Health Inequalities Between Afro-descendants and Non-Afro-descendants in Peru: Evidence from the Demographic and Family Health Survey.

Abstract

Background: The Afro-Peruvian population is one of the ethnic minorities most affected by cultural, socioeconomic, and health barriers; however, there is little evidence on health inequalities in this ethnic group. Therefore, We aimed to determine health inequalities among the Peruvian Afro-descendant population in comparison with non-Afro-descendants.

Methods: A cross-sectional study was conducted using data from the Demographic and Family Health Survey 2022. Twenty indicators related to the health, nutrition, and well-being of the Peruvian Afro-descendant population were included. Individuals identifying as native, as well as those who did not know or did not respond to the ethnicity question, were excluded from the analysis. To assess inequalities in these indicators, the difference in percentages between Afro-descendants and non-Afro-descendants was calculated, and the percentages of these indicators across the tertiles of wealth index and the slope index of inequality (SII) were analysed for each ethnic group.

Results: Of a total of 16,875 adults and 23,206 women included in the study, 16.9% and 17.3% were of African descent, respectively. Afro-descendant population had a lower proportion of self-reported diabetes (- 1.5 percetange points (pp); 95% confidence interval (CI), - 2.7 to - 0.3); alcohol consumption in the last 30 days (- 4.5 pp; 95% CI, - 7.2 to - 1.8); higher education (- 20.6 pp, 95% CI, - 23.2 to - 18.0); access to improved water (- 3.4 pp; 95% CI, - 4.6 to - 2.1) and sanitation (- 12.1 pp; 95% CI, - 14.2 to - 10.0); cesarean section (- 9.5 pp; 95% CI, - 12.6 to - 6.4); institutional delivery (- 6.3 pp; 95% CI, - 8.4 to - 4.1); early initiation of prenatal care (- 3.3 pp; 95% CI, - 5.8 to - 0.9); birth registration (- 1.8 pp; 95% CI, - 3.4 to - 0.2) and higher proportion of stunting (+ 4.8 pp; 95% CI, 3.0 to 6.6) and adolescent maternity (+ 5.0 pp; 95% CI, 1.4 to 8.6) compared to their non-Afro-descendant counterparts. In addition, a similar wealth gap between Afro-descendant and non-Afro-descendant populations was observed in various indicators.

Conclusions: In Peru, some indicators reflect the worse living conditions faced by the Afro-descendant population compared to their non-Afro-descendant counterparts in terms of health, nutrition, and well-being.