Aims: The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. Methods: The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. Results: In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Conclusions: Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use.

Aims The objective of this study was to elucidate the utilisation of Russian health care by immigrants of Russian origin living in Finland (cross‐border health care). The study examined the association of cross‐border health care with social integration and discrimination. Moreover, it studied whether cross‐border health care was used as an alternative to the host‐country's healthcare system. Methods Data from the Finnish Migrant Health and Wellbeing Survey (Maamu) were utilised. The number of respondents of Russian origin was 545. The main analytical method was logistic regression. The outcome variable was based on a survey item on seeking physician's treatment or help abroad during the last 12 months. Social integration was measured multi‐dimensionally, and the indicator was extracted by multiple correspondence analysis. Ethical approval for the study was obtained from the Ethical Committee of the Uusimaa Hospital Region. Results We found that 15.4% of the respondents had visited a physician in Russia during the last 12 months. 10.4% had experienced discrimination in Finnish health services during their stay in Finland. Stronger social integration predicted less frequent utilisation of cross‐border health care. Experiences of discrimination or unfairness were associated with higher odds for seeking cross‐border health care. Cross‐border health care was typically used in parallel to the Finnish services. Conclusions Our findings on integration and discrimination emphasise the importance of general integration policy as well as cultural competence in health care. Parallel use of healthcare systems entails both risks (e.g double medication, problems of follow‐up) and opportunities (e.g. sense of agency), which should be further investigated.

Background In older adults, including those with a migrant background, ill health is associated with less internet use. However, it is not known what are the specific self-perceived barriers to internet use among older migrants with different health conditions. The aim of this study was to investigate the associations between different health conditions and self-perceived barriers to internet use among older migrants. Methods We used the Care, Health and Ageing of Russian-speaking Minority in Finland (CHARM) study, which is a nationally representative survey of community-dwelling Russian-speaking adults aged ≥50 years living in Finland (N=1082, 57% men, mean age 63.2 years, standard deviation 8.4 years, response rate 36%). Postal survey data were collected in 2019. Health indicators were self-rated health (SRH), depressive symptoms, cognitive functioning, and doctor-diagnosed conditions. Linear regression analyses were used to investigate the associations between health indicators and a summary scale consisting of the following barriers of internet use: (1) internet use is too complicated and hard to learn; (2) having concerns about safety issues; (3) internet use is too expensive; (4) physical limitations hinder the internet use; (5) memory problems hinder the internet use. In addition, the two most commonly reported barriers (the first two) were examined separately using logistic regression analyses. The analyses were adjusted for age, sex, education, marital status, local language proficiency, and income support, and the health conditions, and were performed with weights accounting for the survey design and non-response. Results After adjustments, spine/back problems (b=0.13; p=0.049), depressive symptoms (b=0.40; p=0.007), and problems in learning new things (b=0.60; p<0.0005) were associated with higher level of overall barriers to internet use. In addition, a number of health conditions were associated with individual barriers, albeit some health conditions appeared protective. Conclusions In general, older migrants with declining health experience more barriers to internet use than their counterparts with better health. To provide better access to healthcare for older adults, including older migrants, rapidly changing devices, software and apps need to be modified and adapted for those with specific health-related needs.

Recent sociological discussions have examined the classic theme of social integration from the point of view of belonging and multiple solidarities. As a research topic, migration importantly elucidates these general sociological questions. Literature on migration, integration and transnationalism lacks an encompassing theoretical model, which limits our understanding of complex integration processes. We propose a multifocal model of migrant integration including three key foci of integration: the host society; transnational sphere; and co-ethnic community in the host society. Moreover, the model considers integration in terms of different dimensions. With this model, we define multifocal marginalisation and study Russian, Kurdish and Somali migrants in Finland. We find that the different foci do not compete with each other, but are in a moderate positive relationship. There are clear group differences in integration patterns. Determinants of multifocal marginalisation include Kurdish background, weak Internet skills and older age. Discussion themes include belonging and social change.

This study examines the association between digital information technology (DIT) use and the utilization of transnational healthcare (THC) in older migrants, and investigates how this relationship depends on social integration or perceived discrimination in health services in the destination country. The data from a population-based study conducted in Finland in 2019, which targeted Russian-speaking residents aged 50 and above (n = 1082) nationwide, are analyzed. The analysis demonstrates that those who had a high level of DIT use were significantly more likely to use THC than those who had a low level of use. However, the findings do not show that the relationship depends on social integration or perceived discrimination. Older migrants can actively use transnational networks to address their health and well-being issues by using DIT and seeking healthcare abroad. Their health service use can be illustrated as an active process involving various geographical domains.