Healthcare Across Borders: Communication and Intercultural Barriers among Ageing Migrants

Objective

ACROSS-CARE investigates how older Spanish-Galician migrants (>75 years) experience and address linguistic and intercultural barriers in primary and long-term care within German-speaking Switzerland. The project analyses these challenges across the full migration cycle by comparing three trajectories: migrants who remain in the host country after retirement, returnees to Spain, and cross-border commuters. The project addresses a significant paradox: despite strong socioeconomic integration, long-term Southwestern European migrants report the poorest health status among all foreign-born residents in Switzerland. It explores how communication and intercultural barriers contribute to these disparities and how they can be mitigated by connecting clinical consultations to migrants' everyday multilingual repertoires and institutional expectations. The methodology employs a mixed-methods and multi-actor design, combining sociolinguistics, discourse analysis, and sociopragmatics. Evidence will be gathered from (i) semi-structured interviews with migrants and key stakeholders, (ii) audio-recorded primary care consultations, and (iii) ethnographic observation. The project will analyse how communication barriers and coping strategies evolve over the life course and manifest in medical settings in older age, assessing outcomes from both user and provider perspectives. This analysis will yield two key outputs: first, evidence-informed, locally adapted guidelines for multilingual communication to support migrants, professional training, service design, and policy; and second, a transferable mixed-data methodology for studying other migrant communities across Europe.