Skip to main content
Top
Published in: International Journal for Equity in Health 1/2015

Open Access 01-12-2015 | Research

Perceived discrimination among Maghrebi users of health services in Tarragona (Spain)

Authors: Lourdes Rubio-Rico, Alba Roca-Biosca, Inmaculada de Molina-Fernández

Published in: International Journal for Equity in Health | Issue 1/2015

Login to get access

Abstract

Background

Discrimination in health services for reasons of nationality or ethnicity is not a rare occurrence. This work aims to qualitatively analyse the perceived discrimination among Maghrebi community in Tarragona (Spain) with regard to the healthcare services they receive.

Methods

A qualitative study was carried by means of 12 semi-structured interviews and 10 focus groups with Maghrebi adults living in Tarragona. The scope of the study was public health services in the area. A content analysis was performed using open coding.

Results

Our results show that perceived discrimination is greater than actual discrimination because the deficiencies of the healthcare system are often interpreted as unfairness. However, our subjects also recounted incidents of clear discrimination against Maghrebi users of the healthcare system. The tendency to feel discriminated against is the culmination of an interaction between the group's low self-esteem and locals' often negative sentiments towards the group.

Conclusions

We suggest addressing the shortcomings of the healthcare system in order to reduce this level of perceived discrimination and thus improve patient satisfaction. To improve this group's self-esteem and change how they are perceived, public policies should be put into effect which promote social inclusion and the respect for Maghrebis' rights as people, with actions taken on both fronts: in the host society and within the Maghrebi community itself. Furthermore, an active role for the patient with regard to his or her rights should be encouraged in order to minimize abuse from professionals and to facilitate institutional control of individual actions.
Literature
1.
go back to reference World Health Organization. Healht of migrants. The way forward. Report of a global consultation. Madrid, Spain. 3–5 March 2010. Geneva: World Health Organization; 2010. World Health Organization. Healht of migrants. The way forward. Report of a global consultation. Madrid, Spain. 3–5 March 2010. Geneva: World Health Organization; 2010.
2.
go back to reference Rodríguez Álvarez E, González-Rábago Y, Bacigalupe A, Martín U, Lanborena Elordui N. Inmigración y salud: Desigualdades entre la población autóctona e inmigrante en el País Vasco. Gac Sanit. 2014; doi:10.1016/j.gaceta.2014.01.010. Rodríguez Álvarez E, González-Rábago Y, Bacigalupe A, Martín U, Lanborena Elordui N. Inmigración y salud: Desigualdades entre la población autóctona e inmigrante en el País Vasco. Gac Sanit. 2014; doi:10.​1016/​j.​gaceta.​2014.​01.​010.
3.
go back to reference Harris R, Cormack D, Tobias M, Yeh LC, Talamaivao N, Minster J, et al. Self-reported experience of racial discrimination and health care use in New Zealand: results from the 2006/07 New Zealand Health Survey. Am J Public Health. 2012; doi:10.2105/AJPH.2011.300626. Harris R, Cormack D, Tobias M, Yeh LC, Talamaivao N, Minster J, et al. Self-reported experience of racial discrimination and health care use in New Zealand: results from the 2006/07 New Zealand Health Survey. Am J Public Health. 2012; doi:10.​2105/​AJPH.​2011.​300626.
5.
go back to reference Scheppers E, van Dongen E, Dekker J, Geertzen J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract. 2006. doi:10.1093/fampra/cmi113. Scheppers E, van Dongen E, Dekker J, Geertzen J. Potential barriers to the use of health services among ethnic minorities: a review. Fam Pract. 2006. doi:10.​1093/​fampra/​cmi113.
6.
go back to reference Sanchez-Birkhead AC, Kennedy HP, Callister LC, Miyamoto TP. Navigating a new health culture: experiences of immigrant Hispanic women. J Immigr Minor Heal. 2011; doi:10.1007/s10903-010-9369-x. Sanchez-Birkhead AC, Kennedy HP, Callister LC, Miyamoto TP. Navigating a new health culture: experiences of immigrant Hispanic women. J Immigr Minor Heal. 2011; doi:10.​1007/​s10903-010-9369-x.
