Social exclusion in service settings amongst Swedish-speaking older adults in Finland: Language incongruency or identity discrimination, or both?

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Emilia Häkkinen
Fredrica Nyqvist
Camilla Nordberg
Mikael Nygård
Siv Björklund
Jessica Hemberg

Abstract

Previous studies suggest that older adults from minority linguistic groups are at a higher risk of experiencing social exclusion, with service exclusion being a highly evident form. This article explores how Swedish- speaking older adults in Finland experience the availability and adequacy of services in their first language and how their experiences are linked to social exclusion. Anchored in the intersection between two dimensions of social exclusion, service exclusion and identity exclusion, this study presents findings from 14 semi-structured interviews with uni- and bilingual Swedish-speaking older adults. The results indicate that inequitable access to services and facing language discordant services can shape experiences of exclusion. The inability to receive everyday services in Swedish further fosters feelings of inferiority and identity discrimination. This study findings contribute to the social gerontological
literature on social exclusion and demonstrate how identity intersections with service exclusion.

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References

Abfalter, D., Mueller-Seeger, J. & Raich, M. (2020). Translation de¬cisions in qualitative research: A systematic framework. Inter¬national Journal of Social Research Methodology 24(4): 469–486. doi: 10.1080/13645579.2020.1805549

Alimezelli, H. T., Leis, A., Karunanayake, C. & Denis, W. (2013). Determi¬nants of self-related health of Francophone seniors in a minority situ¬ation in Canada. Minorités Linguistiques et Société/Linguistic Minorities and Society 3: 144–170. doi: 10.7202/1023804ar

Arzoz, X. (2007). The nature of language rights. Journal of Ethnopolitics and Minority Issues in Europe 6(2): 1–35.

Association of Finnish Local and Regional Authorities. (2020). Kaksikiel¬iset kunnat ja kaksikielisyys. Available on https://www.kuntaliitto.fi/ kunnat-ja-kuntayhtymat/kaksikieliset-kunnat (Accessed: December 10, 2022)

Batista, R., Prud’homme, D., Hsu, A. T., Guérin, E., Bouchard, L., Rhodes, E., Talarico, R., Desaulniers, J., Manuel, D. & Tanuseputro, P. (2019). The health impact of living in a nursing home with a predominantly different spoken language. Journal of the American Medical Directors As¬sociation 20(12): 1649–1651. doi: 10.1016/j.jamda.2019.06.003

Bialystok, E., Abutalebi, J., Bak, T. H., Burke, D. M. & Kroll, J. F. (2016). Aging in two languages: Implications for public health. Ageing Re¬search Reviews 27: 56–60. doi: 10.1016/j.arr.2016.03.003

Bouchard, L., Chomienne, M. H., Benoit, M., Boudreau, F., Lemonde, M. & Dufour, S. (2012). Do chronically ill, elderly Francophone patients believe they are adequately served by Ontario’s health care system?: Exploratory study of the effect of minority-language communities. Ca¬nadian Family Physician/ Le Médecin de Famille Canadien 58(12): 686–687.

Bowen, S. (2001). Language barriers in access to health care. Health Canada. Available on https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-accessibility/ language-barriers.html (Accessed: April 12, 2023)

Bucholtz, M. & Hall, K. (2004). Language and identity. In A. Duranti (ed.), A Companion to Linguistic Anthropology (pp. 369–394). Blackwell publishing.

Burchardt, T., Le Grand, J. & Piachaud, D. (2002). Degrees of exclusion: Developing a dynamic multidimensional measure. In J. Hills, J. Le Grand & D. Piachaud (eds.), Understanding Social Exclusion (pp. 30–43). Oxford: Oxford University Press.

