Health in the Americas Sees Gains with Gaps
Life expectancy in North, South and Central America and the Caribbean has gained six years during the past quarter-century, but important gaps remain in health status between and within countries of the region, according to the 2007 edition of Health in the Americas, a report issued every five years by the Pan American Health Organization (PAHO).
According to the report, a child born in the Americas can expect to live to nearly 75. However, a child born in the United States or Canada will, on average, live seven years longer than a child born in Latin America or the Caribbean. A baby born in Haiti will live 18 years less than a child born in Costa Rica. People in Brazil, Nicaragua, and Peru today have life expectancy levels similar to levels in the United States during the 1950s.
On a more positive note, the gap between life expectancy in North America and Latin America and the Caribbean has declined three years since the mid-1960s.
Health in the Americas 2007, released during the 27th Pan American Sanitary Conference, outlines a number of critical trends that are shaping health in the PAHO region. These include slower population growth, longer life spans, and fewer deaths related to communicable diseases and childbirth.
The report notes a major increase in chronic noncommunicable diseases, or NCDs, which are now the leading cause of death in the PAHO region, accounting for two out of three deaths. Contributing to the trend are an aging population, sedentary lifestyles, diet, tobacco use, and alcohol and drug abuse. Along with the increase in NCDs, communicable diseases such as HIV/AIDS, malaria, dengue, and tuberculosis still cause significant illness and deaths.
In addition to population aging, slower population growth is also impacting the region's health. Annual growth has slowed from around 2.7 percent during the early 1950s to 1.5 percent today. Fertility rates, which were among the world's highest in the 1960s, are now below the world average in many PAHO member countries.
Urbanization is higher in Latin America and the Caribbean than in any other region in the world, with more than three out of four people living in urban areas. Along with economic growth, urbanization has helped expand basic services, so that most of the region's population today has better access to education, water and sanitation, primary health care, and immunization. Yet pockets of deprivation persist, according to the report:
"In Latin America and the Caribbean, migration has spawned large, sprawling cities with marginalized areas that breed poverty, unemployment, violence, insecurity, pollution, and poorly distributed basic services."
Among the most difficult health challenges facing the region, according to the report, are the "social determinants of health," that is, economic, political, social and environmental factors that have an impact on people's health.
Among other developments highlighted in the report:
- Nearly 40 percent of all deaths of children under 5 occur in the poorest 20 percent of the region's countries.
- Some 218 million people in the Americas lack social security coverage in health, and 100 million lack access to health services due to geographic location or economic barriers.
- Some 110,000 to 120,000 homicides occurred in the region in the last 10 years and 55,000 to 58,000 suicides, according to official registries.
- In 2002, 374,000 people died in traffic crashes, the ninth-leading cause of death in the region that year.
- Mortality among children under 5 declined by two-thirds between 1990 and 2005, and under-1 mortality decreased by one-half.
- Despite advances in poverty reduction, over 40 percent of the population of the Americas (nearly 213 million people) live in poverty, with 16.8 percent (88 million) living in extreme poverty.
The full text of Health in the Americas 2007 can be downloaded here.