7.
go back to reference Agudelo-Suárez A, Ronda-Perez A, Gil-gonzález D, Vives-Cases C, García, AM, et al. The effect of perceived discrimination on the health of immigrant workers in Spain. BMC Public Health. 2011; doi:10.1186/1471-2458-11-652. Agudelo-Suárez A, Ronda-Perez A, Gil-gonzález D, Vives-Cases C, García, AM, et al. The effect of perceived discrimination on the health of immigrant workers in Spain. BMC Public Health. 2011; doi:10.​1186/​1471-2458-11-652.
8.
go back to reference Epel OB, Kaplan G, Moran M. Perceived discrimination and health-related quality of life among Arabs and Jews in Israel: a population-based survey. BMC Public Health. 2010; doi:10.1186/1471-2458-10-282. Epel OB, Kaplan G, Moran M. Perceived discrimination and health-related quality of life among Arabs and Jews in Israel: a population-based survey. BMC Public Health. 2010; doi:10.​1186/​1471-2458-10-282.
9.
10.
go back to reference Sawyer PJ, Major B, Casad BJ, Townsend SSM, Mendes WB. Discrimination and the stress response: psychological and physiological consequences of anticipating prejudice in interethnic interactions. Am J Public Health. 2012; doi:10.2105/AJPH.2011.300620. Sawyer PJ, Major B, Casad BJ, Townsend SSM, Mendes WB. Discrimination and the stress response: psychological and physiological consequences of anticipating prejudice in interethnic interactions. Am J Public Health. 2012; doi:10.​2105/​AJPH.​2011.​300620.
11.
go back to reference Williams DR, John DA, Oyserman D, Sonnega J, Mohammed SA, Jackson JS. Research on discrimination and health: an exploratory study of unresolved conceptual and measurement issues. Am J Public Health. 2012; doi:10.2105/AJPH.2012.300702. Williams DR, John DA, Oyserman D, Sonnega J, Mohammed SA, Jackson JS. Research on discrimination and health: an exploratory study of unresolved conceptual and measurement issues. Am J Public Health. 2012; doi:10.​2105/​AJPH.​2012.​300702.
12.
go back to reference Achotegui J. Migración y salud mental. El síndrome del inmigrante con estrés crónico y múltiple (síndrome de Ulises). Zerbitzuan. 2009;46:163–71. Achotegui J. Migración y salud mental. El síndrome del inmigrante con estrés crónico y múltiple (síndrome de Ulises). Zerbitzuan. 2009;46:163–71.
14.
go back to reference Hansen KL, Sørlie T. Ethnic discrimination and psychological distress: A study of Sami and non-Sami populations in Norway. Transcult Psychiatry. 2012; doi:10.1177/1363461511433944. Hansen KL, Sørlie T. Ethnic discrimination and psychological distress: A study of Sami and non-Sami populations in Norway. Transcult Psychiatry. 2012; doi:10.​1177/​1363461511433944​.
15.
go back to reference Brody GH, Kogan SM, Chen Y. Perceived discrimination and longitudinal increases in adolescent substance use: gender differences and mediational pathways. Am J Public Health. 2012; doi: 10.2105/AJPH.2011.300588. Brody GH, Kogan SM, Chen Y. Perceived discrimination and longitudinal increases in adolescent substance use: gender differences and mediational pathways. Am J Public Health. 2012; doi: 10.​2105/​AJPH.​2011.​300588.
16.
go back to reference Agudelo-Suárez A, Ronda-Pérez E, Gil-González D, Vives-Cases C, García A, García-Benavides F, et al. Proceso migratorio, condiciones laborales y salud en trabajadores inmigrantes en España (proyecto ITSAL). Gac Sanit. 2009; doi:10.1016/j.gaceta.2009.07.007. Agudelo-Suárez A, Ronda-Pérez E, Gil-González D, Vives-Cases C, García A, García-Benavides F, et al. Proceso migratorio, condiciones laborales y salud en trabajadores inmigrantes en España (proyecto ITSAL). Gac Sanit. 2009; doi:10.​1016/​j.​gaceta.​2009.​07.​007.
19.
go back to reference Shavers VL, Fagan P, Jones D, Klein WM, Boyington J, Moten C, et al. The state of research on racial/ethnic discrimination in the receipt of health care. Am J Public Health. 2012; doi:10.2105/AJPH.2012.300773. Shavers VL, Fagan P, Jones D, Klein WM, Boyington J, Moten C, et al. The state of research on racial/ethnic discrimination in the receipt of health care. Am J Public Health. 2012; doi:10.​2105/​AJPH.​2012.​300773.
20.