Cameron, C. (2006). Geographies of welfare and exclusion: Social inclu¬sion and exception. Progress in Human Geography 30(3): 396–404. doi: 10.1191/0309132506ph614pr

Day, G., Davis, H. & Drakakis-Smith, A. (2010). ‘There’s one shop you don’t go into if you are English’: The social and political integration of English migrants into Wales. Journal of Ethnic and Migration Studies 36(9): 1405–1423. doi: 10.1080/1369183X.2010.501134

de Moissac, D. (2016). The experience of sparsely populated Francophone mi¬nority communities in Canada (Research report – INTACC-project). Société Santé en français. Available on https://reseausantene.ca/ wp-content/uploads/2018/05/Experience-minority-comms.pdf (Ac-cessed: February 16, 2022)

de Moissac, D. & Bowen, S. (2019). Impact of language barriers on qual¬ity of care and patient safety for official language minority fran¬cophones in Canada. Journal of Patient Experience 6(1): 1–9. doi: 10.1177/2374373518769008

Drolet, M., Savard, J., Benoît, J., Arcand, I., Savard, S., Lagacé, J., Lauzon, S. & Dubouloz, C. (2014). Health services for linguistic minorities in a bilingual setting: Challenges for bilingual professionals. Qualitative Health Research 24(3): 295–305. doi: 10.1177/1049732314523503

Dupuis-Blanchard, S., Gould, O. N., Gibbons, C., Simard, M., Éthier, S. & Villalon, L. (2015). Strategies for aging in place: The experience of language-minority seniors with loss of independence. Global Qualita¬tive Nursing Research 4(2): 1–9. doi: 10.1177/2333393614565187

Dupuis-Blanchard, S. & Villalon, L. (2013). La perception des aînés fran¬cophones en situation minoritaire face aux défis et aux enjeux liés au maintien à domicile en milieu urbain néo-brunswick-ois. Canadian Journal of Public Health/Revue Canadienne de Santé Publique 104(6): 71–74. doi: 10.17269/cjph.104.3458

Dupuis-Blanchard, S., Villalon, L. & Alimezelli, H. T. (2014). Vieillir en sante en situation minoritaire linguistique au Canada: Enjeux, defis et mobilisation collective. Global Health Promotion 21(1): 70–75. doi: 10.1177/1757975913512161

Eriksson-Backa, K. (2008). Access to health information: Perceptions of barriers among elderly in a language minority. Information Research 13(4). Available on https://informationr.net/ir/13-4/paper368.html (Accessed: February 16, 2022)

EUROFOUND. (1995). Public Welfare Services and Social Exclusion: The Development of Consumer Oriented Initiatives in the European Union. Dublin: The Foundation. Available on https://op.europa.eu/en/pub¬lication-detail/-/publication/dec435bf-b20d-44c7-8536-b4139023e6ae (Accessed: May 13, 2023)

Evans, C. J., Ison, L., Ellis-Smith, C., Nicholson, C., Costa, A., Oluyase, A. O., Namisango, E., Bone, A. E., Brighton, L. J., Yi, D., Combes, S., Bajwah, S., Gao, W., Harding, R., Ong, P., Higginson, I. J. & Maddocks, M. (2019). Service delivery models to maximize quality of life for older people at the end of life: A rapid review. The Milbank Quarterly 97(1): 113–175. doi: 10.1111/1468-0009.12373

Garcia, O. (2014). Countering the dual: Transglossia, dynamic bilingual¬ism and translanguaging in education. In R. Rubdy & L. Alsagoff (eds.), The Global-local Interface, Language Choice and Hybridity (pp. 100– 118). Bristol: Multilingual Matters.

Graneheim, U. H. & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 24(2): 105–112. doi: 10.1016/j. nedt.2003.10.001

Guerin, E., Batista, R., Hsu, A. T., Gratton, V., Chalifoux, M., Prud’homme, D. & Tanuseputro, P. (2018). Does end-of-life care differ for Anglo¬phones and Francophones? A retrospective cohort study of dece¬dents in Ontario, Canada. Journal of Palliative Medicine 22(3): 1–8. doi: 10.1089/jpm.2018.0233

Heikkilä, R. (2008). Bättre folk, bättre smak? Suomenruotsalaisten iden¬tifikaation haastatteluaineiston valossa. Yhteiskuntapolitiikka 73(5): 494–507.

