Objectives: Among social determinants of health, culture and ethnicity play a key role in defining the needs of different population groups. The aim of this study was to consider and compare the social and leisure time activities of the three elderly groups: Iranian residing in Iran, Iranian residing in Sweden and Swedish residing in Sweden.

Methods & Materials: Via the cross-sectional design, 825 Iranian elderly who were living in Tehran compared with 305 Swedish elderly and 101 Iranian elderly living in Stockholm on social relations, group activities and leisure time activities. Only, elderly who could communicate properly entered the study. A structured questionnaire designed by the Iranian and Swedish Research Group on the" Assessment of Social Health Status and Needs" implemented for the subjects. Estimation method and logistic regression used to analyze the gathered data.

Results: Subjects of all 3 groups were in the age range of 60-77 years old and mostly were married. Results showed despite very common characteristics, there are, also, many differences which can be explained by cultural and environmental factors. Rapid urbanization, limited resources and unawareness of or disregard for healthy life style resulted in lower levels of satisfaction with social and leisure life in the Iranian elderly. On the other hand, level of activities related to the spiritual dimension of health were more in Iranians than Swedish and the difference was significant (P=0.000), whereas the reverse was true for the group activities (P=0.000). Poor attitude toward physical activity and exercise in Iranian elderly, especially women, with consequent hazards for health, needs special consideration on behalf of the health planners and providers.

Conclusion: Needs assessment with trance- cultural approach, especially on social determinants of the health of elderly is a necessity. Using valid and reliable instruments, designed to overcome the cultural barriers would help planners to apply the experience of the aged societies more reasonably, properly and creatively.