Socio-environmental inequalities in indigenous public policies: an analysis from the discourse of implementers of the Special Program for Health and Indigenous Peoples (PESPI) in a a Southern Chilean city

Abstract

This study aimed to analyze the perceptions of intercultural facilitators (hereinafter referred to as IF) as implementers of the Special Program for Health and Indigenous Peoples (PESPI) regarding the participation of Indigenous communities, health practices, and socio-environmental inequalities. The study was conducted using a qualitative approach through semi-structured interviews with intercultural facilitators and a health directive. The results reveal that elements such as community participation are important for advancing their political and technical agenda; however, such participation within the program fails to address issues that affect the communities and are linked to structural factors. Health practices have been developed for both Mapuche and non-Mapuche populations. Nevertheless, to advance toward buen vivir or kume mongen (good living, a concept of well-being in harmony with nature and community), health actions are needed that go beyond the concept of disease. Therefore, it is essential to consider the relationship between health processes and industrial activities within a territory.