Las dimensiones económicas de las enfermedades no transmisibles en América Latina y el Caribe / Economic Dimensions of Non-communicable Diseases in Latin America and the Caribbean

[Prefacio]. Las dimensiones económicas de las enfermedades no transmisibles (ENT) en América Latina y el Caribe (ALC), obra complementaria de Prioridades para el control de enfermedades (DPC3 por sus siglas en inglés) , explora el impacto y la relación entre las ENT y el desarrollo y crecimiento económico en los países de ALC. En los artículos que la component se examina la compleja interacción entre las ENT, el gasto sanitario y las inversiones económicas en las áreas de salud, pobreza e inequidades, utilizando para ello la información y los datos de investigación más recientes relativos a la región de ALC. Existen pruebas categóricas de que las ENT constituyen un problema de gran importancia cuya frecuencia va en aumento en los países de ingresos bajos y de ingresos medianos, y de que consumen proporciones cada vez mayors de los presupuestos destinados a la atención de salud. Las ENT no son simplemente la consecuencia indirecta del aumento de los ingresos y de la reducción paulatina de las enfermedades infecciosas, sino que también figuran entre las principales causas de discapacidad y mala salud y son la causa principal de muerte prevenible y prematura en las Américas. Las ENT generan cuantiosos gastos de bolsillo en salud tanto en los individuos como en las familias, así como enormes desembolsos en salud en los presupuestos nacionales. Durante los últimos 20 años, muchos países de ALC han tenido un crecimiento económico sin precedentes; y a pesar de la reciente crisis económica mundial, los indicadores económicos y de salud han mejorado en términos generales, especialmente en el plano nacional. Sin embargo, las ENT siguen poniendo en riesgo el crecimiento económico y el potencial de desarrollo de muchas naciones, sobre todo de aquellas de ingresos bajos y medianos que enfrentan un aumento más marcado de la carga de ENT como resultado del rápido crecimiento y envejecimiento de sus poblaciones. Estas enfermedades propician la inequidad; menoscaban los logros económicos de las personas, las comunidades y las sociedades, y obstaculizan el desarrollo de manera sostensible. Es imprescindible conocer más a fondo las repercusiones económicas de las ENT y mitigar sus consecuencias nocivas para las sociedades [...] En la presente obra también se aprovechan las evidencias previas y se evalúan las investigaciones empíricas más recientes con la finalidad de influir en la formulación de políticas, la preparación de programas y la asignación de recursos en torno a las ENT en los planos regional y nacional. Esta publicación también recomienda medidas específicas y hace un llamado a la participación de toda la sociedad en el manejo de las ENT como un problema económico urgente y un obstáculo al desarrollo. Con estos objetivos en mente se redactó Las dimensiones económicas de las enfermedades no transmisibles en América Latina y el Caribe, fruto de la labor de asesores técnicos de la OPS y de muchos otros expertos en el tema. La obra está dirigida a un auditorio variado que comprende desde académicos y profesionales de la salud hasta formuladores de políticas y directores de programas, así como medios de comunicación, legisladores y público en general. En la preparación de este libro, la OPS colaboró con el Banco Mundial, el Instituto Nacional de Salud Pública de México y la Disease Control Priorities Network (Red de prioridades en la lucha contra las enfermedades), del Departamento de Salud Global de la Universidad de Washington. Asimismo, la OPS contrató a destacados investigadores de toda la región ALC. Cada artículo se escribió por separado, en función de los conocimientos y las experiencia de los distintos autores.

Economic Dimensions of Non-Communicable Disease in Latin America and the Caribbean. Disease Control Priorities. 3. ed. Companion Volume

