Access to Medical Care of Migrants in a Honduran City

Abstract

The adequacy of the notion that traditional cultural attitudes and beliefs of the internal migrants in Latin American cities explains much of their reluctance to make use of modern scientific medical care is empirically tested. A longitudinal study of health and medical care was done in San Pedro Sula, Honduras, in a low-income sector where 80 per cent of the residents were not born in the city. Data collection included migration and health questionnaires, retrospective life histories, clinical examinations, and participant observation. Findings reveal low access rates of the population to professional medical care institutions. No consistent relationships are found between migratory status and access to medical care once socioeconomic status is held constant. Positive selectivity, prior urban experience, and extensive kinship networks aided most migrants in the transition to urban life and norms of institutional participation. The Roemer model of a socially stratified medical care system in most of Latin America is corroborated in the case of San Pedro Sula. As a consequence, whether a person or family manifests "modern" medical care utilization behavior depends more on the urban opportunity structure than on attributed "traditional" cultural beliefs and attitudes.