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      La formación integral del médico para enfrentar las barreras para la atención comunitaria a propósito de El médico africano Translated title: Integral medical education to face barriers for community healthcare in The African physician

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          Abstract

          Resumen El conjunto de conocimientos, habilidades, principios y valores de un individuo para ejercer bien su trabajo en medicina sirven para fortalecer el desenvolvimiento en una comunidad. La película Bienvenue à Marly-Gomont (2016) de Julien Rambaldi, tiene por tema principal el esfuerzo y las actitudes del médico congoleño Zantoko ante el racismo que demuestran los habitantes de la villa rural Marly-Gomont de los años setenta. La película muestra a una comunidad francesa aislada, quienes nunca habían visto a una persona de color; nos sitúa con la familia de Zantoko en el contexto de la comunidad, lo que nos permite comprender los puntos fundamentales que pudieron haber servido como herramientas prácticas y necesarias para la labor del médico comunitario. Nos invita a reflexionar acerca de las dificultades que pueden presentarse ante la falta de conocimientos necesarios para atender una comunidad y la poca prevención en dicha comunidad. En suma, es una película excelente para la enseñanza y aprendizaje de temas relacionados con la labor que desarrollan los profesionales de la salud a nivel poblacional/local.

          Translated abstract

          Summary An individual's set of knowledge, skills, principles and values to carry out his medical work well serves to strengthen the unfolding in a community. The film the African physician (2016) of Julien Rambaldi, has as its main theme the effort and attitudes of the Congolese doctor Zantoko and how he faces the fear racism of the habitans of rural village Marly-Gomont on the seventies. The film shows an isolated French community, who had never seen black people; places us with Zantoko's family in the context of the community, which allows us to understand the fundamental point that may have served as practical and necessary tools for the work of the community doctor. It invites us to reflect on the difficulties that may occur in the face of the lack of knowledge needed to serve a community and ignorance of it. It is an excellent film for teaching and learning topics related to the work of health professionals at the population/local level.

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          Most cited references19

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          Racism and Health: Evidence and Needed Research

          In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism—structural racism, cultural racism, and individual-level discrimination—to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to advance knowledge in this area.
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            Public health ethics theory: review and path to convergence.

            Lisa M Lee (2012)
            Public health ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the "patient" in public health is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of public health ethics, the use of bioethics as its model, and the proposed frameworks for public health ethics through 2010. Review of 13 major public health ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of public health is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If public health is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives. © 2012 American Society of Law, Medicine & Ethics, Inc.
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              Discrimination in healthcare as a barrier to care: experiences of socially disadvantaged populations in France from a nationally representative survey

              Background People in socially disadvantaged groups face a myriad of challenges to their health. Discrimination, based on group status such as gender, immigration generation, race/ethnicity, or religion, are a well-documented health challenge. However, less is known about experiences of discrimination specifically within healthcare settings, and how it may act as a barrier to healthcare. Methods Using data from a nationally representative survey of France (N = 21,761) with an oversample of immigrants, we examine rates of reported discrimination in healthcare settings, rates of foregoing healthcare, and whether discrimination could explain disparities in foregoing care across social groups. Results Rates of both reporting discrimination within healthcare and reporting foregone care in the past 12 months were generally highest among women, immigrants from Africa or Overseas France, and Muslims. For all of these groups, experiences of discrimination potentially explained significant proportions of their disparity in foregone care (Percent disparity in foregone care explained for: women = 17%, second-generation immigrants = 8%, Overseas France = 13%, North Africa = 22%, Sub-Saharan Africa = 32%, Muslims = 26%). Rates of foregone care were also higher for those of mixed origin and people who reported “Other Religion”, but foregone healthcare was not associated with discrimination for those groups. Conclusions Experiences of discrimination within the healthcare setting may present a barrier to healthcare for people that are socially disadvantaged due to gender, immigration, race/ethnicity, or religion. Researchers and policymakers should consider barriers to healthcare that lie within the healthcare experience itself as potential intervention targets.
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                Author and article information

                Journal
                rmc
                Revista de Medicina y Cine
                Rev Med Cine
                Universidad de Salamanca (Salamanca, Salamanca, Spain )
                1885-5210
                September 2021
                : 17
                : 3
                : 187-195
                Affiliations
                [1] Yucatán orgnameUniversidad Marista de Mérida orgdiv1Escuela de Medicina Mexico
                Article
                S1885-52102021000300003 S1885-5210(21)01700300003
                10.14201/rmc2021173187195
                e2a4a8cb-6b0f-4d4f-8c6f-d5dbd8b2664d

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 26 December 2020
                : 07 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 19, Pages: 9
                Product

                SciELO Spain

                Categories
                Originales

                primary care,salud pública,educación médica,atención primaria,racismo,aprendizaje y responsabilidad social,public health,medical education,racism,learning and social accountability

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