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      Access to healthcare for deaf people: a model from a middle-income country in Latin America

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          ABSTRACT

          OBJECTIVE

          To determine if there are existing healthcare access inequities among the deaf Chilean population when compared to the general Chilean population.

          METHODS

          Data were obtained from a population-based national survey in Chile. In total, 745 prelingually deaf individuals were identified. The number of times the person used the healthcare system was dichotomized and analyzed using a multivariate logistic regression model.

          RESULTS

          Prelingually deaf people had lower incomes, fewer years of education, and greater rates of unemployment and poverty when compared with the general population. Moreover, they visited more general practitioners, mental health specialists, and other medical specialists. On average, they attended more appointments for depression but had fewer general checkups and gynecological appointments than the general population.

          CONCLUSIONS

          Deaf people in Chile have a lower socioeconomic status than the rest of the Chilean population. The results from this study are similar to the findings reported for high-income countries, despite differences in the magnitude of the associations between being deaf and healthcare access. Further studies should be conducted to determine the health status of deaf people in Chile and other Latin American countries and what factors are associated with a significantly lower prevalence of gynecological appointments among deaf women when compared with non-deaf women.

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          Most cited references21

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          Gradient of disability across the socioeconomic spectrum in the United States.

          Although the relationship between extreme poverty and poor health among older adults has long been recognized, less attention has been devoted to investigating whether a gradient in disability exists in the United States among persons with middle-class and upper-class incomes. We attempted to determine whether a gradient in functional limitation exists across the full spectrum of income among persons 55 years of age or older. We obtained data from the Census 2000 Supplementary Survey, which used the methods and questionnaire of the American Community Survey, a nationally representative survey of 890,698 households with a response rate of 95 percent. Our sample included 149,000 men and 186,675 women who were at least 55 years of age, of whom 32,680 men and 48,111 women reported having a functional limitation (a long-lasting condition that substantially limited one or more basic physical activities, such as climbing stairs or lifting). A social-class gradient was observed for both men and women between the ages of 55 and 84, a gradient that held true even at the upper rungs of the socioeconomic ladder. For example, in comparison to persons between the ages of 55 and 64 who lived at 700 percent of the poverty line or above, persons of the same age but below the poverty line had six times the odds of reporting a functional limitation. With increasing income, the odds ratio declined. A significant gradient was present up to, but not beyond, the age of 85 years. Our findings suggest that functional limitation in Americans between the ages of 55 and 84 years is inversely related to social class across the full spectrum of the socioeconomic gradient. Copyright 2006 Massachusetts Medical Society.
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            Association of hearing loss with hospitalization and burden of disease in older adults.

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              Health Care Access Among Deaf People.

              Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health.
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                Author and article information

                Journal
                Rev Saude Publica
                Rev Saude Publica
                rsp
                Revista de Saúde Pública
                Faculdade de Saúde Pública da Universidade de São Paulo
                0034-8910
                1518-8787
                23 January 2020
                2020
                : 54
                : 13
                Affiliations
                [I ]orgnamePontificia Universidad Católica de Chile orgdiv1Facultad de Medicina orgdiv2Departamento de Ciencias de la Salud SantiagoChileoriginalPontificia Universidad Católica de Chile. Facultad de Medicina. Departamento de Ciencias de la Salud. Santiago, Chile
                [II ]orgnameUniversité de Montréal orgdiv1Faculté de médecine orgdiv2École d’orthophonie et d’audiologie Montréal QuébecCanadaoriginalUniversité de Montréal. Faculté de médecine. École d’orthophonie et d’audiologie. Montréal, Québec, Canada
                [III ]orgdiv1Centre de recherche orgnamel’Institut universitaire de gériatrie de Montréal Montréal QuébecCanadaoriginalCentre de recherche de l’Institut universitaire de gériatrie de Montréal. Montréal, Québec, Canada
                Author notes
                Correspondence: Eduardo Fuentes-López Pontificia Universidad Católica de Chile. Facultad de Medicina. Departamento de Ciencias de la Salud. Carrera de Fonoaudiología. Santiago, Chile. Avenida Vicuña Mackenna 4860, Macul, Santiago, Chile. Phone: (56) (22) 3541345 Email: eduardo.fuentes@ 123456uc.cl

                Authors’ Contribution: Design and planning of the study: EF-L, AF. Collection, analysis, and interpretation of the data: EF-L, AF. Preparation or review of the study: EF-L, AF. Approval of the final version: EF-L, AF. Public responsibility for the content of the article: EF-L, AF

                Conflict of Interest: The authors hereby declare they have no conflicts of interest.

                Author information
                https://orcid.org/0000-0002-0141-0226
                https://orcid.org/0000-0003-3736-5057
                Article
                00211
                10.11606/s1518-8787.2020054001864
                6986863
                32022141
                7acccf05-bf26-4bc1-9a43-6a21dfdf57db

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 June 2019
                : 22 July 2019
                Page count
                Figures: 1, Tables: 4, Equations: 0, References: 26
                Categories
                Original Article

                persons with hearing impairments,effective access to health services,socioeconomic factors,health status disparities

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