Attached press release from the Pan American Health Organisation related to it's
new publication Health in the Americas

More information and access to the executive summary available at

http://www.paho.org/english/dbi/mds/HIA_2002.htm

David McDaid
LSE Health and Social Care

Washington, September 23, 2002 (PAHO) - Social inequalities present a major
obstacle to health in the Americas today, and the wider the gap between the rich
and poor in a given country, the worse the health situation, according to a new
report by the Pan American Health Organization (PAHO).

The region has made significant strides in controlling communicable diseases and
reducing mortality rates by the start of the 21st century. However, "strikingly
unjust and avoidable inequalities in health persist," PAHO says in a quadrennial
report, Health in the Americas.

These inequalities are most clearly seen between countries where income is more
equitable and those with a wide income gap, PAHO says. A lower income gap means
fewer health disparities and better health conditions, even if median income is
not high.

Differences in life expectancy are an illustration of this. Low-income countries
with narrow income gaps had a life expectancy one year higher than high-income
countries with a wide gap in the 1990s. The risk of a dying from cardiovascular
disease - a major threat in the Americas - and of dying a violent death was
higher in countries with wide gaps between the richest and poorest people, PAHO
says. Per capita spending on health care was greater in more equitable
countries.

"The healthier societies in the Americas are not necessarily those that are
wealthier," but those "which are the most equitable in the distribution of their
income, regardless of its amount," PAHO says.

After fighting communicable diseases for many years, the Americas now face an
"epidemiological polarization," in which different social groups have different
health needs. The poorest and those in less equitable countries still have to
contend with parasitic and infectious diseases, while in wealthier social groups
and more equitable countries, the chronic and degenerative conditions associated
with aging are of growing concern.

PAHO estimated that some 20 to 25 percent of the population in the Americas lack
permanent access to health care services or social protection measures. Many of
these are adolescents, elderly people, and those in geographically isolated
areas.

Driven by socioeconomic factors, many of the countries find they need to
redefine and reform the health sector. Government health ministries are leaning
away from providing direct services and toward regulating health services. All
countries in the region now have a system to evaluate and measure essential
health functions.

Public health services in the Americas are still exploring ways to better
finance and administer health services and to create basic health care packages
for peoples in the region. The new report, Health in the Americas, is published
every four years and presents a regional analysis of the health situation and
trends as well as individual analyses for each of the countries and territories
in the Americas.

PAHO, which also serves as the Regional Office for the Americas of the World
Health Organization, was established in 1902. PAHO Member States include all 35
countries in the Americas. France, the Kingdom of the Netherlands, and the
United Kingdom of Great Britain and Northern Ireland are Participating States.
PAHO is celebrating 100 years of work with all the countries of the Americas to
improve the health and raise the living standards of their peoples

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