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Vol. 21. Num. 3. 2012. Pages 305-318

Mental Health Care for Latino Immigrants in the U.S.A. and the Quest for Global Health Equities

[Servicios de Salud Mental para los Inmigrantes Latinos en los Estados Unidos y la Lucha por una Igualdad en Salud Global]

Ramírez García, Jorge I.

Oregon Research Institute, USA

Abstract

Currently, approximately 190 million immigrants world-wide live in host societies located in countries that have higher economic resources and political power than the countries of origin of immigrants. In this paper I use ecological and system theories (eco-systems) to frame the relationship between Latino immigrants and the host society in the U.S.A. The eco-system perspective highlights that policies and initiatives to address the mental health care of Latino immigrants must weigh dilemmas such as: (a) containing the costs of care while providing high quality (efficacious) care, and (b) the power inequity between immigrants and their host society. I posit that Social Justice/Public Health frameworks are needed to address these dilemmas because they are mindful of the receiving community needs, inclusive of immigrants, as well as of other marginalized populations. The framework is consistent with the proposed focus on Health Equity in public health in the U.S. (Braveman et al., 2011) and is relevant for the global phenomenon of immigration.

Resumen

En la actualidad, aproximadamente 190 millones de inmigrantes de todo el mundo viven en sociedades de acogida situadas en países con mayores recursos económicos y mayor poder político que los países de origen de los inmigrantes. En este artículo utilizo las teorías ecológicas y de sistemas (ecosistemas) para analizar la relación entre los inmigrantes latinos y la sociedad de acogida en los EEUU. El enfoque de ecosistemas pone de relieve que las políticas e iniciativas para abordar la asistencia sanitaria de los inmigrantes latinos deben sopesar dilemas como: (a) la contención de costes sanitarios al tiempo que se proporciona una atención de alta calidad (eficaz), y (b) la desigualdad de poder entre los inmigrantes y su sociedad de acogida. Postulo que el marco de la Justicia Social/Salud Pública es necesario para abordar estos dilemas, porque toma en consideración las necesidades de la comunidad receptora, así como de los inmigrantes y de otras poblaciones marginadas. Dicho marco concuerda con el enfoque propuesto basado en la Igualdad Sanitaria del sistema de salud de los EEUU (Braveman et al., 2011) y es relevante para el fenómeno global de la inmigración.

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