[Foreword]. Economic Dimensions of Noncommunicable Diseases in Latin America and the Caribbean is a companion volume to Disease Control Priorities, Third Edition (DCP3). This volume explores the relationship between and the impact of noncommunicable diseases (NCDs) on development and economic growth in the countries of Latin America and the Caribbean (LAC). This collection of manuscripts examines the complex interplay among NCDs, health expenditures and financial investments in health, poverty, and inequities, using up-to-date information and evidence from the LAC region. There is compelling proof that NCDs are a major and growing problem for low- and middle-income countries, and that they consume increasingly greater proportions of health care budgets. NCDs are not simply a byproduct of higher incomes and declining infectious disease rates, but are also a major cause of disability and ill health and the leading cause of preventable and premature mortality in the Americas. NCDs are responsible for significant out-of-pocket health expenditures for individuals and families, as well as substantial health outlays in national budgets [...] Economic Dimensions of Noncommunicable Diseases in Latin America and the Caribbean recognizes the relationship between NCDs and sociodemographic trends in the LAC region. These include unprecedented rates of urbanization, globalization, rapid population aging, and inadequate health system responses to these changes. This volume provides health planners and decision makers with relevant information about how NCDs contribute to economic development and makes a case for greater investments in the prevention and control of chronic conditions. This book also builds on previous evidence and assesses new empirical work, with the goal of influencing NCD policies, program design, and resource allocation at the regional and country level. The volume also recommends specific, concrete actions and calls for an all-of-society approach to address NCDs as both an urgent economic concern and a development issue. With these objectives in mind, Economic Dimensions of Noncommunicable Diseases in Latin America and the Caribbean has been written by PAHO technical advisors and a range of other, specially selected experts, for an audience that ranges from academics and health professionals to policy makers and program managers, as well as the media, lawmakers, and the general public.

Global health: the twenty-first century global health priority agenda.

Growth in global health interest in the past 20 years has been overwhelming and many universities throughout the world have created departments or institutes of global health. The essence of global health has to be promoting health equity globally. The global health agenda must embrace design of mixed health systems, involving both private and public components to address the emerging threat of noncommunicable diseases and existing communicable diseases as well as to reduce health inequity. The priority agenda for the twenty-first century is challenging but the improvements of the past give hope that the barriers to improving global health are surmountable.

Ensuring safe blood in the Americas

This issue will deal not only with blood banks as the places where blood is collected and processed, but also with the whole spectrum of transfusion medicine. Blood has a special place in the culture of our civilizations as symbolizing strength and the vital force of life. Its use in forms that may seem macabre to us now found its way into many ancient rituals. All physicians regard blood with some awe since so far there is no substitute for it, and its transfusion may be regarded as the first organ transplant ... Most of the blood collected in Latin America and the Caribbean is still through replacemrnt donation. Although this practice is being strongly discouraged, it is easy to see its genesis. There must be few more gratifying feelings than that of giving one's own blood not to go into some great amorphous pool but to help someone who is known and loved. We have seen increased promotion of standards and norms for blood banks in the countries and sustained efforts to rationalize the large number of blood banks that are currently operating under a large number of different schemes in the countries. Because there is increased screening of blood, the number of transfusional infections has ben reduced, and this has been documented very clearly in the case of Chagas' disease. I have been pleased to see the emphasis placed on education, even by distance, and the dissemination of both technical and popular information (AU)

Nuevos rumbos para la salud en las Américas: informe cuadrienal del Director - edición del Centenario

Destaca con detalles la labor de la OPAS durante el siglo en sus principales campos de acción, relata sus actividades hasta el presente, y describe los recursos que la OPS haempleado y la repercusión que ha tenido su cooperación con los países miembros. Documento en formato pdf; requiere Acrobat Reader.

Overview of social inequalities in health in the region of the Americas, using various methodological approaches

Over the past decade, according to several important indicators, health conditions have improved in the Region of the Americas. However, inequalities persist among the countries of the Region. This article has two primary objectives: 1) to provide some unbiased evidence on health inequalities among countries of the Region of the Americas and 2) to illustrate the application of some of the more frequently used methods for measuring inequalities, including effect measurements, population attributable risk, the slope index of inequality, the relative index of inequality, and the concentration index. Analyses have shown that there are great health disparities in the Region of the Americas. For example, residents of the poorest countries of the Region live nearly 10 years less, on average, than do residents of the richest countries. If the other countries of the Americas had the same incidence of tuberculosis as does the subregion of North America (Bermuda, Canada, and the United States of America), there would be 76% fewer cases of this disease in the Region. In the Americas, nearly 35% of deaths of infants under 1 year old are concentrated in the 20% of live births that occur in the group with the lowest income. As for maternal mortality in the Americas, fewer than 2% of maternal deaths occur in association with the 20% of live births in the group with the highest income. The analyses of health inequalities based on the use of various methods highlight the existence of important disparities among subregions and countries of the Americas that are not readily seen when using only the more-traditional methods for analyzing mortality and morbidity. There is also a need to incorporate the concepts of distribution and socioeconomic dimensions of health when interpreting a given situation. Using this approach will allow decisionmakers to target areas and populations that are in less-favorable conditions. A considerable body of aggregate data at the...

