Dalal Jyoti, Izquierdo Martínez Laura Catalina, Martínez-R Angela, Cuculick Jess, Groce Nora, Rivas Velarde Minerva
Faculty of Medicine, University of Geneva, Geneva, Switzerland
Faculty of Medicine, University of Geneva, Geneva, Switzerland.
BMJ Glob Health. 2025 May 12;10(5):e018377. doi: 10.1136/bmjgh-2024-018377.
Despite efforts to improve health equity, there is still limited knowledge about the number and characteristics of people with disabilities, particularly the Deaf community. Our aim is to use linguistically and culturally adapted research instruments to measure key health indicators and priorities within the Deaf community from a low- and middle-income country-Colombia, contributing to a better understanding of health inequities.
We used data from the Health Survey for Deaf (HSD) and National Quality of Life Survey (NQLS) from Colombia. We included various communication and technology-related indicators-usage of smartphone, modes of interacting with healthcare personnel, along with health indicators-self-perception of health, healthcare quality, hospitalisation and functional difficulties in various domains. ORs were computed to depict the differences in two groups, adjusted for both age and gender, using logistic regressions.
We included 204 and 877 Deaf participants from HSD and NQLS, respectively. Owning a phone was significantly associated with a better self-perception of health (ORs=2.27, 95% CI 1.63 to 3.17 for NQLS-Deafs; 1.49, 1.43 to 1.54 for NQLS-general population) but also with more functional difficulties corresponding to most domains (all ORs >1). However, for HSD datasets, we found that phone ownership was associated with having significantly less functional difficulties in moving hands (0.34, 0.14 to 0.81) and cognition (0.36, 0.15 to 0.89). Access to professional interpreting services was correlated with increased communication-related functional difficulties (2.02, 1.00 to 4.08), for HSD participants. Better self-perception of health was linked to fewer functional difficulties (all ORs <1), while recent hospitalisation was associated with more functional difficulties (all ORs >1).
We found that Deaf individuals generally experience poorer health outcomes compared with hearing individuals. To address these disparities, we recommend (1) improving data quality that could lead to targeted responses and monitoring of it and (2) implementing personalised health surveys that account for the Deaf population's fluency in Spanish and Colombian Sign Language and their specific understanding of health issues.
尽管人们努力改善健康公平状况，但对于残疾人，尤其是聋人群体的数量和特征，了解仍然有限。我们的目标是使用经过语言和文化调整的研究工具，来衡量来自低收入和中等收入国家哥伦比亚的聋人群体的关键健康指标和优先事项，以更好地理解健康不平等现象。
我们使用了来自哥伦比亚聋人健康调查（HSD）和国民生活质量调查（NQLS）的数据。我们纳入了各种与通信和技术相关的指标——智能手机的使用情况、与医护人员互动的方式，以及健康指标——对健康的自我认知、医疗质量、住院情况和各领域的功能困难。使用逻辑回归计算比值比（OR），以描述两组之间的差异，并对年龄和性别进行调整。
我们分别纳入了来自HSD的204名和来自NQLS的877名聋人参与者。拥有手机与对健康的更好自我认知显著相关（对于NQLS中的聋人群体，OR = 2.27，95%置信区间为1.63至3.17；对于NQLS中的普通人群，OR = 1.49，1.43至1.54），但也与大多数领域中更多的功能困难相关（所有OR均>1）。然而，对于HSD数据集，我们发现拥有手机与手部活动（0.34，0.14至0.81）和认知方面（0.36，0.15至0.89）功能困难显著减少相关。对于HSD参与者，获得专业口译服务与沟通相关功能困难增加相关（2.02，1.00至4.08）。对健康的更好自我认知与较少的功能困难相关（所有OR均<1），而近期住院与更多的功能困难相关（所有OR均>1）。
我们发现，与听力正常的人相比，聋人总体上健康状况较差。为了解决这些差异，我们建议：（1）提高数据质量，这可能会带来有针对性的应对措施并对其进行监测；（2）开展个性化的健康调查，考虑到聋人群体对西班牙语和哥伦比亚手语的熟练程度以及他们对健康问题的特定理解。
