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Health in Cuba refers to the overall health of the population of Cuba. Like the rest of the Cuban economy, Cuban medical care suffered following the end of Soviet subsidies in 1991; the stepping up of the US embargo against Cuba at this time also had an effect.
In the 1950s, the island had some of the most positive health indices in the Americas, not far behind the United States and Canada. Cuba was one of the leaders in life expectancy, and the number of doctors per thousand of the population ranked above Britain, France and the Netherlands. In Latin America it ranked in third place after Uruguay and Argentina. [1] There remained marked inequalities however. Most of Cuba's doctors were based in the relatively prosperous cities and regional towns, and conditions in rural areas, notably Oriente, were significantly worse. [2] The mortality rate was the third lowest in the world. [3] According to the World Health Organization, the island had the lowest infant mortality rate of Latin America. [3]
Following the Revolution and the subsequent United States embargo against Cuba, an increase in disease and infant mortality worsened in the 1960s. [4] The new Cuban government asserted that universal healthcare was to become a priority of state planning. In 1960 guerrilla leader and physician Che Guevara outlined his aims for the future of Cuban healthcare in an essay entitled On Revolutionary Medicine , stating: "The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices." [5]
The loss of Soviet subsidies brought food shortages to Cuba in the early 1990s.
A Canadian Medical Association Journal paper states that "The famine in Cuba during the Special Period was caused by political and economic factors similar to the ones that caused a famine in North Korea in the mid-1990s. Both countries were run by authoritarian regimes that denied ordinary people the food to which they were entitled when the public food distribution collapsed; priority was given to the elite classes and the military." [6] The regime did not accept donations of food, medicines and money from the US until 1993. [6] Malnutrition created epidemics. [7]
| Life expectancy at birth m/f: | 77/81 (years, 2016) |
| Healthy life expectancy at birth m/f: | 67.1/69.5 (years) |
| Child mortality m/f: | 5 (per 1000 live births, 2018) |
| Adult mortality m/f: | 116/68 (per 1000 population, 2016) |
| Total health expenditure per capita: | 2475 (Intl $, 2014) |
| Total health expenditure as % of GDP: | 11.1 (2014) |
| Rank | Countries surveyed | Statistic | Date of Information | |
| 125 | 167 | HIV/AIDS adult prevalence rate | 0.10% | 2003 est. |
| 162 | 175 | Fertility rate | 1.66 (children/woman) | 2006. |
| 153 | 224 | Birth rate | 11.89 (births/1,000 population) | 2006 est. |
| 168 | 226 | Infant mortality rate | 6.04 (deaths/1,000 live births) | 2006. |
| 129 | 224 | Death rate | 6.33 (deaths/1,000 population) | 2005. |
| 37 | 225 | Life expectancy at birth | 77.23 (years) | 2006. est |
| 17 | 99 | Suicide rate | 18.3 per 100,000 people per year | 1996.* |
Life expectancy at birth in Cuba in 1955 was 63 years [8] in 1960 it was 63.9 years. [9] To put these values in context, life expectancy at birth in some other regions and countries in 1960 were: (World Bank data):
World, 50.18 years; Latin America and Caribbean, 56.21 years; high-income OECD countries, 69.01 years; United States, 69.77 years. [10]
In 2007, the life expectancies at birth were as follows (World Bank data): Cuba, 78.26 years;
World, 68.76 years; Latin America and Caribbean, 73.13 years; high income OECD countries, 79.66 years; United States, 77.99 years. [11]
The mortality rate for children under five years old was 54 per 1000 in Cuba in 1960 (World Bank). [12] That year in Latin America and the Caribbean it was 154.66 per 1000; in the high-income OECD countries it was 43.11; in the United States, 30.2. No World datum is available for 1960, but for 1970 it was 145.67 per 1000 (World Bank data). [11]
The mortality rates for children under five in 2007 were as follows (World Bank): Cuba, 6.5; World, 68.01; Latin America and Caribbean, 26.37; high-income OECD, 5.71; United States, 7.60. [11]
Infant mortality was 32 per 1000 live births in Cuba in 1957. [13] In 2000–2005 it was 6.1 per 1000 in Cuba; and, for comparison, 6.8 per 1000 in the United States. [14] The 2007 infant mortality rates published by the World Health Organization in 2009 were: Cuba, 5; World, 46;
High income countries, 6; United States, 6. [15]
The table below shows CEPAL (United nations) data spanning the pre- and post-revolutionary periods for three public health indicators. Health levels were better than the Latin American average before the revolution and showed continued steady improvement throughout the post-revolutionary period. The total mortality rate shown is the crude – i.e., not age-adjusted – rate, and therefore tends to rise as the proportion of elderly people in the population increases, which has been the case in Cuba because the birth rate is falling and life expectancy is rising.
