Cahiers d'études et de recherches francophones / Santé


Social origins of health inequalities in Ecuador Volume 1, issue 1, Avril 1991

Institut français d’études andines, A.P. 17.11.06596, Quito, Équateur.
  • Page(s) : 25-32
  • Published in: 1991

Poverty in the third world is often seen as a temporary and marginal problem. But on the contrary, it is a structural and central phenomenon which characterizes developing societies, as the study of health inequalities in Ecuador has shown. A geographical approach reveals sharp contrasts in life expectancy between the three main regions, and even more so between the provinces. Differences between the regions and provinces have increased during recent decades. Nevertheless, a simple analysis of the statistics can not explain the mechanisms generating inequalities in health. Sociological and anthropological methods based on extended observation and biographical material are necessary. On the basis of a short but illustrative life story, we describe the respective roles of economic, physical and cultural factors in the disparities in epidemiological risk and health care. To understand the situation at the social level, one has to take into consideration the political dimension, i.e. the international and national background, the consequences of external endebtment and the new world division of labour which tend to bring a reduction in welfare programs and social protection. For the governments the room for manoeuvre is extremely limited. The nature of the local and world contexts thus appears clearly as generating more and more social inequalities which have severe consequences in terms of health. International and national authorities have to take these realities into account in their public health programs.