A critical review of theoretical frameworks for health service use among older immigrants in the United States

Research on older immigrants' health service use in the United States is important for making intelligent plans for and delivering services to this population. However, despite the growing importance of the topic, there has been little discussion in the literature regarding the comparative merits of different theoretical approaches in explaining health service use behavior among older immigrants in the host country. In this article, cognitive models, dynamic approaches and the health behavioral model are discussed in relation to their applications to the older immigrant population. Considering systemic barriers to health service use among older immigrants in the United States, which are beyond an individual level, this article proposes a modified Andersen model to explain health behaviors among older immigrants, based on its comprehensiveness. The model's flexibility also allows the incorporation of key concepts from cognitive models and the Network Episode Model that are relevant to the target population. Social Theory & Health (2011) 9, 183-202. doi:10.1057/sth.2010.13; published online 2 February 2011