Why does life expectancy vary so much in the Region of the Americas?

Washington, DC, July 11, 2002 (PAHO) -- At birth, a Haitian child has a life expectancy of 54 years, while a Canadian born the same day can expect to live to 79 years. Differences in health indicators such as life expectancy or infant mortality also occur within countries, with geographical areas where infant mortality reaches 130 per every 1,000 live births. Although general health indicators have improved in the Americas, there are still inequalities that continue to be a challenge for public health in the region.

"Various analyses indicate that behind the disturbing differences between various geographical areas and groups of population are, among other causes, marked deficiencies in crucial aspects of public health. Access to drinking water, health facilities, sewerage and electricity is limited for broad sectors. This creates risk factors that weigh heavily in health. It is estimated that 130 million people lack drinking water. On the other hand, the cost of the water for the poor is much higher than for the middle and upper classes," according to Bernardo Kliksberg of the Inter-American Development Bank (IDB), in a study published in the Pan American Journal of Public Health of the Pan American Health Organization (PAHO).

When looking at infant mortality rates, the average ranges from a low of 5.3 deaths per 1,000 live births in Canada to 80 deaths per 1,000 in Haiti. This means that the probability of a child under one year old dying in one country is 15 times greater than in the other country. Even so, 14 of 18 countries have attained the goal that was set in the plan health for all in the Year 2000 to reduce infant mortality rates to below 30 per 1,000 live births. However, these averages tend to mask important differences within the countries, according to the Special Program for Health Analysis of PAHO.

The analysis of causes includes a look at the environment and the biological, socioeconomic and cultural determinants of the society. Demographic and socioeconomic characteristics of a population are determining factors of their living conditions. The Special Program for Health Analysis study showed "an inverse relation between the infant mortality rate and the proportion of population with access to drinking water" in areas of Peru. "The negative correlation indicates that infant mortality is reduced as access to drinking water increases," the study noted.

Differences in life expectancy are directly proportional to lack of equity in access to medical care and are related to the poverty and all its implications, both at the regional and national levels.

The lack of drinking water and adequate sanitation accentuate risks to health, particularly for infants who are more likely to catch intestinal infections. In 11 countries of the region, diarrhea is one of the two leading causes of death in children under one year old. The lack of drinking water also facilitated the spread of cholera in the nineties, causing 811,000 cases in three years, Kliksberg said.

Major food problems in the region also have important health impacts. A joint report of PAHO and the Economic Commission for Latin America and the Caribbean (ECLAC) pointed out that "an increase in chronic noncommunicable diseases associated with food and nutrition is observed in almost all the countries of the region." The report indicated that "the adjustment measures implemented by the countries have affected the national availability of food and have had negative impact on the purchasing power of the poorer groups, threatening food security."

These factors cause considerable risks for the health of various sectors of the population. In turn, health coverage is restricted for sectors most affected by these risk factors. PAHO has estimated that 130 million Latin Americans lack regular access to health services.

On the other hand, marked differences persist among the countries. In higher income countries, average national health expenditures represent more than 10 percent of gross domestic product, exceeding $1,600 dollars per year per person. In medium and low income countries the figures for health expenditures per person are below US$ 90 and US$ 35, respectively. In general, countries with higher per capita income spend 45 times more on health that those with lower income.

"Moreover, it has been observed that the accessibility, coverage, and availability of medical care decrease as GDP per capita falls. These variables also differ depending on a population's geographical location. In several developing countries only 5 percent to 10 percent of workers have access to occupational health services, while in industrialized countries, 20 percent to 50 percent do," noted a PAHO study.

PAHO, which also serves as the Regional Office for the Americas of the World Health Organization, was established officially in 1902. It works with all the countries of the Americas to improve the health and raise the living standards of their peoples.

Related Information:
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Patterns of Birthweights