Indigenous peoples in Latin America are frequently economically and socially disadvantaged and have historically been among the poorest in most countries. Space or location is essential in population health because neither the quantity nor the quality of health services is distributed uniformly. The spatial distribution of ethnic groups creates inequalities in access to services, employment, and life opportunities.

Using the case of Mexico, the country with the largest indigenous population in Latin America, we describe ethnic inequalities in coverage in five women's health interventions, both at individual and according to the proportion of the indigenous population at municipal level. The interventions included modern contraception, antenatal care, birth attendance and screening for cervical and breast cancer.

Our analyses show that ethnic gaps are present not only at individual level but also, and more importantly, at municipal level. Both indigenous and non-indigenous women living in municipalities with higher proportions of indigenous people were systematically excluded. Coverage gaps at municipal level tended to be wider than at individual level.  Our findings suggest that social and health interventions targeted at the individual level should be complemented by structural interventions in municipalities with high proportions of indigenous people, including strengthening health and social services. Read the full article: EClinicalMedicine