Hemispheric Health Successes Mask Underlying Gaps
Average life expectancy in the Americas has risen 6 years during the past quarter-century; today the average child born in the region can expect to live to nearly 75, according to Health in the Americas 2007, a major report released this week by the Pan American Health Organization (PAHO).
The averages, however, mask significant differences between and within countries of the region. A child in North America can expect to live 6 years longer than a child in Latin America and the Caribbean. In Haiti, life expectancy is 59.7 years, compared with 77.7 in Costa Rica. People in Brazil, Nicaragua and Peru face life expectancy similar to levels seen in the United States in the 1950s.
Still, the gap between life expectancy in Latin America and the Caribbean and life expectancy in the United States and Canada has decreased from 10 years in the mid-1960s to 6 years as of 2005.
These and other trends in health, demographics, and living standards are presented in the new edition of Health in the Americas, a major PAHO report issued every five years. This newest edition points to significant progress in human development, reflecting well on regional health guidelines, policies, and programs. But it acknowledges that enormous challenges remain, chief among them inequities and gaps that keep the most vulnerable populations from sharing equally in the region's overall health progress.
The report points to several major trends that are shaping health in the Americas. In nearly all countries of the region, chronic illnesses'such as cardiovascular diseases, cancer and diabetes'have replaced communicable diseases as the leading causes of illness, disability and death. These diseases are on the increase throughout the region and are associated with population aging as well as such risk factors as sedentary lifestyles, changes in diet, tobacco use, and alcohol and drug abuse.
Coverage of basic services has improved in most of the region, though less so in rural areas. Today most of the region's population has better access to education, water and sanitation services, primary health care, and immunization. Growing urbanization has increased access to such services for some but has also created new pockets of deprivation.
'In Latin America and the Caribbean, migration has spawned large, sprawling cities with marginalzied areas that breed poverty, unemployment, violence, insecurity, pollution, and poorly distributed basaic services,' says the report.
Among the major health challenges facing the region are the continuing HIV/AIDS epidemic, malaria, dengue and tuberculosis, as well as increasing chronic diseases. The most difficult to address, however, may be the economic, political, social and environmental factors affecting health.
'The greatest share of health problems is attributable to broad social determinants'the 'causes behind the causes' of ill health: poverty, malnutrition, unemployment, lack of access to education and health services, the social exclusion of certain populations, among others,' says the report.
Other developments highlighted in the report include the following: