Living conditions and access to health services by Bolivian immigrants in the city of São Paulo, Brazil

Cássio Silveira,Rita de Cássia Barradas Barata,Nivaldo Carneiro Junior,Manoel Carlos Sampaio de Almeida Ribeiro

doi:10.1590/0102-311x00113212

Abstract

Bolivian immigrants in Brazil experience serious social problems: precarious work conditions, lack of documents and insufficient access to health services. The study aimed to investigate inequalities in living conditions and access to health services among Bolivian immigrants living in the central area of São Paulo, Brazil, using a cross-sectional design and semi-structured interviews with 183 adults. According to the data, the immigrants tend to remain in Brazil, thus resulting in an aging process in the group. Per capita income increases the longer the immigrants stay in the country. The majority have secondary schooling. Work status does not vary according to time since arrival in Brazil. The immigrants work and live in garment sweatshops and speak their original languages. Social networks are based on ties with family and friends. Access to health services shows increasing inclusion in primary care. The authors conclude that the immigrants' social exclusion is decreasing due to greater access to documentation, work (although precarious), and the supply of health services from the public primary care system.

Highlights

The presence of Bolivian immigrants in downtown São Paulo, Brazil, has raised a debate on social inclusion, especially access to health services
Historical evidence points to the economic attraction exerted by the work market as the main factor for the contingent of Bolivian immigrants that came to São Paulo since the mid-20th century, with an important increase since the 1980s due to expansion of the Brazilian textile industry and economic difficulties in the immigrants’ home country 1,2
The data show that the group consists mainly of young people and adults of both sexes who were not living with partners at the time of the interview, with a mean monthly income of 1 to 3 times the minimum wage, using Spanish or an indigenous language on a daily basis, and legally documented to live in Brazil

Summary

Introduction

The presence of Bolivian immigrants in downtown São Paulo, Brazil, has raised a debate on social inclusion, especially access to health services. Historical evidence points to the economic attraction exerted by the work market as the main factor for the contingent of Bolivian immigrants that came to (and stayed in) São Paulo since the mid-20th century, with an important increase since the 1980s due to expansion of the Brazilian textile industry and economic difficulties in the immigrants’ home country 1,2. A demographic transition can already be seen with the “aging” that has occurred in parallel to the arrival of new Bolivian immigrants 3. As these immigrants come to and stay in São Paulo, they are exposed to hardships along the way and in their adaptation to a new living situation in a foreign country, often including precarious work relations, unhealthy housing, the language barrier, and racism, discrimination, and prejudice in public institutions. A complex set of situations shape various vulnerabilities, with evidence of loss of social rights and social protection 4,5,6,7

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Conclusion