| 1950–55 | 1955–60 | 1960–65 | 1965–70 | 1970–75 | 1975–80 | 1980–85 | 1985–90 | 1990–95 | 1995–00 | 2000–05 | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Life expectancy | 59.5 | 62.4 | 65.4 | 68.6 | 71.0 | 73.1 | 74.3 | 74.6 | 74.8 | 76.2 | 77.1 |
| Mortality rate | 10.73 | 9.21 | 8.56 | 7.30 | 6.37 | 5.94 | 6.31 | 6.65 | 7.06 | 6.66 | 7.08 |
| Under-5 mortality | 112.4 | 93.9 | 75.9 | 58.6 | 43.6 | 27.0 | 21.2 | 19.3 | 18.7 | 11.8 | 7.72 |
| Notes: Life expectancy is life expectancy at birth. Mortality rate is the crude mortality rate; i.e., annual number of deaths per 1,000 inhabitants. The under-5 mortality is the number of deaths of children up to age five, per 1,000 live births. | |||||||||||
According to The World Factbook, by 2009 Cuba had an average life expectancy of 78.05 years. [16] [ non-primary source needed ]
Cuba began a food rationing program in 1962 to guarantee all citizens a low-priced basket of basic foods. As of 2007, the government was spending about $1 billion annually to subsidise the food ration. The ration would cost about $50 at an average grocery store in the United States, but the Cuban citizen pays only $1.20 for it. The ration includes rice, legumes, potatoes, bread, eggs, and a small amount of meat. It provides about 30 to 70 percent of the 3,300 kilocalories that the average Cuban consumes daily. The people obtain the rest of their food from government stores (Tiendas), free market stores and cooperatives, barter, their own gardens, and the black market. [17]
According to the Pan American Health Organization, daily caloric intake per person in various places in 2003 were as follows (unit is kilocalories):
Cuba, 3,286;
America, 3,205;
Latin America and the Caribbean, 2,875;
Latin Caribbean countries, 2,593;
United States, 3,754. [18]
| Place | Communicable | Non-communicable | Injuries |
|---|---|---|---|
| Cuba | 9 | 75 | 16 |
| World | 51 | 34 | 14 |
| High income countries | 8 | 77 | 15 |
| United States | 9 | 73 | 18 |
| Low income countries | 68 | 21 | 10 |
| Source: World Health Organization. World Health Statistics 2009, Table 2, "Cause-specific mortality and morbidity". | |||
Diseases of the circulatory system are the most common cause of death in Cuba, killing 306 people per 100,000 population in 2005. Neoplasms (cancer) are second, killing 173 per 100,000 population in 2005. The numbers killed by some other causes, in 2005 per 100,000 population, were: influenza and pneumonia 64, accidents 40, diabetes mellitus 18, intentional self-harm (suicide) 12, cirrhosis and other chronic liver diseases 10. Total mortality per 100,000 population was 754.[ citation needed ]
Abortion rates, which are high in Cuba, increased dramatically during the 1980s, but had almost halved by 1999 and declined to near-1970s levels of 32.0 per 1000 pregnancies. The rate is still among the highest in Latin America. [19] [ non-primary source needed ]
Among adults less than 49 years old, accidents are the leading cause of death, though occupational accidents have declined significantly in the last decade. The homicide rate is 7.0 per 100,000. The rate of suicide in the island is higher than average in Latin America and has been among the highest in the region and the world since the nineteenth century. [20] Annual suicide deaths per 100,000 population (2003–2005 data) were: Cuba 13.6, Americas 7.7, Latin America and Caribbean 5.8, Latin Caribbean 8.7, United States 10.8. [21] Among older adults heart disease and cancer predominate as causes of mortality. General mortality has been "characterized by a marked predominance of causes associated with chronic noncommunicable diseases", according to the Pan American Health Organization. [22] [ non-primary source needed ]
While preventive medical care, diagnostic tests and medication for hospitalized patients are free, some aspects of healthcare are paid for by the patient. Items which are paid by patients who can afford it are: drugs prescribed on an outpatient basis, hearing, dental, and orthopedic processes, wheelchairs and crutches. When a patient can obtain these items at state stores, prices tend to be low as these items are subsidized by the state. For patients on a low-income, these items are free of charge. [23] [ non-primary source needed ]
