Behind the Paper: Intersecting Impacts of Ageing, Migration, and Socioeconomic Disparities on Health Equity – A Post-Pandemic Policy Review

Born from the COVID-19 crisis, this paper reveals how ageing, migration, and socioeconomic inequality intersect to shape health outcomes. It highlights that these forces must be studied together to address deepening health inequities and guide inclusive post-pandemic recovery policies.
Like

Share this post

Choose a social network to share with, or copy the URL to share elsewhere

This is a representation of how your post may appear on social media. The actual post will vary between social networks

Explore the Research

BioMed Central
BioMed Central BioMed Central

Intersecting impacts of ageing, migration, and socioeconomic disparities on health equity: a post-pandemic policy review - International Journal for Equity in Health

Background The COVID-19 pandemic exposed and intensified structural inequities at the nexus of ageing, migration, and socioeconomic vulnerability. These overlapping disadvantages resulted in uneven health outcomes and highlighted systemic fragilities in health systems; yet, few policy reviews have integrated these demographic dimensions into a single analytical framework. Objectives This review critically examines how ageing, migration, and socioeconomic disparities intersect to shape health equity during and after the pandemic. It identifies structural bottlenecks, adaptive responses, and lessons for policy design in low- and middle-income as well as high-income contexts. Methods A systematic policy review was conducted following PRISMA 2020 guidelines and preregistered on the Open Science Framework. Peer-reviewed studies, institutional reports, and grey literature published between 2020 and 2024 were appraised using differentiated quality criteria. Thematic convergence, guided by the Social Determinants of Health, Human Capital Theory, and Feminist Gerontology, informed narrative synthesis across 49 included sources. Results A total of four intersecting themes emerged: (1) demographic inequality and uneven risk exposure; (2) exclusionary health systems and digital divides; (3) socioeconomic precarity and erosion of human capital; and (4) fragmented policy responses with limited ageing- and migrant-sensitivity. Comparative evidence underscores persistent inequities across regions, with gaps most pronounced in the Global South. Conclusion Post-pandemic health equity demands integrated and anticipatory governance. Strengthened geriatric and migrant-inclusive health systems, expanded universal social protection, investment in digital and community infrastructure, and institutionalised intersectional policy design are essential to break cycles of cumulative disadvantage and advance health justice. This review uniquely integrates ageing, migration, and socioeconomic inequities into a unified framework across regions, offering theory-informed policy clusters to guide future governance. Protocol registration The review protocol was prospectively registered on the Open Science Framework (OSF) under the DOI: https://doi.org/10.17605/OSF.IO/6YHC4 .

The Story Behind the Paper

The Spark From Observation to Question

During the pandemic, we witnessed older adults in nursing homes devastated by COVID-19, migrant labourers losing their jobs and social protections, and low-income communities suffering high infection rates and poor access to care. These patterns felt connected. For example, an ageing migrant worker living precariously, lacking protection, and exposed to the virus illustrates overlapping vulnerabilities that erode health resilience.
In Ghana and many low- and middle-income countries, age-related care gaps, internal and external migration, and informal work intersect. We asked what the evidence reveals when ageing, migration, and socioeconomic inequality are examined together. How did the pandemic deepen these links, and what policy gaps emerged?

Conceptual Framing: Bringing Theory to Life

We grounded the study in three theoretical lenses
Social Determinants of Health (SDH) explains how living and working conditions, social protection, and public policy shape health outcomes.
Human Capital Theory, which considers how investment or disinvestment in health and skills influences lifetime resilience.
Feminist Gerontology, which captures ageing as a gendered life course process and highlights the burdens borne by older women and ageing migrants.

Our premise is that ageing, migration, and socioeconomic disadvantage are not additive. They intersect to multiply risk. The pandemic was a global stress test of this reality.

Methodology Systematic Review of the Policy Terrain

Following PRISMA 2020 guidelines, we preregistered our protocol on the Open Science Framework (OSF) and reviewed studies, reports, and grey literature from 2020 to 2024 that linked ageing, migration, and socioeconomic factors to health equity. In total, 49 sources met inclusion standards.

Key Findings: Four Intersecting Themes

  1. Demographic inequality and uneven exposure. Older adults, migrants, and low-income groups faced the greatest risk with limited protection.

