During the past 110 years, health in the Americas has improved significantly, but inequalities persist, says the 2012 PAHO/WHO report Health in the Americas
Washington, D.C., 18 September 2012 (PAHO/WHO) — Average life expectancy in Latin America and the Caribbean rose from 29 years in 1900 to 74 years in 2010, and today 98% of children live to see their first birthday, while 100 years ago only 75% did. However, inequalities persist among and within countries, according to the 2012 edition of Health in the Americas, published by the Pan American Health Organization/World Health Organization (PAHO/WHO).
The report, presented today at the 28th Pan American Sanitary Conference (17-21 September) in Washington, D.C., describes the progress made by the countries of the Americas and the challenges they face as they work to improve health in the Region, presenting an integrated approach to the most pressing health issues. A central theme of the publication is the high level of inequality in the distribution of health and well-being in the Region.
"The countries of the Region have been collectively successful in making this part of the world healthier and more prosperous," said PAHO Director Dr. Mirta Roses in presenting the report. "However, after reviewing the most recent developments in population health and its determinants in the Americas, we have to get to work urgently and energetically to make this Region a more equitable and sustainable home for all of its current and future inhabitants."
Life expectancy at birth in North America in 1900 was 48 years, while life expectancy in Latin America and the Caribbean was 29 years. In 2010, those figures were 78 and 74 years, respectively.
However, differences among countries of the Region persist. For example, life expectancy in 2010 was 79.2 in Chile but only 66.8 in Bolivia, a difference of 12.4 years. These differences are also seen within countries. In Colombia, mortality in children under 5 in 2010 was 11.3 times greater in the poorest quintile than in the wealthiest.
Major demographic trends in the Region of the Americas include population growth, urbanization, and population aging. In 1900 the population of the Americas was 194 million people; 110 years later, it has risen to over 940 million. It is estimated that by 2020 it will rise to slightly more than one billion inhabitants, representing 13.4% of the global population.
Progress in public health in the Americas since 1900 is presented in the regional volume of Health in the Americas. A separate country volume consists of reports from each of the 48 countries and territories of the Western Hemisphere, based on data from 2005—2010.
Infant mortality also fell significantly in the past 110 years. One of every four children born in 1900 in Latin America and the Caribbean died before reaching his or her first birthday. Today, 98% survive their first year and have a high probability of reaching old age.
However, the infant mortality rate in Latin America and the Caribbean varies by country, ranging from 4.8 deaths per 1,000 live births in Cuba to 5.1 in Canada, 7.8 in Chile, 50 in Bolivia, and 33 in Nicaragua, according to the latest available data (2009).
Other problems such as maternal mortality, malnutrition, tuberculosis, malaria, and the lack of access to safe water and sanitation--issues that usually affect populations living in social exclusion--tend to be obscured by regional averages, which in general reflect significant progress in health in the Region.The Americas is the most urbanized region in the world. In 2010, 82.1% of North America's population and 79.4% of Latin America and the Caribbean's resided in urban areas. By 2025, nine of the 30 largest cities in the world are expected to be in the Americas: Bogotá, Buenos Aires, Chicago, Lima, Los Angeles, Mexico City, New York City, Rio de Janeiro, and São Paulo. There has also been a movement away from rural areas. In 1950, 58.6% of the population in Latin America and the Caribbean lived in the countryside, compared with 36.1% in North America. By 2010, those figures had fallen to 21.2% and 18%, respectively.
Data assembled in Health in the Americas show increasing longevity in the Americas. In 2006, there were nearly 100 million people over 60 years in the Region. By 2020, this figure is expected to double, with more than half of these people living in Latin America and the Caribbean. A projected 69% of all those born in North America and 50% of those born in Latin America and the Caribbean will live beyond the age of 80.
In the United States, chronic diseases account for about 75% of health expenditures, according to the report. This is due in part to population aging.
Poverty is another factor that determines population health. Inequalities are greater between urban and rural inhabitants and between Spanish-speaking and indigenous populations. For example, while 19.1% of the urban population in Peru lives in poverty, the number reaches 54.2% in rural areas. In 2010, more than half of the indigenous population (51.8%) lived in poverty.
Health in the Americas also provides updated 2005-2010 data on health determinants and inequalities; the environment and human security; health conditions and trends; health systems and social protection in health; and knowledge, technology, and information. It also provides a summary and future outlook on the Region.
More than 600 officials and experts contributed to the production of this publication. Data from official sources, both national and international, as well as from unofficial sources, were used in the report.
This is the latest edition in a long series of similar reports that have been published by PAHO/WHO since 1954.
The report is available online free of charge at www.paho.org/saludenlasamericas.
PAHO, which celebrates its 110th anniversary this year, is the world's oldest public health organization. It works with all the countries of the Hemisphere to improve the health and quality of life of the peoples of the Americas and serves as the WHO Regional Office for the Americas.
Regional health overview 2005-2010
Major diseases affecting the Americas today
- About 250 million people in the Americas suffer from a noncommunicable disease such as cancer, diabetes, or cardiovascular diseases. In 2007, 3.9 million people died of these causes; 37% were under age 70.
- Cardiovascular diseases are the leading cause of death in most of the countries of the Americas. Thirty percent of premature deaths from cardiovascular diseases occur among the poorest population quintile, while only 13% occur among the wealthiest quintile. Between 2000 and 2007, mortality from these causes dropped by 19% (from 207.8 per 100,000 population to 167.9) in the Region as a whole.
- Between 2001 and 2009, the estimated rate of new HIV infections in Latin America and the Caribbean dropped from 22.5 per 100,000 population to 18.6. In North America the rates of new annual infections have remained stable for at least the past five years.
- Mental disorders in Latin America and the Caribbean are responsible for nearly 22% of the total burden of disease as expressed in disability-adjusted life years. Depression and alcohol-related disorders rank first and second within this category.
Traffic accidents and violence are leading causes of death
- Between 2000 and 2007, the death rate from external causes among men rose from 229.1 to 237.8 per 100,000 population. Among women the rate rose from 63.2 to 69.9 per 100,000 population.
- Traffic accidents and violence are the leading causes of death among young people and adults aged 15 to 44 years, especially men. Were this trend to continue, traffic accidents would be the third leading contributor to the disease burden in the Region by 2020.
- Some 600,000 homicides per year are reported in the Region, with a frequency 10 times higher among men than among women. In the Americas, half of all homicides are concentrated in the least-educated quintile of the adult male population.
Public health spending increased, but with per-capita differences among countries.
- From 2005 to 2010, total health expenditures in Latin America and the Caribbean rose from 6.8% to 7.3% of GDP, behind the United States (14.6%), Canada (9.7%), and Europe (8.5%). In 2010, total per capita health expenditures ranged from US$ 90 in Bolivia to US$ 2,711 in the Bahamas, US $5,499 in Canada, and US$ 8,463 in the United States.
- 274 million people (46%) in Latin America and the Caribbean do not have health insurance.
- 120 million people in Latin America and the Caribbean do not have access to health services due to economic reasons.
- 107 million lack access to health services due to geographical reasons.
