Socioeconomic disparities in access to healthcare among Venezuelan immigrants in Peru: an analysis of ENPOVE 2022

Authors

DOI:

https://doi.org/10.21142/mecp.2026.1.3.e036

Keywords:

Health Inequities, Health Services Research, Social Determinants of Health, Transients and Migrants

Abstract

Objectives: To assess socioeconomic inequalities in health service utilization among Venezuelan adult migrants residing in Peru. Methods: Cross-sectional analytical study of the 2022 Survey of the Venezuelan Population Residing in Peru (ENPOVE 2022). We included migrants aged 18 years or older who reported a health problem in the four weeks prior to the survey and considered it necessary to seek healthcare. The dependent variable was health service utilization (yes/no). The independent variable was the wealth index, estimated using principal component analysis. Socioeconomic inequality was assessed using the Erreygers Concentration Index (ECI) and the adjusted Slope Index of Inequality (aSII) and Relative Index of Inequality (aRII). Linear and Poisson regression models were fitted adjusting for sociodemographic covariates. All analyses were performed in Stata v19.0, accounting for sampling weights and the complex survey design. Results: Among the 1,569 participants included in the analysis, health service utilization favored higher socioeconomic groups (aSII = 0.309; 95% CI: 0.128–0.490; aRII = 2.11; 95% CI: 1.37–3.24; ECI = 0.132; 95% CI: 0.059–0.205). These inequalities were also observed among uninsured migrants and among those with regular immigration status. Conclusions: Among Venezuelan adult migrants in Peru with recent health problems and a perceived need for care, health service utilization favored those in higher socioeconomic positions. These findings support prioritizing socioeconomically disadvantaged migrants in Peru’s healthcare access initiatives and incorporating socioeconomic inequality indicators into the monitoring of service utilization.

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References

1. Inter-Agency Coordination Platform for Refugees and Migrants from Venezuela. R4V Latin America and the Caribbean, Venezuelan Refugees and Migrants in the Region - November 2025 [Internet]. 2025 [cited 2026 Apr 17]. Available from: https://www.r4v.info/en/document/r4vlatin-america-and-caribbean-venezuelan-refugees-andmigrants-region-november-2025

2. Mazza J, Forero-Villarreal N. Perú and Migration from Venezuela: From Early Adjustment to Policy Misalignment. In: Crawley H, Teye JK, editors. The Palgrave handbook of South–South migration and inequality. Cham: Palgrave Macmillan; 2024. p. 653-678. doi: 10.1007/978-3-031-39814- 8_30.

3. Al-kassab-Córdova A, Villarreal-Zegarra D, Bendezu-Quispe G, Robles-Valcárcel P, Herrera-Añazco P, Benites-Zapata VA. Socio-demographic, migratory and health-related determinants of food insecurity among Venezuelan migrants in Peru. Public Health Nutr. 2023;26(12):2982-94. doi: 10.1017/ S1368980023002513.

4. Instituto Nacional de Estadística e Informática. Condiciones de vida de la Población Venezolana que reside en el Perú. Resultados de la II ENPOVE 2022 [Internet]. Lima, Perú: INEI; 2022 [cited 2026 Apr 17]. Available from: https://www.inei. gob.pe/media/MenuRecursivo/publicaciones_digitales/ Est/Lib1886/libro.pdf

5. Mougenot B, Amaya E, Mezones-Holguin E, RodriguezMorales AJ, Cabieses B. Immigration, perceived discrimination and mental health: evidence from Venezuelan population living in Peru. Global Health. 2021;17(1):8. doi: 10.1186/s12992-020-00655-3.

6. Cabieses B, Gálvez P, Ajraz N. [International migration and health: the contribution of migration social theories to public health decisions]. Rev Peru Med Exp Salud Publica. 2018;35(2):285-91. doi: 10.17843/rpmesp.2018.352.3102.

7. Spencer MRT, Yoon S, Lee Y, Bustamante AV, Chen J. Healthcare and telehealth use among U.S. immigrants during the COVID-19 pandemic. Front Public Health. 2024;12:1422343. doi: 10.3389/fpubh.2024.1422343.

8. Doocy S, Lyles E, Akhu-Zaheya L, Burton A, Burnham G. Health service access and utilization among Syrian refugees in Jordan. Int J Equity Health. 2016;15:108. doi: 10.1186/s12939- 016-0399-4.

9. Carrillo-Larco RM, Guzman-Vilca WC, Leon-Velarde F, Bernabe-Ortiz A, Jimenez MM, Penny ME, et al. Peru – Progress in health and sciences in 200 years of independence. Lancet Reg Health Am. 2022;7:100148. doi: 10.1016/j.lana.2021.100148.