Herberts, K. & Suominen, A. (2019). Om språkklimatet i Finland: Som att åka rulltrappa åt fel håll. Tankesmedjan Agenda. Available on https:// www.agenda.fi/wp-content/uploads/2019/03/Spr%C3%A5kklima¬tet_r%C3%A4tt.pdf (Accessed: May 13, 2022)

Holmqvist, J. & van Vaerenbergh, Y. (2013). Perceived importance of na¬tive language use in service encounters. The Service Industries Journal 33(15–16): 1659–1671. doi: 10.1080/02642069.2011.638919

Hughes, M. L., John, D. N., Jones, A. T., Jones, E. H. & Wilkins, M. L. (2009). Language issues in the community pharmacy: A perspective from Wales. International Journal of Pharmacy Practice 17(3): 157–163.

Irvine, A. (2010). Using phone interviews (Realities Toolkit). National Cen¬tre for Research Methods. Available on https://eprints.ncrm.ac.uk/ id/eprint/1576/ (Accessed: February 28, 2023)

Irvine, F. E., Roberts, G. W., Jones, P., Spencer, L. H., Baker, C. R. & Wil¬liams, C. (2006). Communicative sensitivity in the bilingual healthcare setting: A qualitative study of language awareness. Journal of Advanced Nursing 53(4): 422–434. doi: 10.1111/j.1365-2648.2006.03733.x

Jackson, C. (1999). Social exclusion and gender: Does one size fit all? The European Journal of Development Research 11(1): 125–146. doi: 10.1080/09578819908426730

Jehoel-Gijsbers, G. & Vrooman, J. (2008). Social exclusion of the elderly. Cen¬tre for European Policy Studies, European Network of Policy, Research Institutes, Brussels. Available on https://aei.pitt.edu/9443/2/9443. pdf (Accessed: December 12, 2023)

Kalland, M. & Suominen, S. (2006). Ruotsinkielisten sosiaali- ja ter¬veyspalveluiden saatavuus ja käyttö. In J. Teperi, L. Vuorenkoski, K. Manderbacka, E. Ollila & I. Keskimäki (eds.), Riittävät Palvelut Jokaiselle – Näkökulmia Yhdenvertaisuuteen Sosiaali- ja Terveydenhuollossa (pp. 134–144). Helsinki: Stakes.

Kneale, D. (2012). Is social exclusion still important for older people? The In¬ternational Longevity Centre, UK Report. Available on https://ilcuk. org.uk/wp-content/uploads/2018/11/Social-exclusion-Report.pdf (Accessed: December 12, 2023)

Language Act. (2003:423). Finlex. Available on https://www.finlex.fi/fi/ laki/ajantasa/2003/20030423 (Accessed: February 16, 2022)

Levitas, R., Pantazis, C., Fahmy, E., Gordon, D., Lloyd, E. & Patsios, D. (2007). The Multi-dimensional Analysis of Social Exclusion. London: Cab¬inet Office.

Lindell, M. (2021). Språkbarometern 2020 (Justitieministeriets publikationer, utredningar och anvisningar 2021:3). Justitieministeriet, Helsingfors. Available on https://julkaisut.valtioneuvosto.fi/bitstream/han-dle/10024/162838/OM_2021_3_SO.pdf?sequence=4 (Accessed: Feb¬ruary 17, 2022)

Madoc-Jones, I. (2004). Linguistic sensitivity, indigenous peoples and the mental health system in Wales. International Journal of Mental Health Nursing 13(4): 216–224. doi: 10.1111/j.1440-0979.2004.00337.x

