Even though

Panama Panama ( , ; es, link=no, Panamá ), officially the Republic of Panama ( es, República de Panamá), is a transcontinental country spanning the southern part of North America and the northern part of South America. It is bordered by Co ...

has one of the fastest growing economies in the western hemisphere, an estimated 500,000 people (13.8% of its population) are in extreme poverty. Panama has major socioeconomic and health inequalities between the country’s urban and rural populations. The indigenous population lives in more disadvantaged conditions and experiences greater vulnerability in health. In general, the population living in more marginalized areas has less service coverage and less access to health care.

Burden of disease

The

burden of disease Disease burden is the impact of a health problem as measured by financial cost, mortality, morbidity, or other indicators. It is often quantified in terms of quality-adjusted life years (QALYs) or disability-adjusted life years (DALYs). Both ...

in Panama consists mainly of

non-communicable diseases A non-communicable disease (NCD) is a disease that is not transmissible directly from one person to another. NCDs include Parkinson's disease, autoimmune diseases, strokes, most heart diseases, most cancers, diabetes, chronic kidney disease, oste ...

(76,99% of total deaths).

Communicable diseases An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dis ...

stands for 13,17% of total deaths, and injuries 9,84% of total deaths. The top 10 causes of total deaths in 2017 were; ischemic heart disease, stroke, Alzheimer's disease,

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

, chronic kidney disease, lower respiratory infection,

interpersonal violence Violence is the use of physical force so as to injure, abuse, damage, or destroy. Other definitions are also used, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened o ...

COPD Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...

HIV/AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...

and road injuries The top 10 causes for DALYs (Disability Adjusted Life Years) were;

, ischemic heart disease, headache disorder, stroke, interpersonal violence, HIV/AIDS, lower respiratory infections, road injuries, neonatal disorders and

congenital defects A birth defect, also known as a congenital disorder, is an abnormal condition that is present at birth regardless of its cause. Birth defects may result in disabilities that may be physical, intellectual, or developmental. The disabilities can ...

Life expectancy

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 ...

at birth in

was 75 years for men in 2016 and 81 years for women. There was a 9 year gap in 2014 between

Panama City Panama City ( es, Ciudad de Panamá, links=no; ), also known as Panama (or Panamá in Spanish), is the capital and largest city of Panama. It has an urban population of 880,691, with over 1.5 million in its metropolitan area. The city is locat ...

with the highest life expectancy, 79 years, and the indigenous reservation

Ngäbe-Buglé Comarca Ngäbe-Buglé () is the largest and most populous of Panama's five '' comarcas indígenas''. It was created in 1997 from lands formerly belonging to the provinces of Bocas del Toro, Chiriquí, and Veraguas. The capital is known as Buäbiti in ...

the lowest at 70 years.

Maternal mortality

Maternal mortality Maternal death or maternal mortality is defined in slightly different ways by several different health organizations. The World Health Organization (WHO) defines maternal death as the death of a pregnant mother due to complications related to pre ...

remained at 58.5 deaths per 100,000 live births in 2014, with major differences between urban areas (30.6 deaths per 100,000) and rural areas (110.8 per 100,000). The disparity was particularly acute in indigenous territories (303.4 per 100,000 in the Ngäbe Buglé region). Thus, Panama did not meet the goal for reduction of maternal mortality set by the

Millennium Development Goals The Millennium Development Goals (MDGs) were eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millenn ...

, which called for no more than 12.5 deaths per 100,000 live births.

Child health

In 2014, the

infant mortality rate 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 ...

was 13.8 per 1,000 live births in Panama, while

neonatal mortality Perinatal mortality (PNM) refers to the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Variations in the precise definition of the perinatal mortality exist, specifically concerning the issue of inclusion o ...

was 7.9 per 1,000 live births, up from 6.8 in 2010. Thus, the infant mortality target (for the first year of life) of 6.3 per 1,000 live births was not achieved. There are inequalities, as evident in the disparity between the country’s highest infant mortality rate (21.0 per 1,000 live births in

Guna Yala Guna Yala, formerly known as San Blas, is a '' comarca indígena'' (indigenous province) in northeast Panama. Guna Yala is home to the indigenous people known as the Gunas. Its capital is Gaigirgordub. It is bounded on the north by the Car ...

) and the lowest (6.6 in Los Santos). In 2019, child mortality or the under-five mortality rate was 14,9 per 1,000 live births.

Malnutrition

Panama have The Double Burden of Malnutrition which refers to the coexistence of both under-nutrition and over-nutrition in its population. In 2013, 15.9% of school-age children suffered from chronic

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 ...

, and 3.4% had serious stunting. Chronic malnutrition is more prevalent in areas with indigenous populations. 33.8% of children aged 6 and 59 months and 23.2% of pregnant women suffer from

anemia Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, t ...

. In 2008, an increase in overweight was observed at the national level, with a prevalence of 10% in pre-schoolers, 30% in schoolchildren, 25% in adolescents, and 57% in adults.

HIV/AIDS

Panama has a concentrated

epidemic, with the 2006 adult prevalence rate estimated at 0.92%. In 2016, there were 21.000 people living with HIV in Panama, 54% were accessing

antiretroviral therapy The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of multi ...

. Since 2016, the Ministry of Health has provided free HIV treatment for all. The rate of HIV infection is increasing in Panama. Since 2010, new HIV infections have increased by 9% and AIDS-related deaths have increased by 20%. The key populations that are most affected are transgender people (15%), gay men and other men who have sex with men (13,06%), Prisoners (6,4%) and sex workers (2%).

Neglected Tropical Diseases

Panama has a range of Neglected Tropical Diseases (NTDs) such as

Malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...

Dengue Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. These may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic ...

Chikungunya Chikungunya is an infection caused by the ''Chikungunya virus'' (CHIKV). Symptoms include fever and joint pains. These typically occur two to twelve days after exposure. Other symptoms may include headache, muscle pain, joint swelling, and a ra ...

, Leishmaniasis,

Soil-transmitted helminthiasis Soil-transmitted helminthiasis is a type of helminth infection (helminthiasis) caused by different species of roundworms. It is caused specifically by those worms which are transmitted through soil contaminated with faecal matter and are therefor ...

, Hookworm, Chagas disease, and more recently also the

Zika virus ''Zika virus'' (ZIKV; pronounced or ) is a member of the virus family ''Flaviviridae''. It is spread by daytime-active '' Aedes'' mosquitoes, such as '' A. aegypti'' and '' A. albopictus''. Its name comes from the Ziika Forest of Uganda, w ...

. Most of the NTDs are present in the country’s rural regions. The indigenous populations are especially vulnerable to neglected tropical diseases.

Sanitation

In 2015, improved-water coverage in the country was 95% (98% in urban areas and less than 50% in rural and indigenous communities), while 75% of the population (84% in urban areas and 58% in rural ones) was covered by improved sanitation services.

Health workers

In 2011, there were 29.2 health workers per 10,000 inhabitants, exceeding the goal of 25 per 10,000 set by the Pan American Sanitary Conference. However, the distribution of health workers is inequitable (in 2011, only 12.3% of doctors were serving in the country’s rural areas, where 33% of the population lives). Moreover, in 2011, the presence of health workers was much lower in indigenous regions, where no CSS (Caja de Seguridad Social, or Social Security Fund) facilities or personnel were present.

Healthcare

Healthcare in Panama is provided through a system through the government and a private sector. The public sector is funded through the Ministerio de Salud, (MINSA) and the Social Security Fund (Caja de Seguro Social), which operate separate facilities.

References

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