Health in the Americas has seen a dramatic improvement in the past decades, but many people are being left behind. This is one of the main conclusions of the report called Just societies: Health equity and dignified lives launched on October 1st, during the 57th meeting of the Directing Council of the Pan-American Health Organization (PAHO/WHO), held at the PAHO headquarters, in Washington.
The report gathers evidence of the relationship between health and social factors, such as socioeconomic class, ethnic group, gender, sexual orientation, disability, migrant situation - individually or combined. Other structural factors, such as climate change, environmental threats and the relationship of people with the land are also pointed as determinants for health patterns.
The analysis shows inequalities within countries and between the countries in the region. In Bolivia, for instance, the mortality rate for indigenous children below 5 years old is more than three times higher than that of non-indigenous children. Inequalities persist to the end of life; life expectancy for women in Haiti, for instance, is only 66, while that of Canadian women is 84. The commission also highlights that the rate of health improvements has been slowing down or even receding regarding some measurements in some countries. In the United States, life expentancy has fallen for three consecutive years.
The document proposes 12 recommendations to face this issue. The approached offered by the document is innovative and goes beyond the health sector. “We see this report as a step in this journey of ours. The goal now is to encourage actions in all countries in the region and to provide governments and societies the evidence that must support the action. Could there be a more reasonable goal than that of creating the conditions so that all those who live in this region have a dignified life and thus promoting health equity?”, states the president of the commission, Michael Marmot, who defends the use of evidence, such as that supplied by the report, in the implementation of policies.
The Commission on Equity and Health Inequalities for the Americas was created in 2016 by the director of PAHO, Carissa Etienne, to analyze the impact of factors that influence health, simultaneously proposing actions to improve inequalities in this area. The group gathered twelve specialists, including the former president of Fiocruz and current coordinator of the Fiocruz Global Health Center (Cris/Fiocruz), Paulo Buss.
“This is the result of the 3-year work of a multidisciplinary commission that gathered people with different professional backgrounds, such as physicians, lawyers and economists. We visited different parts of the continent and examined about 400 bibliographic references regarding inequities in health”, said Buss, insisting that the ministers and specialists who attended the launching ceremony take the recommendations into account. “It is important that we leave behind the disastrous and discouraging title of most inequal region in the world. It is time to put a stop to this, and we can do it”, he stated.