10. Seguro Integral de Salud. Requisitos para la afiliación al SIS [Internet]. Lima: Seguro Integral de Salud [cited 2026 Apr 21]. Available from: https://www.gob.pe/institucion/sis/ campa%C3%B1as/8503-requisitos-para-la-afiliacion-al-sis

11. Defensoría del Pueblo. Personas venezolanas en el Perú: análisis de su situación antes y durante la crisis sanitaria generada por el COVID-19 [Internet]. Lima: Defensoría del Pueblo; 2020 [cited 2026 Sep 22]. Informe de Adjuntía No.: 002-2020-DP/ADHPD. Available from: https://www. defensoria.gob.pe/wp-content/uploads/2020/12/Informede-Adjunt%C3%ADa-N-002-2020-DP-ADHPD-PersonasVenezolanas-en-el-Per%C3%BA.pdf

12. Seguro Integral de Salud. SIS garantiza cobertura integral y gratuita de sus cinco planes de seguros para el 2022 [Internet]. Lima: Seguro Integral de Salud; 2021 [cited 2026 Sep 22]. Available from: https://www.gob.pe/institucion/ sis/noticias/573365-sis-garantiza-cobertura-integral-ygratuita-de-sus-cinco-planes-de-seguros-para-el-2022

13. Dedios MC, Ruiz F. Recent Migration to Peru: The Current Situation, Policy Responses and Opportunities [Internet]. New York: United Nations Development Programme; 2022 [cited 2026 Sep 22]. UNDP LAC Policy Documents Series; no. 35. Available from: https://www.undp.org/sites/g/files/ zskgke326/files/2022-10/PNUDLAC-working-paper-35-PeruEN.pdf

14. Pierola MD, Rodriguez-Chatruc M. Migrants in Latin America: Disparities in Health Status and in Access to Healthcare [Internet]. Washington, DC: Inter-American Development Bank; 2020 [cited 2026 Apr 21]. Available from: https:// publications.iadb.org/en/migrants-in-latin-americadisparities-in-health-status-and-in-access-to-healthcare doi: 10.18235/0002432.

15. Pan American Health Organization. International migrants’ health: health systems: health care access. Scientific literature review summary sheet [Internet]. Washington, DC: Pan American Health Organization; 2023 [cited 2026 Sep 22]. Available from: https://www.paho.org/sites/default/ files/2023-08/healthmigration-health-care-access-2023.pdf

16. Hernández-Vásquez A, Bendezu-Quispe G, Azañedo D. Migration Status and Utilization of Healthcare Services Among Venezuelan Immigrants in Peru. J Community Health. 2023;48(6):1031-7. doi: 10.1007/s10900-023-01276-8.

17. World Health Organization. Handbook on Health Inequality Monitoring with a special focus on low-and middle-income countries [Internet]. Geneva, Switzerland: World Health Organization; 2013 [cited 2026 Apr 22]. Available from: https://www.who.int/publications/i/item/9789241548632

18. Moreno-Betancur M, Latouche A, Menvielle G, Kunst AE, Rey G. Relative index of inequality and slope index of inequality: a structured regression framework for estimation. Epidemiology. 2015;26(4):518-27. doi: 10.1097/ EDE.0000000000000311.

19. Conway D, McMahon AD, Brown D, Leyland AH. Measuring socioeconomic status and inequalities. In: Vaccarella S, Lortet-Tieulent J, Saracci R, Conway DI, Straif K, Wild CP, editors. Reducing social inequalities in cancer: evidence and priorities for research [Internet]. Lyon (FR): International Agency for Research on Cancer; 2019 [cited 2026 Apr 22]. Available from: https://www.ncbi.nlm.nih.gov/books/ NBK566205/

20. Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18. doi: 10.1186/1475-9276-12-18.

21. Instituto Nacional de Estadística e Informática. Segunda encuesta dirigida a la población venezolana que reside en el país: II ENPOVE 2021-2022. Ficha técnica [Internet]. Lima: INEI; 2022 [cited 2026 Sep 22]. Available from: https://www. inei.gob.pe/media/encuestas/documentos/enpove/Ficha_ Tecnica_2022_enpove.pdf

22. Instituto Nacional de Estadística e Informática. Encuesta dirigida a la población venezolana que reside en el país (ENPOVE) 2022: microdatos [dataset on the Internet]. Lima: INEI; 2022 [cited 2026 Sep 18]. Available from: https:// proyectos.inei.gob.pe/iinei/srienaho/

23. Hernández-Vásquez A, Visconti-Lopez FJ, Rojas-Cueva AC, Grendas LN, Azañedo D. Food Insecurity and Mental Health among Venezuelan Migrants and Refugees Living in Peru: Secondary Data Analysis of a Cross-Sectional Survey. Nutrients. 2023;15(14):3102. doi: 10.3390/nu15143102.

24. Barros AJD, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21. doi: 10.1186/1471-2288-3-21.

25. Mackenbach JP, Kunst AE. Measuring the magnitude of socioeconomic inequalities in health: an overview of available measures illustrated with two examples from Europe. Soc Sci Med. 1997;44(6):757-71. doi: 10.1016/s0277-9536(96)00073-1.

