Page 62 - Genomic Medicine in Emerging Economies

Colombian Population 51

The high degree of socioeconomic disparity leads to wide differences in both
health indexes and access to health care services among different socioeco-
nomic groups.

Colombia has an ethnically diverse population, composed of three major
groups: the descendants of its indigenous people (Amerindians or Native
Americans), European immigrants (mostly Spanish), and Africans originally
brought as slaves (Aristizabal, 2000) (Fig. 4.1). Spanish immigrants began col-
onization of the country in 1510, in San Sebastián de Urabá. In 1526, the Span-
ish founded Santa Marta on the Caribbean Coast, and in 1533 they founded
Cartagena de Indias, which became the main port for trade and for the import
of African slaves. Spanish colonists settled mainly in the Andean highlands and
the Caribbean coast (Fig. 4.1) (BHEC, 2015) With time, the colonizers estab-
lished populations in areas higher than 1000 m of altitude to escape mosquito-
transmitted diseases, such as malaria or yellow fever. The Spanish conquest
was devastating for the indigenous people. It is believed that 150 years after
the first Spanish settled, nearly 90% of all Native Americans in the country had
died, mainly as a result of diseases brought by Europeans, labor exploitation,
armed conflicts with the European settlers, and separation from their families
(BHEC, 2015). Since European men came with very few women, they had chil-
dren with native women, giving rise to mixed or “mestizo” populations that
replaced the original natives (BHEC, 2015) In spite of this, Colombia has still
over 80 indigenous tribes that speak 66 different languages, making it the sec-
ond country, after Brazil, with the most indigenous tribes (Aristizabal, 2000).
Each tribe is unique in its customs, beliefs, and artistic expressions.
From the early 16th century (starting from 1520) until the 18th century, African
slaves were brought by the Spanish and the English from Congo, Angola, Gam-
bia, Senegal, Nigeria, Ivory Coast, Guinea, Sierra Leone, and Mali to increase
labor force (Navarrete, 2005). The slaves settled mainly along the Pacific coast,
with a minority settling in the Caribbean coast and islands (Fig. 4.1) (Aris-
tizabal, 2000). During this period until the 19th century, there was very little
immigration of other populations. Later waves of immigration brought people
from the Middle East, Romani populations, Germans, Italians, and Jews, and
although these represent only a small minority of the population, they had a
deep impact on economic, social, and cultural development in specific regions
of the country (Tovar Pinzón, 2001).
The largest wave of immigrants from the Middle East (Syria, Lebanon, Jordan,
and Palestine) occurred form 1880 until the 1920s, settling initially on the
Caribbean coast (Cartagena and Barranquilla) (Ángel Arango, 1992). Arabs
continued to immigrate, and in 1940 there was a large wave of Arab migration
to Maicao (border with Venezuela). Jews came initially in the 16th century as
“New Christians” and in the 18th century Spanish and Portuguese Jews came