  2. Exclusionary health systems and digital divides. Health systems often lacked ageing and migrant-sensitive services, and unequal digital access worsened inequities.

  3. Socioeconomic precarity, job losses, informal work, and weak social protection eroded human capital.

  4. Fragmented policy responses. Post-pandemic strategies rarely integrated ageing, migration, and poverty, creating blind spots in design.

Comparative analysis showed these gaps were most severe in the Global South, where social protection and health infrastructure remain weak.

The Ghana Africa Lens and Why It Matters

Although global in scope, the review is deeply relevant to Ghana and similar contexts. Ageing, migration, and economic disparities intersect sharply across rural-urban divides and informal economies. Older migrants and rural elders often lack pensions, insurance, or digital access. Integrating these realities bridges global evidence with local policy relevance.

Policy Implications Beyond Health Care

Health equity cannot be achieved through clinical reforms alone. We recommend

  • Age and migrant-inclusive health system design

  • Comprehensive social protection coverage for informal and cross-border workers

  • Bridging the digital divide in healthcare access

  • Institutionalising intersectional policy design across ministries and agencies

Why the Timing Matters

Published in November 2025, this paper arrives as the world rebuilds from COVID-19. Without embedding ageing and migration into recovery strategies, cycles of cumulative disadvantage will persist. Our review aims to inform that global reckoning.

Personal Motivation and Ethical Imperative

For us as Ghanaian scholars, this study transcends academia and represents an ethical duty. Older adults, migrants, and low-income persons remain invisible in many policies. We sought to make their experiences visible and call for governance that upholds dignity and inclusion across Africa and the Global South.

Conclusion

This paper bridges divides between ageing and migration studies, health policy and social protection, and research and justice. We hope to advance a conversation where no older migrant is left behind and no low-income community is forgotten in future crises.

Please sign in or register for FREE

If you are a registered user on Research Communities by Springer Nature, please sign in

Go to the profile of ANDREW KWEKU CONDUAH
5 months ago

Thank you, Yuanxin, for engaging with my post and for the work you do in building scholarly connections across the Springer Nature Research Communities. I truly appreciate the visibility this platform gives to early career researchers and the spirit of collaboration it fosters across disciplines.

Go to the profile of Yuanxin Zhang
5 months ago

Thank you for your contribution and I'm glad you like the Communities. Here is the  Welcome course which can help you discover how to make the most of the Communities: https://communities.springernature.com/courses/1964

Follow the Topic

Ageing
Life Sciences > Biological Sciences > Physiology > Ageing
Human Migration
Humanities and Social Sciences > Society > Population and Demography > Human Migration
Population and Demography
Humanities and Social Sciences > Society > Population and Demography
Public International Law
Humanities and Social Sciences > Law > Public International Law

Related Collections

With Collections, you can get published faster and increase your visibility.

Racism and Health

The ongoing advancement of our understanding of how racism impacts health - both directly and structurally - is crucial for addressing the deep-rooted health inequities that persist globally. Structural racism shapes health outcomes among racialized populations, contributing to inequities in healthcare access and quality, and impacting social, political, or environmental determinants of health. Existing research also connects direct and visible manifestations of racism, such as major and everyday discrimination, to negative health outcomes. At the same time, racism does not operate in isolation. A growing body of research shows how it intersects with other systems of oppression—such as classism and patriarchy—and with broader social determinants of health, producing compounded and context-specific inequities. An intersectional lens is therefore essential to understand how overlapping structures of power and exclusion shape health and healthcare experiences. These insights are essential in conducting rigorous and thorough health research, guiding anti-racist health policy, and ultimately, ensuring equitable health for all.

Looking forward, research holds the potential to develop new methodologies and indices and unveil complexities in how racism manifests within healthcare systems and societal structures. By deepening our collective understanding, we can develop more effective interventions that target the root causes of health inequities.