Martin, C., Woods, B. & Williams, S. (2018). Language and culture in the caregiving of people with dementia in care homes – What are the im¬plications for well-being? A scoping review with a Welsh perspec¬tive. Journal of Cross-Cultural Gerontology 34(6): 67–114. doi: 10.1007/ s10823-018-9361-9

Mofatt, S. & Glasgow, N. (2009). How useful is the concept of social exclusion when applied to rural older people in the United King¬dom and the United States? Regional Studies 43(10): 1291–1303. doi: 10.1080/00343400903002697

Mustajoki, M. (2020). Language Matters: A Study about Language Communi¬cation with Bilingual Swedish Speakers in Finnish Healthcare. [PhD disser¬tation, University of Helsinki].

Mutchler, J. E., Bacigalupe, G., Coppin, A. & Gottlieb, A. (2007). Lan¬guage barriers surrounding medication use among older Latinos. Journal of Cross-Cultural Gerontology 22(1): 101–114. doi: 10.1007/ s10823-006-9021-3

Nyqvist, F., Häkkinen, E., Renaud, A., Bouchard, L. & Prys, C. (2021a). Social exclusion among official language minority older adults: A rapid review of the literature in Canada, Finland and Wales. Journal of Cross-Cultural Gerontology 36(7): 285–307. doi: 10.1007/ s10823-021-09433-z

Nyqvist, F., Björklund, S., Lindell, M. & Nygård, M. (2021b). Being small and outnumbered: Service and sociocultural exclusion among older linguistic minorities in Finland. Minorités Linguistiques et Société / Lin¬guistic Minorities and Society 15–16: 39–64. doi: 10.7202/1078476ar

Pitkänen, V. & Westinen, J. (2018). Identiteettejä kahdella kielellä: Tutkimus ruotsin- ja suomenkielisistä. Suomen Kulttuurirahasto and e2: 3, Suomen Kulttuurirahasto, Helsinki. Available on https://www.e2.fi/media/ julkaisut-ja-alustukset/identiteetti-tutkimus/identiteetteja.pdf (Ac-cessed: March 2, 2023)

Polanowska, J. (2015). The Swedish-speaking minority in Finland: Iden¬tity, ethnolinguistic vitality and upcoming challenges in the preser¬vation of official language status. In K. Cordell & K. Jajecznik (eds.), The Transformation on Nationalism in Central and Eastern Europe: Ideas and Structures (pp. 117–135). Warsaw: University of Warsaw, Faculty of Journalism and Political Science.

Rawal, N. (2008). Social inclusion and exclusion: A review introduction abstract. Dhaulagiri Journal of Sociology and Anthropology 2: 161–180. doi: 10.3126/dsaj.v2i0.1362

Saarela, J. (2020). Den svenskspråkiga befolkningen i Finland 1990–2040. Tankesmedjan Magma and Svenska Finlands folkting. Available on https://magma.fi/wp-content/uploads/2020/04/Den-svensk¬spr%C3%A5kiga-befolkningen-i-Finland-1990-2040.pdf (Accessed: February 16, 2022)

Saarela, J. (2021). Finlandssvenskarna 2021 – En statistisk rapport. Svenska Finlands Folkting. Available on https://folktinget.fi/Site/ Data/1597/Files/Finlandssvenskarna%202021_statistisk%20rap-port_Folktinget_KLAR.pdf (Accessed: December 12, 2023)

Saarinen, T. (2020). Tensions on Finnish constitutional bilingualism in neo-nationalist times: Constructions of Swedish in monolingual and bilingual contexts. In M. Kuteeva, K. Kaufhold & N. Hynninen (eds.), Language Perceptions and Practices in Multilingual Universities (85–111). London: Palgrave Macmillan.