Según varios indicadores importantes, las condiciones de salud han mejorado en la Región de las Américas a lo largo de la pasada década. Sin embargo, sigue habiendo desigualdades entre los pa¦ses de la Región. Este artículo tiene dos objectivos principales: 1) aportar algunos datos objetivos sobre las desigualdades de salud entre los países de la Región de las Américas, y 2) ilustrar la aplicación de algunos de los métodos utilizados con más frecuencia para medir las desigualdades, como las mediciones de efecto, el riesgo atribuible poblacional, el índice de desigualdad de la pendiente, el índice relativo de desigualdad y el índice de concentración. Los análisis muestran que hay grandes disparidades de salud en la Región de las Américas. Por ejemplo, los residentes en los países más pobres de la Región viven, por término medio, cerca de 10 años menos que los residentes en los países más ricos. Si otros países americanos tuvieran la misma incidencia de tuberculosis que la subregión de Norteamérica (Bermuda, Canadá y Estados Unidos), habría un 76% menos de casos de esta enfermedad en la Región. En América, cerca de 35% de las muertes de niños menores de 1 año se concentran en 20% de los nacidos vivos del grupo con menores ingresos. Por otro lado, las muertes maternas asociadas a 20% de los nacidos vivos del grupo con mayores ingresos representan menos de 2% de la mortalidad materna. Los análisis de las desigualdades de salud basadas en el uso de diversos métodos destacan la existencia de importantes disparidades entre las subregiones y países americanos que no son fácilmente detectables cuando solo se usan los métodos más tradicionales para el análisis de la mortalidad y morbilidad. También hay necesidad de incorporar los conceptos de distribución y las dimensiones socioeconómicas de la salud al interpretar una determinada situación. El uso de este enfoque les permitirá a las instancias decisorias...

Overview of social inequalities in health in the Region of the Americas, using various methodological approaches

Over the past decade, according to several important indicators, health conditions have improved in the Region of the Americas. However, inequalities persist among the countries of the Region. This article has two primary objectives: 1) to provide some unbiased evidence on health inequalities among countries of the Region of the Americas and 2) to illustrate the application of some of the more frequently used methods for measuring inequalities, including effect measurements, population attributable risk, the slope index of inequality, the relative index of inequality, and the concentration index. Analyses have shown that there are great health disparities in the Region of the Americas. For example, residents of the poorest countries of the region live nearly 10 years less, on average, than do residents of the richest countries. If the other countries of the Americas had the same incidence of tuberculosis as does the subregion of North America (Bermuda, Canada, and the United States of America), there would be 76 percent fewer cases of this disease in the region. In the Americas, nearly 35 percent of deaths of infants under 1 year old are concentrated in the 20 percent of live births that occur in the group with the lowest income. As for maternal mortality in the Americas, fewer than 2 percent of maternal deaths occur in association with the 20 percent of live births in the group with the highest income. The analyses of health inequalities based on the use of various methods highlight the existence of important disparities among subregions and countries of the Americas that are not readily seen when using only the more-traditional methods for analyzing mortality and morbidity. There is also a need to incorporate the concepts of distribution and socioeconomic dimensions of health when interpreting a given situation. Using this approach will allow decisionmakers to target areas and populations that are in less-favorable conditions. A considerable body of aggregate data at the regional and country levels from routine information systems is already available-especially on morbidity, mortality, and other health-related factors-that can be used on a regular basis to analyze health inequalities. These kinds of analyses may be regarded as a first step toward the identification of health inequalities (AU)