We invite researchers to contribute to this special Collection on Racism and Health, focusing on advancing our understanding and addressing health inequities. Topics of interest include but are not limited to:

- Racism as a structural determinant of health

- Racism as a direct determinant of health

- Racialized health outcomes in different populations

- Intersectionality and inequities in health, healthcare access and quality

- Nexuses between social, political, and environmental determinants of health and systemic discrimination

- Anti-racist health policy frameworks and systems

- Impact of racism on mental health

- Health inequities in reproductive, maternal, and child health

- Obstetric and reproductive violence

- Community-based interventions for equitable health

- Decolonizing health research and global health epistemologies

We strongly encourage contributions from racialized scholars and authors with lived experience or expertise in addressing systemic discrimination in health research.

This Collection supports and amplifies research related to SDG 3, Good Health and Well-Being and SDG 10, Reduced Inequalities.

All submissions in this collection undergo the journal’s standard peer review process. Similarly, all manuscripts authored by a Guest Editor(s) will be handled by the Editor-in-Chief. As an open access publication, this journal levies an article processing fee (details here). We recognize that many key stakeholders may not have access to such resources and are committed to supporting participation in this issue wherever resources are a barrier. For more information about what support may be available, please visit OA funding and support, or email OAfundingpolicy@springernature.com or the Editor-in-Chief.

Publishing Model: Open Access

Deadline: Aug 14, 2026

Health Inequities’ Lethal Impact

Advancing our collective understanding of health inequities remains essential for addressing the complex and often lethal consequences of systemic disparities in health outcomes. While significant progress has been made in recognizing the role of social determinants of health (SDOH), there is an urgent need to further investigate the structural injustices that perpetuate income inequality, racial and ethnic disparities, and the disproportionate burden of chronic disease—particularly among historically marginalized and underserved populations.

This Collection centers on the lethal impact of health inequities, with a primary focus on mortality and the systemic conditions that lead to preventable deaths. While morbidity—defined as the burden of disease and disability—plays a critical role in shaping health trajectories, it is the escalation to premature mortality that underscores the urgency of this research. Authors are strongly encouraged to examine how inequities contribute to death and life-shortening outcomes, rather than submitting work that addresses health equity in general without engaging with its fatal consequences.

Recent research has revealed that the relationship between morbidity and mortality is complex and non-linear. Some populations endure prolonged suffering due to chronic conditions, while others face abrupt and avoidable death due to systemic neglect. These patterns reflect the cumulative impact of adverse SDOH, such as housing insecurity, food instability, limited education, and lack of access to timely care.

Communities facing intergenerational trauma, persistent socioeconomic disadvantage, and discrimination—including Indigenous populations and other minoritized groups—are disproportionately affected. Individuals living in areas of high social vulnerability experience significantly higher all-cause mortality rates, and those with multiple concurrent adverse SDOH face the poorest health outcomes.

Ongoing examination of these issues is vital for informing evidence-based decision-making and equipping policymakers with the insights needed to foster equity in health. Beyond identifying policy failures, this Collection seeks to highlight mechanisms for translating research into equitable policy action. By bridging the gap between evidence and implementation, we aim to surface practical pathways for systemic change—whether through legislative reform, community-led initiatives, or integrated health system strategies.

We invite researchers to contribute to this special Collection, Health Inequities’ Lethal Impact. Topics of interest include, but are not limited to:

-Structural injustice and health

-The role of income inequality in health outcomes

-Racial and ethnic disparities in chronic disease

-Health inequities in Indigenous communities

-Policy interventions for reducing preventable deaths

-Mechanisms for translating evidence into equitable policy action

-Social determinants of health and morbidity

-Community-based approaches to health equity

-Examining policy failures in health systems

-Intersections of morbidity and mortality in vulnerable populations

This Collection supports and amplifies research related to SDG 3, Good Health and Well-Being and SDG 10, Reduced Inequalities, reinforcing the global imperative to ensure equitable access to health.

All submissions in this collection undergo the journal’s standard peer review process. Similarly, all manuscripts authored by a Guest Editor(s) will be handled by the Editor-in-Chief. As an open access publication, this journal levies an article processing fee (details here). We recognize that many key stakeholders may not have access to such resources and are committed to supporting participation in this issue wherever resources are a barrier. For more information about what support may be available, please visit OA funding and support, or email OAfundingpolicy@springernature.com or the Editor-in-Chief.

Publishing Model: Open Access

Deadline: Nov 02, 2026