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Minorities suffer worse health outcomes - report

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NAIROBI, 1 October 2013 (IRIN) - Minority groups suffer worse health
outcomes than the rest of the population, according to a new report
published by Minority Rights Group International (MRG). State of the
World's Minorities and Indigenous Peoples 2013
e-of-the-worlds-minorities-and-indigenous-peoples-2013.html> , released
to coincide with the UN General Assembly meeting on the post-Millennium
Development Goals (MDGs) agenda, calls for - among other things -
greater measures to combat disparities in global health outcomes
between minority groups and majority communities.

"The MDGs have resulted in much that is good. But one of the
fundamental flaws with them has been the lack of a right or equity
perspective," said
Soderbergh, MRG's policy and communications director. "Minority and
indigenous communities often are marginalized from all aspects of life
in their countries."

For example, infant mortality among indigenous groups in China's Yunnan
Province was 7.8 percent, compared to 5.4 percent for non-indigenous
groups in Yunnan and a national average of 2.6 percent, the report

In Papua, Indonesia, HIV infection rates among minority groups are 15
times the national average. The government does not break down the data
by ethnicity, but in 2008 UNAIDS estimated that the HIV rate was 2.4
percent among the general population, while in the indigenous
Papuan-populated highlands, the rate went up to 3.4 percent.

"Minorities and indigenous peoples around the world suffer far worse
health outcomes than majorities," said Soderbergh. "So, for example, in
Guatemala, indigenous children suffer approximately 20 percent higher
malnutrition than majority communities. In Europe, Roma communities.
disproportionately have less access to vaccines than majorities."

Soderbergh says that the fields of maternal care, child health and
mental health are particularly vulnerable to disparities.

Discrimination and lack of access

According to the report, lack of access to healthcare and systemic
patterns of discrimination are major causal factors behind these

"Partly because minority and indigenous communities don't necessarily
live in the towns and the cities, and they live in remote areas, they
have less access to health," said
Mihlar, co-author of the South Asia section of the report.

In Ethiopia, where the MDG for child mortality has largely been met,
rates of under-five mortality in the Gambela region, inhabited mostly
by minorities, remain stubbornly high: 15.7 percent, more than double
the rate in the capital Addis Ababa, the report shows.

In some regions in countries like India, certain minority groups have
absolutely no healthcare access. "In India, for example, you find in
some cases clear discrimination. In a study that was done, they found
that [in] 21 percent of villages, there was no access for low-caste
people," said Mihlar. "So we're not talking about less access, we're
saying that they just had no access at all to health services."

Link between land and health

For minority indigenous groups, the fight for ownership and access to
traditional lands and the right to health are deeply intertwined.

"The fabric of traditional societies was shredded by colonization,"
wrote Michael Gracey and Malcolm King in a prominent 2009 research
"Many indigenous groups have to live on unproductive land or in towns,
cities and their fringes, slums or squatter camps that are
environmentally degraded health hazards, contaminated by heavy metals
and industrial waste."

"It can be argued that, in securing recognition of their rights to
their traditional lands, they are also securing recognition of the
principal underlying determinants included in their right to health,"
wrote Carla Clarke in the MRG report. "This is because, as they gain
recognition that the land belongs to them, they can then fight for the
need for healthcare services in these areas."

A number of lawsuits have been brought by indigenous peoples concerning
health, but most of these are related to adverse effect on their health
as a result of the use of traditional lands. In Nigeria, for instance,
the Ogoni argued that oil exploration within Ogoniland had led to
significant negative environmental and health consequences.

MRG's Clarke said: "Litigation may not be a complete panacea but, on
current trends, without judicial intervention it is difficult to see
substantial progress being made in realizing the right to health for
indigenous communities."


The UN acknowledged the need for a more inclusive approach to the
post-MDG agenda. In the outcome paper
to the General
Assembly special event on the MDGs released two days ago, member states
said that they would "emphasize inclusivity and accessibility for all,
and will place a particular focus on those who are most vulnerable and

Soderbergh believes that there are simple solutions that can improve
the healthcare services of minority groups. "What governments need to
do is ensure that user fees are kept at a minimum, if [charged] at all,
in order to make sure that healthcare is accessible to all."

Mihlar also argues that getting timely data that is disaggregated by
ethnicity is vital. "One of the major difficulties we had in writing
this report and doing this research was the lack of data on this
subject," she said. "As a result of this, it's difficult to draw a
clear picture and to be able to address policies and practices in a
targeted manner that can improve the situation for minorities."

The report also points to the need to invest in infrastructure to
ensure that even those living in remote areas have access to care.
Although this is considered to be costly, the UN High Level Panel of
Eminent Persons, in their report
on the post-2015
agenda released in May, calculated that doing so would raise
expenditures by "only 15 to 20 percent".

Using simple innovations, such as mobile health clinics, can help
states such as those in South Asia, which lack the capacity to reach
the most remote areas, where many members of minority and marginalized
communities live.

Finally, ensuring access to healthcare information can also aid
disadvantaged groups. In Tanzania, where HIV prevention campaigns are
all conducted in Swahili, pastoral communities are unable to understand
the messages, according to the report. "Public healthcare information
has to be disseminated in languages and in ways that are relevant to
minority and indigenous communities," said Soderbergh.


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[This report does not necessarily reflect the views of the United
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