Health in Cuba refers to the overall health of the population of Cuba. Like the rest of the

Cuban economy The economy of Cuba is a mixed command economy dominated by state-run enterprises. Most of the labor force is employed by the state. In the 1990s, the ruling Communist Party of Cuba encouraged the formation of worker co-operatives and self-empl ...

, Cuban medical care suffered following the end of

Soviet The Soviet Union,. officially the Union of Soviet Socialist Republics. (USSR),. was a List of former transcontinental countries#Since 1700, transcontinental country that spanned much of Eurasia from 1922 to 1991. A flagship communist state, ...

subsidies A subsidy or government incentive is a form of financial aid or support extended to an economic sector (business, or individual) generally with the aim of promoting economic and social policy. Although commonly extended from the government, the ter ...

in 1991; the stepping up of the US embargo against Cuba at this time also had an effect.

History

In the 1950s, the island had some of the most positive health indices in the Americas, not far behind the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...

and

Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...

. Cuba was one of the leaders in

life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, current age, and other demographic factors like sex. The most commonly used measure is life expectancy at birth ...

, 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. 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. The mortality rate was the third lowest in the world. According to the World Health Organization, the island had the lowest infant mortality rate of Latin America. Following the Revolution and the subsequent

United States embargo against Cuba The United States embargo against Cuba prevents American businesses, and businesses organized under U.S. law or majority-owned by American citizens, from conducting trade with Cuban interests. It is the most enduring trade embargo in modern hist ...

, an increase in

disease A disease is a particular abnormal condition that negatively affects the structure or function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medical conditions that a ...

and

infant mortality Infant mortality is the death of young children under the age of 1. This death toll is measured by the infant mortality rate (IMR), which is the probability of deaths of children under one year of age per 1000 live births. The under-five morta ...

worsened in the 1960s. The new

Cuban government Cuba has had a socialist political system since 1959 based on the "one state – one party" principle. Cuba is constitutionally defined as a Marxist–Leninist state. The present Constitution of Cuba, which was passed in a 2019 referendum, also ...

asserted that universal healthcare was to become a priority of state planning. In 1960 guerrilla leader and

physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...

Che Guevara Ernesto Che Guevara (; 14 June 1928The date of birth recorded on /upload.wikimedia.org/wikipedia/commons/7/78/Ernesto_Guevara_Acta_de_Nacimiento.jpg his birth certificatewas 14 June 1928, although one tertiary source, (Julia Constenla, quoted ...

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."

Post-Soviet Union

The loss of Soviet subsidies brought food shortages to Cuba in the early 1990s. A

Canadian Medical Association Journal The ''Canadian Medical Association Journal'' (French ''Journal de l'Association Médicale Canadienne'') is a peer-reviewed general medical journal published by the Canadian Medical Association (CMA). It publishes original clinical research, anal ...

paper states that "The famine in Cuba during the

Special Period The Special Period ( es, Período especial, link=no), officially the Special Period in the Time of Peace (), was an extended period of economic crisis in Cuba that began in 1991 primarily due to the dissolution of the Soviet Union and, by exten ...

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." The regime did not accept donations of food, medicines and money from the US until 1993.

Malnutrition Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues a ...

created epidemics.

Present

All statistics from th
World Factbook
except * taken fro

Comparison of pre- and post-revolutionary indices

Life expectancy at birth in Cuba in 1955 was 63 years in 1960 it was 63.9 years. 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. 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.World Bank, Quick Query, op cit., retrieved 2009-07-01 . The mortality rate for children under five years old was 54 per 1000 in Cuba in 1960 (World Bank). 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). 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. Infant mortality was 32 per 1000 live births in Cuba in 1957. In 2000–2005 it was 6.1 per 1000 in Cuba; and, for comparison, 6.8 per 1000 in the United States. 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. The table below shows CEPAL (United nations) data spanning the pre- and post-revolutionary periods for three public

health indicators 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 populatio ...

. 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.

Health indicators and issues

According to

The World Factbook ''The World Factbook'', also known as the ''CIA World Factbook'', is a reference resource produced by the Central Intelligence Agency (CIA) with almanac-style information about the countries of the world. The official print version is available ...

, by 2009 Cuba had an average

of 78.05 years. 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. 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. 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.

Abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...

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.An evaluation of four decades of Cuban healthcare
. Filipe Eduardo Sixto, 2002. 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. 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. Among older adults

heart disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...

and

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

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 The Pan American Health Organization (PAHO) is an international public health agency working to improve the health and living standards of the people of the Americas. It is part of the United Nations system, serving as the Regional Office for ...

. While preventive medical care,

diagnostic test A medical test is a medical procedure performed to detect, diagnose, or monitor diseases, disease processes, susceptibility, or to determine a course of treatment. Medical tests such as, physical and visual exams, diagnostic imaging, genetic ...

s and

medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and re ...

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 A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health care ...

basis, hearing, dental, and

orthopedic Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...

processes,

wheelchair A wheelchair is a chair with wheels, used when walking is difficult or impossible due to illness, injury, problems related to old age, or disability. These can include spinal cord injuries ( paraplegia, hemiplegia, and quadriplegia), cerebr ...

s and

crutch A crutch is a mobility aid that transfers weight from the legs to the upper body. It is often used by people who cannot use their legs to support their weight, for reasons ranging from short-term injuries to lifelong disabilities. History Crutc ...

es. 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.

Child healthcare

According to WHO figures for 2016, Cuba (U5M) has an under-5 child mortality U5M rate of 5.5 per 1000 live births.

References

{{Reflist, refs= Dominguez, Jorge (1993), "Cuba since 1959", in Bethell, Leslie (ed., 1993), ''Cuba: a short history'', Cambridge: Cambridge University Press CIA World FactBook - Cuba
- 2009 Gott, R. (2004) ''Cuba: A New History'' (Yale : Yale University Press) p165. {{ISBN, 0-300-10411-1 {{cite web, title=Cuba Before Fidel Castro, url=http://www.fiu.edu/~fcf/cubaprecastro21698.html {{cite journal, title=Health consequences of Cuba's Special Period, journal = Canadian Medical Association Journal , volume = 179, issue = 3, pages = 257, pmc = 2474886, year = 2008, pmid = 18663207, doi = 10.1503/cmaj.1080068