Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil

Abstract

Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…In addition to Brazilians potentially infected by T. cruzi living abroad, a considerable number of people have migrated to Brazil from other endemic countries such as Bolivia; an estimated 80,000 to 200,000 Bolivian migrants live in the State of Sao Paulo (46) . This fact has prompted discussion, within the country, about public health policies consistent with the need for greater attention to this migrant population, including viewing the precarious life and work conditions to which they are subjected (46) (47) .…”

“…This fact has prompted discussion, within the country, about public health policies consistent with the need for greater attention to this migrant population, including viewing the precarious life and work conditions to which they are subjected (46) (47) . In addition to the migration context, there is a clear shift in the prevalence of infection by T. cruzi to older age groups, which brings new challenges for the SUS.…”

Por um campo específico de estudos sobre processos migratórios e de saúde na Saúde Coletiva

“…In addition, preliminary results from investigations have shown that in a general manner, the immigrants have maintained or resignified or changed their conceptualizations and practices relating to the health-disease-care process from their origins, with regard to those experienced within the social and healthcare context of their new location. However, the complicating factor within this is that they use public healthcare services less often that the "natives" do [4][5][6][7][8][9][10] . We have observed that there is a relative scarcity of research on this subject, produced within the disciplines that form the field of public health.…”

O lugar dos trabalhadores de saúde nas pesquisas sobre processos migratórios internacionais e saúde

“…Por exemplo, a constatação de perfis etnoepidemiológicos específicos a cada grupo; o incremento de iniquidades associadas às desigualdades e modos de vida e de trabalho precários, a emergência das doenças infecciosas, como a tuberculose; a transposição, pelas fronteiras, de doenças endêmicas, como a doença de Chagas; além da constatação da existência de barreiras no acesso aos cuidados de saúde. As investigações têm evidenciado, também, que os imigrantes muitas vezes ressignificam ou mudam suas concepções e práticas sobre o processo saúde-doença-cuidados quando têm oportunidades de inserções nos serviços, mas com o agravante de que utilizam, com menor frequência, os serviços públi-cos de saúde quando comparados aos "nativos" 1,2,3,4,5,6,7,8,9,10,11,12,13 .…”

“…No Brasil, estudos sobre os deslocamentos migratórios e suas motivações 14,15,16 , sobre os movimentos transnacionais de trabalhadores da indústria de confecção 17 , sobre demografia 18 e sobre condições de vida e de saúde 9,10,19,20,21 , já permitem compor um quadro analítico abrangente sobre a complexidade da situação migratória e das condições de saúde da população boliviana no país.…”