included self-rated general health, poor physical health days in the past 30 days, poor psychological health days in the past 30 days, and frequent mental distress. Healthcare access was measured by whether respondents had received healthcare in Latvia, in the country of residence, or in another country during the previous 5 years. Descriptive statistics, cross-tabulations, ANOVA and regression-oriented interpretation were used to examine health outcomes and healthcare-access location. Poor psychological health days did not differ significantly across mobility groups, F (2, 3,322) = 1.472, p  = 0.230. Poor physical health days also did not differ significantly, F (2, 3,400) = 1.667, p  = 0.189. In contrast, healthcare-access location differed strongly by mobility pattern. Healthcare use in Latvia increased from 34.8% among respondents living outside Latvia to 55.5% among those living mostly outside Latvia and 72.6% among those alternating between Latvia and another country. Healthcare use in the country of residence decreased across the same mobility gradient, from 87.2 to 76.2 and 58.7%, respectively. Use of healthcare in another country was highest among alternating migrants, at 18.0%. Among ageing Latvian migrants, mobility pattern does not significantly differentiate recent poor physical or psychological health days, but it strongly differentiates where healthcare is obtained. The findings suggest that later-life healthcare use among migrants reflects not only morbidity, but also language, institutional familiarity, trust, welfare anchorage and transnational mobility. Active ageing among migrants therefore depends not only on health status, but also on effective, understandable and continuous access to healthcare across borders.