Health in the Indigenous, Afro-descendant, and Other Ethnic Diversities of the Americas

Health understood as a process: health – disease­ ­- medical attention – care, is totally interdependent of social, cultural, economic, political, religious and environmental processes. Indigenous and ethnic communities are not alien to these processes and have created their own medical and therapeutic systems that respond to their history, context, region and way of seeing themselves in the world.

On the other hand, health as a Human Right assists all people regardless of their ethnicity, gender, religion, class or race. This implies the opportunity to receive medical attention in all areas of individual and collective life. This has been a challenge for the states, which results, for example, into inaccurate data on the health situation of indigenous peoples, African descents and other ethnic groups.

Although specific detailed health information is not available, it is known that the social and economic conditions of a large part of the ethnic communities of the region are precarious. Many of these populations suffer the consequences of significant health gaps. The available data regarding some indigenous and Afro-descendant populations account for existing inequities compared to the general population.

The health and development indicators of indigenous peoples are precarious and this responds to historical structural problems. For example, in the past decade, the PAHO warned that in the Region of the Americas 400,000 children under the age of five died each year from preventable diseases and that the results were poor in terms of health, especially when they related ethnic groups. To date, maternal and infant mortality is significantly higher in indigenous and Afro-American populations than in other ethnic groups. Similarly, child malnutrition rates are higher in the indigenous population than in the general population. The rates of violence against women and suicide tend to be higher in the indigenous population.

In some countries of the region, indigenous peoples are the majority, such as the Mayas, Quechua or Kichwa, Guarani, Achi or Aymara, who due to economic, social and cultural social factors have precarious life and health conditions. In these cases, the relationship between the variable of poverty and ethnicity is always in direct proportion. Therefore, indigenous populations, in general, have more adverse conditions than other population groups. Health indicators ranging from maternal mortality to hospital deliveries and vaccination coverage have less performance in indigenous populations than in non-indigenous ones.

Some figures according to the Ethnicity and Health Policy:

• Although indigenous peoples constitute between 8-10% of the population, they currently represent 17% of the population living in extreme poverty in Latin America.
• The fertility rate of indigenous and Afro-descendant women is approximately 10% higher than the rate of the general population, and yet they receive less quality care during pregnancy, delivery and post-partum.
• In Guatemala, 58% of indigenous children suffer from chronic malnutrition and 23% suffer from severe malnutrition. While in the case of children who are not indigenous, 34% suffer chronic malnutrition and 10% suffer severe malnutrition.
• In Panama and Peru, infant mortality is three times higher in indigenous populations than in non-indigenous.
• In Chile, the mortality of the young indigenous population is almost four times higher than in the general population.
• It is estimated that 62.6% of indigenous children in the Region suffer some degree of deprivation of drinking water, compared to 36.5% of children who are not indigenous.
• In some countries, the fertility rate of Afro-descendant adolescents is 40% above other populations; in indigenous adolescents, this rate can be twice as high compared to the fertility rate in the non-indigenous population.

The coverage of health care, already low in rural areas, reaches the most critical levels in the settlement areas of indigenous peoples. The collective knowledge, local practices, therapists of indigenous medicine and community resources are very necessary, together with the resources of biomedicine, to address the health problems of indigenous communities, African-Americans and the diverse ethnic groups that are affected by health problems.

Taking into account health in the indigenous populations of the Americas involves important challenges (benefits). It can provide concrete answers to health problems and the determinants that act over them, It also recognizes the existence of traditional medical systems that have benefited the whole humanity, and that form a fundamental part of the integral responses to health and the common good.

For several decades and fundamentally framed in the recognition of rights through the ILO Convention 169 the nations are making progress in intercultural health processes, whose developments are of different magnitude, as they respond to national realities, in terms of systems of health, a breakthrough in rights, etc. This implies that each country has developments, integration of health systems and data about their ethnic communities.