go back to reference Rubio-Rico L. Magribins a Catalunya: determinants socials i necessitats de salut. PhD [dissertation]. Tarragona: Universitat Rovira i Virgili; 2014. Rubio-Rico L. Magribins a Catalunya: determinants socials i necessitats de salut. PhD [dissertation]. Tarragona: Universitat Rovira i Virgili; 2014.
22.
go back to reference Navas M, Cuadrado I. Actitudes hacia gitanos e inmigrantes africanos: un estudio comparativo. Apunt Psicol. 2003;21(1):29–49. Navas M, Cuadrado I. Actitudes hacia gitanos e inmigrantes africanos: un estudio comparativo. Apunt Psicol. 2003;21(1):29–49.
23.
go back to reference Generalitat de Catalunya. Departament d’Acció Social i Ciutadania. Secretaria per a la Immigració. Pla de ciutadania i immigració 2009–2012. 1a. ed. Barcelona: Generalitat de Catalunya; 2010. Generalitat de Catalunya. Departament d’Acció Social i Ciutadania. Secretaria per a la Immigració. Pla de ciutadania i immigració 2009–2012. 1a. ed. Barcelona: Generalitat de Catalunya; 2010.
24.
go back to reference Bermann S, Lurbe K, La salut i el Marroc. Guia de suport als professionals sanitaris sobre l’atenció sanitària a la població immigrada procedent del Marroc. Barcelona: Pla director d’immigració en l'àmbit de la salut. Departament de Salut; 2008. Bermann S, Lurbe K, La salut i el Marroc. Guia de suport als professionals sanitaris sobre l’atenció sanitària a la població immigrada procedent del Marroc. Barcelona: Pla director d’immigració en l'àmbit de la salut. Departament de Salut; 2008.
25.
go back to reference Borrell i Thió C, Benach J, Bofill FJ. Les Desigualtats en la salut a Catalunya : informe CAPS-Fundació Jaume Bofill. Polítiques. Barcelona: Mediterrània; 2003. Borrell i Thió C, Benach J, Bofill FJ. Les Desigualtats en la salut a Catalunya : informe CAPS-Fundació Jaume Bofill. Polítiques. Barcelona: Mediterrània; 2003.
26.
go back to reference Tajeu GS, Cherrington AL, Andreae L, Prince C, Holt CL, Halanych JH. “We’ll Get to You When We Get to You”: Exploring Potential Contributions of Health Care Staff Behaviors to Patient Perceptions of Discrimination and Satisfaction. Am J Public Health. 2015; doi: 10.2105/AJPH.2015.302721. Tajeu GS, Cherrington AL, Andreae L, Prince C, Holt CL, Halanych JH. “We’ll Get to You When We Get to You”: Exploring Potential Contributions of Health Care Staff Behaviors to Patient Perceptions of Discrimination and Satisfaction. Am J Public Health. 2015; doi: 10.​2105/​AJPH.​2015.​302721.
27.
go back to reference Piette JD, Bibbins-Domingo K, Schillinger D. Health care discrimination, processes of care, and diabetes patients’ health status. Patient Educ Couns. 2006;60:41–8.CrossRefPubMed Piette JD, Bibbins-Domingo K, Schillinger D. Health care discrimination, processes of care, and diabetes patients’ health status. Patient Educ Couns. 2006;60:41–8.CrossRefPubMed
28.
go back to reference Anderson J, Perry J, Blue C, Browne A, Henderson A, Khan KB, et al. “Rewriting” cultural safety within the postcolonial and postnational feminist project: toward new epistemologies of healing. Advances Nurs Sci. 2003;26:196–214.CrossRef Anderson J, Perry J, Blue C, Browne A, Henderson A, Khan KB, et al. “Rewriting” cultural safety within the postcolonial and postnational feminist project: toward new epistemologies of healing. Advances Nurs Sci. 2003;26:196–214.CrossRef
29.
go back to reference Jacobs EA, Leos GS, Rathouz PJ, Fu Jr P: Shared networks of interpreter services, at relatively low cost, can help providers serve patients with limited english skills. Health Aff. 2011; doi:10.1377/hlthaff.2011.0667. Jacobs EA, Leos GS, Rathouz PJ, Fu Jr P: Shared networks of interpreter services, at relatively low cost, can help providers serve patients with limited english skills. Health Aff. 2011; doi:10.​1377/​hlthaff.​2011.​0667.
31.
go back to reference Ikuspegi. Observatorio Vasco de la Inmigración. Percepciones, valores y actitudes de la población vasca hacia la inmigracion estranjera. Vitoria: Gobierno Vasco; 2004. Ikuspegi. Observatorio Vasco de la Inmigración. Percepciones, valores y actitudes de la población vasca hacia la inmigracion estranjera. Vitoria: Gobierno Vasco; 2004.
32.
