Does Ethnic Origin matter for Health Inequalities in Bolivia? An Assessment of the Effect of Ethnicity on Health Care Access and Health Outcomes

Abstract: Good health is of utmost importance to individuals and economic growth. Nevertheless, inequalities concerning health services and conditions are observed in developed as well as developing countries. Often such disparities are related to ethnicity, with indigenous populations exhibiting lower health performance. Bolivia features a large indigenous population, which still experiences disadvantages concerning education, employment and poverty. However, there are few recent empirical assessments of the inequalities in access to health care and health performance of indigenous people compared to non-indigenous people. The few studies that do exist tend to focus on maternal and child health. The present study utilizes data from the Bolivian household survey from 2013 to 2019 to research ethnicity-related patterns in health performance. Several indicators regarding overall population health are scrutinized using binary logistic regressions. These are health insurance affiliation, prevalence of chronic and recent tropical diseases and the prevalence of diarrhea, which serves as a proxy for child health. This thesis focuses on ethnicity-related disparities regarding these health aspects. The study reveals considerable health inequalities between indigenous and non-indigenous populations concerning all examined indicators. Considering that indigenous people account for almost 50% of the population, these findings imply considerable shortcomings in Bolivia’s health care provision. Moreover, indigenous heterogeneity, referring to disparities between different indigenous groups, is examined. Significant differences are discovered between the ethnic groups of Aymara, Quechua, other indigenous people and Afro-Bolivians. Consequently, future health interventions to decrease the health gap should not only focus on the group of “indigenous” but consider the heterogeneity within that group to achieve effective improvements in indigenous health status.