Abstract:
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BACKGROUND: An estimated 2.7 million Latin Americans reside in
Europe, mostly in Spain. Part of a broader project aimed at
developing a research agenda on the health status and
determinants of this population, this qualitative study engaged
Latin American migrants in the identification of research
priorities. METHODS: We conducted 30 group discussions between
November 2012-March 2013 with 84 participants purposively
selected for maximum diversity in Madrid and Barcelona (Spain).
We facilitated sequences of task-oriented visual activities to
explore their views on priority health concerns. We
tape-recorded and transcribed discussions and developed a coding
frame based on socio-ecological frameworks, which we applied to
all the data using NVIVO-10. A final round of eight group
discussions allowed us to triangulate and enrich interpretations
by including participants' insights. FINDINGS: The cumulative
toll of daily stresses was the major health concern perceived by
a population that conceptualised ill-health as a constellation
of symptoms rather than as specific diseases. Work-related
factors, legislative frameworks regulating citizenship
entitlements and feeling ethnically discriminated were major
sources of psycho-social strain. Except for sexually transmitted
infections, participants rarely referred to communicable
diseases as a concern. The perception that clinicians
systematically prescribed painkillers discouraged health seeking
and fostered self-medication. Participants felt that the
medicalised, chemicalised, sexually liberal and accelerated
culture of the host society damaged their own, and the local
populations' health. CONCLUSION: Health systems bear a
disproportionate responsibility in addressing health problems
rooted in other sectors. Occupational and migration policies
should be recognised explicitly as health policies. The mismatch
between researchers' emphasis on communicable infections and the
health concerns of Latin American migrants highlights the need
for greater interaction between different forms of knowledge. In
this process, the biomedical culture of reliance on
pharmacological solutions should not remain unquestioned. |