Ethnicity and Health in Colombia: A Cross Sectional Analysis of the National Health Survey

Background: The National Health Survey (ENS-2007) offers an opportunity for identifying health determinants in vulnerable populations, considering the model of social determinants of health proposed for the WHO (the role of social, economic and politic determinants such as, gender, social class and ethnicity). We aim to analyse the relationship of two self-perceived indicators with the origin ethnic.

Methods: Cross sectional study with the information provided for the ENS-2007. This survey was carried out in 80.631 people in the Colombian households.  Exposure variable: Ethnic group (yes/no and regrouped in: Romani, Raizal, Palenquero and Afro-Colombian, none). Outcomes were: Self-rated health (good/poor) Mental Health problems (Yes/No). Sociodemographic variables: Age, education and occupation.  We calculated crude and adjusted Odds Ratio for possible confounders (aOR) with confidence intervals (95% CI) by mean of logistic regression separately for men (M) and women (W).

Results: People belonging to any ethnic group were more likely to report poor self rated health (M: aOR 1.49, 95%CI 1.37-1.62; W: aOR 1.41, 95%CI 1.27-1.56) and mental health problems (M: aOR 1.33, 95%CI 1.14- 1.56; W: aOR 1.27 95%CI 1.09-1.49).  Analyses for groups shown that Indigenous people (M: aOR 1.65, 95%CI 1.46-1.86; W: aOR 1.38, 95%CI 1.17-1.62), Afrocolombians (M: aOR 1.40, 95% CI 1.27- 1.56; W: aOR 1.41, 95% CI 1.24-1.59) and Palenquero (only for W: aOR 6.84, 95%CI 2.55-18.31 were more likely to report poor self rated health.  Indigenous people (M: aOR 1.75, 95%CI 1.42-2.17; W: aOR 1.63 95%CI 1.30-2.04) were more likely to report mental health problems.

Conclusions: Ethnic groups in Colombia are sensible to report self-perceived health problems. Differences according to ethnic group, gender and type of indicator were observed.  Political actions focused in social determinants of health are required in order to diminish health inequalities.

Support: Ministry of Social Protection- Colombia-University of Antioquia (Reference: 519-2008)