Ahora que parece que España lleva camino de volver a convertirse en un país de emigrantes, tal vez es buen momento para recordar la asignatura pendiente que seguimos teniendo con la investigación de la inmigración y su relación con la salud.
La investigación en este ámbito había empezado a despegar pero parece que la actual situación económica puede cercenarla.
Por eso es interesante ver cómo en otros países afrontan la investigación en este campo. Y así encontramos que en el European Journal of Public Health se acaba de publicar el artículo titulado: "Principles for research on ethnicity and health: the Leeds Consensus Statement" (aunque en nuestro país es más frecuente hablar de investigación en inmigración y salud, no sucede así en otros países, particularmente en el Reino Unido, en el que se utiliza investigación sobre etnia y salud, aunque podríamos discutir si es exactamente lo mismo o no).
En este artículo se definen los principios de la investigación en esta materia acordados mediante una técnica de consenso (Delphi). Y han sido sintetizados en 10 puntos (abajo puede verse en la versión original en inglés).
Resulta interesante, sobre todo, recalcar los dos primeros, referidos a la importancia y propósito de la investigación. En traducción propia (e imperfecta), son estos:
The Leeds Consensus Principles for research on ethnicity and health
Importance and purpose
1. Ethnicity is often associated with disadvantage and ill-health. Researchers consequently have both a professional and ethical responsibility to incorporate evidence on ethnicity into their work and recommendations.
2. The purpose of research on ethnicity and health should be for the well-being and betterment of populations being studied and equity should be the guiding ethical principle. Researchers must be alert to the dangers of discriminatory thinking and behaviour and guard against actual and potential harm resulting from their research.
Framing and focus.
3. It is important to be explicit about the assumptions and theories that underlie research on ethnicity and health.
4. There is a need for research to, where appropriate, examine diversity within ethnic groups and avoid homogenization. For example, age, gender, religion, education, socio-economic position, geography or time of migration may all impact on the generation of ethnic health inequalities. Investigation of ethnic health inequalities should pay due regard to the ways in which ethnicity intersects with other forms of difference in order to understand how and why it may be relevant.
5. There is a need to improve the participation of minority ethnic communities in all stages of the research process. Appropriate participation should be defined by these communities, then promoted by researchers and statutory agencies and resourced by funding bodies.
Data collection and analysis
6. The use of ethnic categories and labels should be meaningful in relation to the particular experiences and outcomes being explored.
7. Census categories are often useful for exposing disadvantage, but additional measures may be needed to explore the processes through which disadvantage is created.
8. Analysis of health inequalities should pay attention to the social context in which ethnic differences in health outcomes are measured and health behaviours occur.
Future priorities
9. There is a need to focus on intervention studies that help identify effective ways of reducing inequalities.
10. More research is needed on appropriate models for involving minority ethnic communities throughout the research process. For example, models for community capacity building, empowerment, representativeness and continuity of engagement.
1. La etnia está frecuentemente asociada con desventajas y mala salud. Los investigadores consecuentemente tienen la responsabilidad ética y profesional de incorporar evidencias sobre etnia en su trabajo y recomendaciones
2. El propósito de la investigación sobre etnia y salud debería estar dirigido al bienestar y mejoría de las poblaciones que son estudiadas y la equidad debería ser el principio ético que la guíe. Los investigadores deben estar alerta de los peligros de discriminación (tanto de juicio como de comportamiento) y en guardia contra los riesgos potenciales de su investigación.
Una llamada a la responsabilidad de quienes se dedican a la investigación. Tengámoslo en cuenta.
The Leeds Consensus Principles for research on ethnicity and health
Importance and purpose
1. Ethnicity is often associated with disadvantage and ill-health. Researchers consequently have both a professional and ethical responsibility to incorporate evidence on ethnicity into their work and recommendations.
2. The purpose of research on ethnicity and health should be for the well-being and betterment of populations being studied and equity should be the guiding ethical principle. Researchers must be alert to the dangers of discriminatory thinking and behaviour and guard against actual and potential harm resulting from their research.
Framing and focus.
3. It is important to be explicit about the assumptions and theories that underlie research on ethnicity and health.
4. There is a need for research to, where appropriate, examine diversity within ethnic groups and avoid homogenization. For example, age, gender, religion, education, socio-economic position, geography or time of migration may all impact on the generation of ethnic health inequalities. Investigation of ethnic health inequalities should pay due regard to the ways in which ethnicity intersects with other forms of difference in order to understand how and why it may be relevant.
5. There is a need to improve the participation of minority ethnic communities in all stages of the research process. Appropriate participation should be defined by these communities, then promoted by researchers and statutory agencies and resourced by funding bodies.
Data collection and analysis
6. The use of ethnic categories and labels should be meaningful in relation to the particular experiences and outcomes being explored.
7. Census categories are often useful for exposing disadvantage, but additional measures may be needed to explore the processes through which disadvantage is created.
8. Analysis of health inequalities should pay attention to the social context in which ethnic differences in health outcomes are measured and health behaviours occur.
Future priorities
9. There is a need to focus on intervention studies that help identify effective ways of reducing inequalities.
10. More research is needed on appropriate models for involving minority ethnic communities throughout the research process. For example, models for community capacity building, empowerment, representativeness and continuity of engagement.
Óscar, agradecer tu trabajo incansable y sabes que de lectura en muchas ocasiones minoritaria... aún nos cuesta entender que el gran margen de mejora en salud se encuentra en las personas que sufren una desigualdad social en salud (DSS).
ResponderEliminarInteresantisimo artículo e interesantes 10 puntos, tanto los 2 que señalas como los que se orientan a la acción y dan un "norte" a como investigar en DSS.
Te agradezco mucho tu esfuerzo y te felicito por tu estupendo blog.
ANTONIO JESUS
Muchas gracias. Viniendo además de un "turronero" se agradece todavía más. Yo sigo aprendiendo de vosotros.
ResponderEliminar