Ariza-Montoya John F, Hernández-Alvarez Mario E
Universidad Nacional de Colombia, Bogotá.
Rev Salud Publica (Bogota). 2008 Dec;10 Suppl:58-71. doi: 10.1590/s0124-00642008000600006.
Identifying inequalities in gaining access to health services resulting from ethnicity in Bogota.
39 in-depth interviews with focus groups and six members of ethnic groups were conducted during 2007. Qualitative findings were contrasted with the results from statistically processing data from the Quality of Life Survey 2003 and characterising the Primary Health Care strategy called 'Health in your Home in Bogota', discriminating the following variables: demographic, socio-economic, needs, access and health outcomes.
The following ethnic groups were characterised: indigenous people, black people, gypsies and islanders. Differences in socioeconomic status, education, employment, access to health insurance, use of health services and outcomes were documented as these were considered to be inequities related to the following determinants: ethnic and racial discrimination, differences in social, economic and political status and violation of rights, interactions between immigration, acculturation and assimilation and differentials exposure.
There are ethnic inequities in gaining access to health services because there is no adequate access as required; there is violation of rights, discrimination, a lack of adaptation and appreciation of differences. These situations are considered to be examples of cultural and distributive injustice. Ethnicity determines levels of social vulnerability and takes specific forms regarding life, health and disease, thereby becoming a structural determinant of studying ethnic-equity in gaining access to health services.
确定波哥大因种族因素导致的获得医疗服务方面的不平等现象。
2007年对焦点小组和六个种族群体的成员进行了39次深入访谈。将定性研究结果与2003年生活质量调查数据的统计处理结果进行对比,并对名为“波哥大居家健康”的初级卫生保健策略进行特征分析,区分以下变量:人口统计学、社会经济、需求、获得医疗服务的机会和健康结果。
确定了以下种族群体:原住民、黑人、吉普赛人和岛民。记录了社会经济地位、教育、就业、获得医疗保险的机会、医疗服务的使用情况和结果方面的差异,因为这些被视为与以下决定因素相关的不平等现象:种族和族裔歧视、社会、经济和政治地位的差异以及权利的侵犯、移民、文化适应和同化之间的相互作用以及不同的暴露情况。
在获得医疗服务方面存在种族不平等现象,因为没有所需的充分获得途径;存在权利侵犯、歧视、缺乏适应性和对差异的认识。这些情况被视为文化和分配不公的例子。种族决定社会脆弱性水平,并在生活、健康和疾病方面呈现特定形式,从而成为研究获得医疗服务方面种族平等的结构决定因素。