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Background <p>Hearing loss is comparatively frequent in the Latin America and Caribbean (LAC) region, where the prevalence of disabling hearing loss is higher than in many areas of the world. The current societal infrastructure in the Dominican Republic (DR) for Deaf people is insufficient: services such as sign language interpreters are lacking, as are accessible and widespread educational and health care services or access to emergency services. This project was formed through four partnerships, including United States- and Dominican Republic-based academic institutions and community organizations serving Deaf communities, to identify lived experience of Deaf Dominicans in accessing health care.</p> Methods <p>We recruited 102 people in the DR self-identifying as Deaf to participate in 51 qualitative interviews. All interviews were conducted in Dominican Sign language (“LSRD”) by Deaf interviewers and were visually recorded. Interview transcripts were analyzed using thematic analysis informed by grounded theory to identify categories explaining participants’ experiences.</p> Results <p>Three themes emerged in our grounded theory showing that Deaf Dominicans (1) rely heavily on hearing people as facilitators and navigators for the Deaf person to access health care; (2) often as a result of this dependence, Deaf Dominicans frequently experience lack of health care information in transactional health-related encounters and, more broadly, in general health knowledge; and (3) communicate frequently with the hearing world (including health care providers and workers) through gestures other than an established sign language. Further, Deaf Dominicans routinely experience structural audism, defined as systemic discrimination and prejudice against Deaf indivdiuals, when they are unable to fully access health care.</p> Conclusions <p>Urgent attention is needed to address these systemic barriers. Deaf Dominicans are an underserved linguistic and cultural minority population who face barriers and challenges in accessing the health care system. Full communication and comprehension for the Deaf community is vital in ensuring equitable access to health care.</p>

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Social determinants of access to health care among deaf people in the Dominican Republic: a qualitative study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月15日

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  • Shazia Siddiqi,
  • Pablo Lemuel Taveras Cueto,
  • Zahira Quiñones Tavarez,
  • Wyatte C. Hall,
  • Sachiko Flores,
  • History Estill-Varner,
  • José Javier Sánchez,
  • Cristobalina Betemit,
  • Alan Jesurum,
  • Timothy De Ver Dye

摘要

Background

Hearing loss is comparatively frequent in the Latin America and Caribbean (LAC) region, where the prevalence of disabling hearing loss is higher than in many areas of the world. The current societal infrastructure in the Dominican Republic (DR) for Deaf people is insufficient: services such as sign language interpreters are lacking, as are accessible and widespread educational and health care services or access to emergency services. This project was formed through four partnerships, including United States- and Dominican Republic-based academic institutions and community organizations serving Deaf communities, to identify lived experience of Deaf Dominicans in accessing health care.

Methods

We recruited 102 people in the DR self-identifying as Deaf to participate in 51 qualitative interviews. All interviews were conducted in Dominican Sign language (“LSRD”) by Deaf interviewers and were visually recorded. Interview transcripts were analyzed using thematic analysis informed by grounded theory to identify categories explaining participants’ experiences.

Results

Three themes emerged in our grounded theory showing that Deaf Dominicans (1) rely heavily on hearing people as facilitators and navigators for the Deaf person to access health care; (2) often as a result of this dependence, Deaf Dominicans frequently experience lack of health care information in transactional health-related encounters and, more broadly, in general health knowledge; and (3) communicate frequently with the hearing world (including health care providers and workers) through gestures other than an established sign language. Further, Deaf Dominicans routinely experience structural audism, defined as systemic discrimination and prejudice against Deaf indivdiuals, when they are unable to fully access health care.

Conclusions

Urgent attention is needed to address these systemic barriers. Deaf Dominicans are an underserved linguistic and cultural minority population who face barriers and challenges in accessing the health care system. Full communication and comprehension for the Deaf community is vital in ensuring equitable access to health care.