go back to reference Rodriguez Alvarez E, Lanborena Elordui N, Errami M, Rodriguez Rodriguez A, Pereda Riguera C, Vallejo de la Hoz G, et al. Relationship between migrant status and social support and quality of life in Moroccans in the Basque Country (Spain). Gaceta sanitaria. 2009; doi:10.1016/j.gaceta.2009.07.005. Rodriguez Alvarez E, Lanborena Elordui N, Errami M, Rodriguez Rodriguez A, Pereda Riguera C, Vallejo de la Hoz G, et al. Relationship between migrant status and social support and quality of life in Moroccans in the Basque Country (Spain). Gaceta sanitaria. 2009; doi:10.​1016/​j.​gaceta.​2009.​07.​005.
33.
go back to reference Saura RM, Sunol R, Vallejo P, Lahoz S, Atxotegui J, El Manouari M. Study of the healthcare background and psychosocial environment of the Maghrebian immigrant population in Catalonia [Spain]. Gac Sanit. 2008. doi:10.1016/S0213-9111(08)75353-6. Saura RM, Sunol R, Vallejo P, Lahoz S, Atxotegui J, El Manouari M. Study of the healthcare background and psychosocial environment of the Maghrebian immigrant population in Catalonia [Spain]. Gac Sanit. 2008. doi:10.​1016/​S0213-9111(08)75353-6.
34.
35.
go back to reference Adell CN, Cavallé TB, García AC, Caballero I V, Canela-Soler J. La opinión de los usuarios como oportunidad de mejora en atención primaria. Aten Primaria. 2005; doi:10.1157/13073414. Adell CN, Cavallé TB, García AC, Caballero I V, Canela-Soler J. La opinión de los usuarios como oportunidad de mejora en atención primaria. Aten Primaria. 2005; doi:10.​1157/​13073414.
36.
go back to reference Carrión Bolaños MI, Blanco Rodríguez JM, Salinero-Aceituno M, Rodríguez Jiménez MA, Calvo Martín C, Valenzuela-Álvarez D. Calidad percibida por los pacientes en un hospital de agudos, medida a través de encuestas. Rev Calid Asist. 2003;1:39–45.CrossRef Carrión Bolaños MI, Blanco Rodríguez JM, Salinero-Aceituno M, Rodríguez Jiménez MA, Calvo Martín C, Valenzuela-Álvarez D. Calidad percibida por los pacientes en un hospital de agudos, medida a través de encuestas. Rev Calid Asist. 2003;1:39–45.CrossRef
37.
go back to reference Caminal J, Sánchez E, Schiaffino A. El análisis por segmentos de población insatisfecha: una propuesta para optimizar la información de las encuestas de satisfacción global. Rev Calid Asist. 2002;1:4–10.CrossRef Caminal J, Sánchez E, Schiaffino A. El análisis por segmentos de población insatisfecha: una propuesta para optimizar la información de las encuestas de satisfacción global. Rev Calid Asist. 2002;1:4–10.CrossRef
39.
go back to reference Mira SJ. Causas de satisfacción e insatisfacción en los pacientes en hospitales y atención primaria. Rev Calid Asist. 2002;5:273–83.CrossRef Mira SJ. Causas de satisfacción e insatisfacción en los pacientes en hospitales y atención primaria. Rev Calid Asist. 2002;5:273–83.CrossRef
40.
go back to reference Bandura A. Pensamiento y acción :fundamentos sociales. Barcelona: Martínez Roca; 1987. Bandura A. Pensamiento y acción :fundamentos sociales. Barcelona: Martínez Roca; 1987.
41.
go back to reference Rodney P, Kadyschuk S, Liaschenko J, Brown H, Musto L, Snyder N. Moral agency: Relational connections and support. In: Storch JL, Starzomski R, Rodney P, editors. Toward a Moral Horizon: Nursing Ethics for Leadership and Practice. Toronto: Pearson; 2012. p. 160–87. Rodney P, Kadyschuk S, Liaschenko J, Brown H, Musto L, Snyder N. Moral agency: Relational connections and support. In: Storch JL, Starzomski R, Rodney P, editors. Toward a Moral Horizon: Nursing Ethics for Leadership and Practice. Toronto: Pearson; 2012. p. 160–87.
43.
go back to reference Bandura A. Selective activation and disengagement of moral control. J Soc Issues. 1990;1:27–46.CrossRef Bandura A. Selective activation and disengagement of moral control. J Soc Issues. 1990;1:27–46.CrossRef
Metadata
Title
Perceived discrimination among Maghrebi users of health services in Tarragona (Spain)
Authors
Lourdes Rubio-Rico
Alba Roca-Biosca
Inmaculada de Molina-Fernández
Publication date
01-12-2015
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2015
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-015-0275-7

Other articles of this Issue 1/2015

International Journal for Equity in Health 1/2015 Go to the issue