Migrants face Barriers to Obtaining Electronic Identification: A population-based Study Among Older Russian-speakers in Finland

As digital technologies continue to transform health care and health systems, they will continue to have a lasting impact on health services. Many health and social care services have rapidly become 'digital by default'. The electronic identification (e-ID) technology is needed for secure authentication to digital services. Recent studies have shown that the 'digital divide' is prominent between ethnic minorities and the majority populations and between older and younger adults. Inequalities related to not having an e-ID, which is in many countries required to access digital health services, remain under-researched. Moreover, there is a lack of knowledge of the use of digital services among older migrants. This study analyses general socio-demographic as well as migration specific factors that may be associated with not having an e-ID among older migrants. 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%). Our results showed that 21% of older Russian-speakers did not have an e-ID. Our regression analysis showed that older age and poorer economic situation were associated with a lower probability of having an e-ID. In addition, we found an association between not speaking local languages and not having an e-ID. This may relate to private banks regulating the requirements for obtaining the most common e-ID method, online banking ID. We argue that for individuals who are already in vulnerable positions, current e-ID practices might pose yet another obstacle to obtaining the health services they need and are entitled to.