Analysis of health inequalities. A qualitative approach

Abstract

Objective: To present the findings of a study about social inequalities based on experiences of care and treatment of patients affected by type 2 Diabetes Mellitus and to provide theoretical and methodological elements to analyze social inequalities in health. Methodology: Qualitative study based on biographical stories of patients diagnosed for more than one year having different socioeconomic and sociocultural features was carried out. In an attempt to have representation of diverse social classes, genders and ethnic-racial conditions, cases were selected from different healthcare facilities of the Santiago de Cali municipality (Colombia). Results: Three interrelated domains which constitute conditions of inequality throughout life and in experiences of the care and treatment of diabetes were identified. They were health domain, which comprises the access and use of health services and satisfaction of health needs, health care and health results; socioeconomic domain, which includes social spaces, social positions, resources, sociocultural frames of social hierarchy formation; and finally, context domain, which involves policies and economic, social and cultural features of the patient's environment. Conclusions: In order to analyze health inequalities, not only understanding their manifestations in organisms or access to health services is necessary but also the comprehension of their social development. Four key elements for the development of inequalities were identified: the territory, the link between education and employment, gender, and various forms of violence.