According to WHO figures for 2016, Cuba (U5M) has an under-5 child mortality U5M rate of 5.5 per 1000 live births. [24] [25] [ non-primary source needed ]
Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pregnancy, underlying conditions worsened by the pregnancy or management of these conditions. This can occur either while they are pregnant or within six weeks of resolution of the pregnancy. The CDC definition of pregnancy-related deaths extends the period of consideration to include one year from the resolution of the pregnancy. Pregnancy associated death, as defined by the American College of Obstetricians and Gynecologists (ACOG), are all deaths occurring within one year of a pregnancy resolution. Identification of pregnancy associated deaths is important for deciding whether or not the pregnancy was a direct or indirect contributing cause of the death.
The Kerala model refers to the practices adopted by the Indian state of Kerala to further human development. It is characterised by results showing strong social indicators when compared to the rest of the country such as high literacy and life expectancy rates, highly improved access to healthcare, and low infant mortality and birth rates. Despite having a lower per capita income, the state is sometimes compared to developed countries. These achievements along with the factors responsible for such achievements have been considered characteristic results of the Kerala model. Academic literature discusses the primary factors underlying the success of the Kerala model as its decentralization efforts, the political mobilization of the poor, and the active involvement of civil society organizations in the planning and implementation of development policies.
The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the health care of all its citizens. All healthcare in Cuba is free to Cuban residents. There are no private hospitals or clinics as all health services are government-run. The public health minister is Dr. José Angel Portal Miranda.
Health in Iraq refers to the country's public healthcare system and the overall health of the country's population. Iraq belongs to WHO health region Eastern Mediterranean and classified as upper middle according to World Bank income classification 2013. The state of health in Iraq has fluctuated during its turbulent recent history and specially during the last 4 decade. The country had one of the highest medical standards in the region during the period of 1980s and up until 1991, the annual total health budget was about $450 million in average. The 1991 Gulf War incurred Iraq's major infrastructures a huge damage. This includes health care system, sanitation, transport, water and electricity supplies. UN economic sanctions aggravated the process of deterioration. The annual total health budget for the country, a decade after the sanctions had fallen to $22 million which is barely 5% of what it was in 1980s. During its last decade, the regime of Saddam Hussein cut public health funding by 90 percent, contributing to a substantial deterioration in health care. During that period, maternal mortality increased nearly threefold, and the salaries of medical personnel decreased drastically. Medical facilities, which in 1980 were among the best in the Middle East, deteriorated. Conditions were especially serious in the south, where malnutrition and water-borne diseases became common in the 1990s. Health indicators deteriorated during the 1990s. In the late 1990s, Iraq's infant mortality rates more than doubled. Because treatment and diagnosis of cancer and diabetes decreased in the 1990s, complications and deaths resulting from those diseases increased drastically in the late 1990s and early 2000s.
As of 31 December 2016, Turkish population is 79,814,871 of which 23.7% are between 0-14, 68% are between 15-64 and 8.3% are older than 65 years old. Life expectancy at birth for men is 75.3 and for women is 80.7 years. Maternal mortality ratio has decreased from 23 to 16 per 100,000 live births between the years 2010 to 2015. According to the data from 2015, Under-five mortality and infant mortality rates per 1000 live births are 13.5 and 11.6. Air pollution in Turkey is particularly dangerous to children’s health.
