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Abstract
In Latin America countries with the lowest life expectancy at birth and the highest infant and child mortality, have a high proportion of indigenous population. In studies of mortality differentials within each country indigenous populations invariably have higher mortality than the non-indigenous.
In the present study I examine differences in child health between indigenous and non-indigenous populations of Bolivia, Guatemala, and Chile. First I look at the relative position of the indigenous population within each country to assess their access to social security and public health programs. I then use an exposure-standardized mortality measure and recent surveys taken in Bolivia, Guatemala and Chile to analyze the association between socioeconomic circumstances and child mortality experience of the different ethnic groups. To examine how the health system and indigenous populations interact in a program that requires voluntary active participation from mothers I look at knowledge and use of Oral Rehydration Therapy in Bolivia and Guatemala.
Results show that important differences by ethnicity exist in the way socio-economic differentials affect child survival. For most of the variables representing social and economic circumstances in all three countries, the lower the mortality risks associated with a particular category the higher the differences between children of indigenous and non-indigenous women. For Bolivia and Chile, significant differences between indigenous and non-indigenous populations or between Mapuche and Spanish speakers persist after controlling for social and economic circumstances. In Guatemala, controlling for education of the mother eliminates the differences in mortality levels.
Results on the importance of ethnicity in use and knowledge of Oral Rehydration Therapy showed that being indigenous matters more for knowledge than for use. Only a very low proportion of indigenous women knew the correct preparation of an oral rehydration solution.
In all three countries the differences in child mortality between indigenous and non-indigenous populations seem to depend on the degree to which indigenous people are able to take advantage of programs and availability of services not specifically targeted to them.