Saarinen, T. & Taalas, P. (2017). Nordic language policies for higher edu¬cation and their multi-layered motivations. Higher Education 73: 597– 612. doi: 10.1007/s10734-015-9981-8

Saukkonen, P. (2011). Mikä suomenruotsalaisissa ärsyttää? Selvitys mediake¬skustelusta Suomessa (Magma-study 2011:1). Magma, Helsingfors. Available on https://magma.fi/mika-suomenruotsalaisissa-arsyt¬taa-magma-studie-1-2011/ (Accessed: February 28, 2023)

Savard, J., Labossière, S., Cardinal, D., Pinet, B. & Borris, C. (2018). Évalu¬ation de Marche vers le futur, un programme novateur de prevention des chutes ofert par videoconference. Canadian Journal on Aging/ La Revue Canadienne du Vieillissement 37(4): 363–376. doi: 10.1017/ S0714980818000326

Scharf, T. (2015). Between inclusion and exclusion in later life. In K. Walsh, G. Carney & A. Ní Léime (eds.), Ageing through austerity: Critical perspectives from Ireland (pp. 113–130). Bristol: Policy Press.

Schmid, M. S. & Keijzer, M. (2009). First language attrition and reversion among older migrants. International Journal of the Sociology of Language 200: 83–101. doi: 10.1515/IJSL.2009.046

Simard, M. (2019). Enjeux et défis du vieillissement en milieu minoritaire francophone: Une analyse sous l’angle des représentations sociales. Le cas de Tracadie au Nouveau-Brunswick. Minorités Linguistiques et So¬ciété/Linguistic Minorities and Society 11: 3–28.

Statistics Finland. (2022a). Population structure. Available on https://stat. fi/til/vaerak/2021/vaerak_2021_2022-03-31_tau_001_en.html (Ac¬cessed: March 9, 2023)

Statistics Finland. (2022b). The correspondence table between municipalities and language distribution in 2022. Available on https://www.stat.fi/en/lu-okitukset/corrmaps/kunta_1_20220101%23kielisuhde_1_20220101/ (Accessed: February 27, 2023)

Stout, D., Filion, E., Chiasson, M., de Man, A., Charpentier, C. & Pope, M. (2008). The effects of age and culture on subjective well-being: A case study in the Eastern Townships. Journal of Eastern Townships Studies/ Revue d’études des Cantons-de-l’Est 32: 53–72.

The Constitution of Finland. (1999:731). Finlex. Available on https://www. finlex.fi/en/laki/kaannokset/1999/en19990731 (Accessed: January 13, 2023).

Törmä, S., Huotari, K., Tuokkola, K. & Pitkänen, S. (2014). Ikäihmisten moninaisuus näkyväksi – Selvitys vähemmistöihin kuuluvien ikääntyneiden henkilöiden kokemasta syrjinnästä sosiaali – Ja terveyspalveluissa (Inrike¬sministeriet 2014:14). Available on https://julkaisut.valtioneuvosto. fi/handle/10024/78988 (Accessed: February 16, 2022)

Tsakloglou, P. & Papadopoulos, F. (2002). Aggregate level and determining factors of social exclusion in twelve European countries. Journal of European Social Policy 12(3): 211–225. doi: 10.1177/0952872002012003394

van Regenmortel, S., De Donder, L., Dury, S., Smetcoren, A. S., De Witte, N. & Verté, D. (2016). Social exclusion in later life: A systematic review of the literature. Population Ageing 9: 315–344.

Vincze, L. & Henning-Lindblom, A. (2016). Swedish, Finnish and bilin¬gual? Multiple ethnolinguistic identities in relation to ethnolinguistic vitality in Finland. International Journal of Bilingualism 20(4): 488–498. doi: 10.1177/1367006915572169

Walsh, K., Scharf, T. & Keating, N. (2017). Social exclusion of older per¬sons: A scoping review and conceptual framework. European Journal of Ageing 14(1): 81–98.

Zhao, Y., Segalowitz, N., Voloshyn, A., Chamoux, E. & Ryder, A. G. (2021). Language barriers to healthcare for linguistic minorities: The case of second language-specific health communication anxiety. Health Com¬munication 36(3): 334–346. doi: 10.1080/10410236.2019.1692488