26. Department of Health and Social Care. Slope index of inequality (SII) and relative index of inequality (RII). In: Public health technical guidance [Internet]. London: Department of Health and Social Care; 2025 [cited 2026 Sep 22]. Available from: https://fingertips.phe.org.uk/static-reports/publichealth-technical-guidance/Inequality/SII.html

27. Hosseinpoor AR, Parker LA, Tursan d’Espaignet E, Chatterji S. Socioeconomic inequality in smoking in low-income and middle-income countries: results from the World Health Survey. Plos One. 2012;7(8):e42843. doi: 10.1371/journal. pone.0042843.

28. Schlotheuber A, Hosseinpoor AR. Summary Measures of Health Inequality: A Review of Existing Measures and Their Application. Int J Environ Res Public Health. 2022;19(6):3697. doi: 10.3390/ijerph19063697.

29. O’Donnell O, O’Neill S, Van Ourti T, Walsh B. conindex: Estimation of concentration indices. Stata J. 2016;16(1):112-38. doi: 10.1177/1536867X1601600112.

30. Bowser DM, Agarwal-Harding P, Sombrio AG, Shepard DS, Harker Roa A. Integrating Venezuelan Migrants into the Colombian Health System during COVID-19. Health Syst Reform. 2022;8(1):2079448. doi: 10.1080/23288604.2022.2079448.

31. Quizhpe E, Sebastian MS, Teran E, Pulkki-Brännström AM. Socioeconomic inequalities in women’s access to health care: has Ecuadorian health reform been successful? Int J Equity Health. 2020;19(1):178. doi: 10.1186/s12939-020-01294 -1.

32. Palacios A, Espinola N, Rojas-Roque C. Need and inequality in the use of health care services in a fragmented and decentralized health system: evidence for Argentina. Int J Equity Health. 2020;19(1):67. doi: 10.1186/s12939-020-01168-6.

33. Etemadi M, Shahabi S, Hedayati M, Lankarani KB, Behzadifar M, Rad ND. Identifying challenges and enabling factors in utilizing health care services by undocumented immigrant women: a scoping review of qualitative research. J Health Popul Nutr. 2025;44(1):301. doi: 10.1186/s41043-025-01051-6.

34. World Health Organization. World report on the health of refugees and migrants [Internet]. Geneva: World Health Organization; 2022 [cited 2026 Sep 18]. Available from: https://www.who.int/publications/i/item/9789240054462

35. Ruiseñor H, Das S, Hakim A, Wickramage K, Sosa K, Calvo G, et al. Biobehavioral survey (BBS) among Venezuelan migrants living in Lima/Callao and Trujillo: final report [Internet]. Lima: International Organization for Migration; 2023 [cited 2026 Sep 22]. Available from: https://stacks.cdc.gov/view/ cdc/164657

36. Ornelas IJ, Yamanis TJ, Ruiz RA. The Health of Undocumented Latinx Immigrants: What We Know and Future Directions. Annu Rev Public Health. 2020;41:289-308. doi: 10.1146/ annurev-publhealth-040119-094211.

37. Obach A, Blukacz A, Sadler M, Carreño Calderón A, Cabieses B, Díaz C. Barriers and facilitators to access sexual and reproductive health services among young migrants in Tarapacá, Chile: a qualitative study. BMC Public Health. 2024;24(1):386. doi: 10.1186/s12889-024-17884-5.

38. Kisa S, Kisa A. “No Papers, No Treatment”: a scoping review of challenges faced by undocumented immigrants in accessing emergency healthcare. Int J Equity Health. 2024;23(1):184. doi: 10.1186/s12939-024-02270-9.

39. van Hees SGM, O’Fallon T, Hofker M, Dekker M, Polack S, Banks LM, et al. Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review. Int J Equity Health. 2019;18(1):134. doi: 10.1186/s12939-019-1040-0.

40. World Health Organization. Module 2: mainstreaming refugee and migrant health in the global, regional and country agenda and access to inclusive people-centred health services. In: Refugee and migrant health toolkit [Internet]. Geneva: World Health Organization; 2026 [cited 2026 Apr 23]. Available from: https://www.who.int/tools/ refugee-and-migrant-health-toolkit/module-2

41. World Health Organization. Refugee and migrant health [Internet]. Geneva: World Health Organization; 2026 [cited 2026 Apr 23]. Available from: https://www.who.int/newsroom/fact-sheets/detail/refugee-and-migrant-health

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Published

2026-09-28

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Original article

How to Cite

1.
Salas-Lavado X, Saldarriaga-Medina M, Eckhardt-Arias E, Bendezu-Quispe G, Iwami M, Azañedo D. Socioeconomic disparities in access to healthcare among Venezuelan immigrants in Peru: an analysis of ENPOVE 2022. Med Educ Clin Pract [Internet]. 2026 Sep. 28 [cited 2026 Oct. 18];1(3):e036. Available from: https://revistas.cientifica.edu.pe/index.php/mecp/article/view/3720