The current population of Myanmar is 54.05 million. It was 27.27 million in 1970. The general state of healthcare in Myanmar is poor. The military government of 1962-2011 spent anywhere from 0.5% to 3% of the country's GDP on healthcare. Healthcare in Myanmar is consistently ranked among the lowest in the world. In 2015, in congruence with a new democratic government, a series of healthcare reforms were enacted. In 2017, the reformed government spent 5.2% of GDP on healthcare expenditures. Health indicators have begun to improve as spending continues to increase. Patients continue to pay the majority of healthcare costs out of pocket. Although, out of pocket costs were reduced from 85% to 62% from 2014 to 2015. They continue to drop annually. The global average of healthcare costs paid out of pocket is 32%. Both public and private hospitals are understaffed due to a national shortage of doctors and nurses. Public hospitals lack many of the basic facilities and equipment. WHO consistently ranks Myanmar among the worst nations in healthcare.
According to the World Bank income level classification, Portugal is considered to be a high income country. Its population was of 10,283,822 people, by 1 July 2019. WHO estimates that 21.7% of the population is 65 or more years of age (2018), a proportion that is higher than the estimates for the WHO European Region.
The Republic of Moldova has a universal health care system.
Healthcare in the United States is subject to far higher levels of spending than any other nation, measured both in per capita spending and as a percentage of GDP. Despite this, the country has significantly worse healthcare outcomes when compared to peer nations. The U.S. is the only developed nation without a system of universal healthcare, with a significant proportion of its population not carrying health insurance.
This article provides a brief overview of the health care systems of the world, sorted by continent.
Lesotho's Human development index value for 2018 was 0.518—which put the country in the low human development category—positioning it at 164 out of 189 countries and territories. Health care services in Lesotho are delivered primarily by the government and the Christian Health Association of Lesotho. Access to health services is difficult for many people, especially in rural areas. The country's health system is challenged by the relentless increase of the burden of disease brought about by AIDS, and a lack of expertise and human resources. Serious emergencies are often referred to neighbouring South Africa. The largest contribution to mortality in Lesotho are communicable diseases, maternal, perinatal and nutritional conditions.
The quality of health in Rwanda has historically been very low, both before and immediately after the 1994 genocide. In 1998, more than one in five children died before their fifth birthday, often from malaria. But in recent years Rwanda has seen improvement on a number of key health indicators. Between 2005 and 2013, life expectancy increased from 55.2 to 64.0, under-5 mortality decreased from 106.4 to 52.0 per 1,000 live births, and incidence of tuberculosis has dropped from 101 to 69 per 100,000 people. The country's progress in healthcare has been cited by the international media and charities. The Atlantic devoted an article to "Rwanda's Historic Health Recovery". Partners In Health described the health gains "among the most dramatic the world has seen in the last 50 years".
A new measure of expected human capital calculated for 195 countries from 1990 to 2016 and defined for each birth cohort as the expected years lived from age 20 to 64 years and adjusted for educational attainment, learning or education quality, and functional health status was published by The Lancet in September 2018. Latvia had the twenty-first highest level of expected human capital with 23 health, education, and learning-adjusted expected years lived between age 20 and 64 years.
As of 2019 Lithuanian life expectancy at birth was 76.0 and the infant mortality rate was 2.99 per 1,000 births. This is below the EU and OECD average.
New Zealand is a high income country, and this is reflected in the overall good health status of the population.
Health indicators are quantifiable characteristics of a population which researchers use as supporting evidence for describing the health of a population. Typically, researchers will use a survey methodology to gather information about a population sample, use statistics in an attempt to generalize the information collected to the entire population, and then use the statistical analysis to make a statement about the health of the population. Health indicators are often used by governments to guide health care policy or to make goals for improving population health.
Sustainable Development Goal 3, regarding "Good Health and Well-being", is one of the 17 Sustainable Development Goals established by the United Nations in 2015. The official wording is: "To ensure healthy lives and promote well-being for all at all ages." The targets of SDG 3 cover and focus on various aspects of healthy life and healthy lifestyle. Progress towards the targets is measured using twenty-one indicators.
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