Latin Americans live longer, but not healthier, lives

When Mario Rodriguez’s dad was diagnosed with high-blood pressure, his whole family took steps to deal with this silent but deadly condition: they all changed their diet, both to support the eldest Rodriguez but also to avoid the fate of many Latin Americans these days.

High-blood pressure is just one of the chronic conditions now plaguing Latin America, creating an increasing burden to health in the region, according to a new report, The Global Burden of Disease: Generating Evidence, Guiding Policy.

Since 1970, life expectancy within the region has increased dramatically, with people in many countries today living, on average, 30 years longer than their counterparts 40 years ago.

However, while Latin Americans are living longer, the report warns they face an increased threat from chronic diseases, violence and road-traffic injuries. In fact, in 2010, non-communicable diseases (NCD) in adults, such as heart disease, obesity and diabetes had overtaken communicable diseases in children as the leading cause of death in the region.

And nowhere is this more relevant than in the Caribbean, where the burden of NCDs has escalated to the point that five times as many people are dying from chronic diseases than from all other illnesses combined.

Latin America’s growing prosperity is one of the factors fueling this switch. As the middle class swells, so has the region’s access to high-fat, high-sugar foods, which are helping fuel the changing outlook in many countries.

But it’s not just junk food. As the countries in Latin America have become more developed, road injuries have begun to take a growing toll on human health. Each year 130 000 people die on the region’s roads, with a further 6 million left injured. As a result,  Latin America now holds the unenviable top spot in a global ranking of road traffic deaths.

Non-communicable diseases on the increase

This year, World Health Day, the focus was on high-blood pressure. The second biggest risk factor for heart disease after obesity in Latin America, it’s estimated that 1 in 3 do not know they have high-blood pressure.

As yet the exact causes are unknown, but lifestyle factors such as overeating, alcohol consumption, lack of exercise and smoking are considered to be major contributors.

In Latin America today, a quarter of men and 13% of women in Latin America smoke, which constitutes a ticking time bomb for the region. Speaking on World No Smoking Day, Former President of Uruguay, Tabaré Vasquez, said that the key to kicking the habit is education.

“Making people aware of the toll smoking has on their health is more efficient and cost-effective than caring for them after they get sick,” explained Vasquez .”

This, too, resonates in the Caribbean, where diabetes and obesity are changing the burden of health. Indeed, the former is ranked among the top five causes of health loss in many Caribbean countries, whereas in Jamaica alone more than 60% of adult women (35-54 years old) are either overweight or obese.

“Much of the rise in NCDs in the Caribbean can be traced to individual risk factors such as unhealthy diets (the fried chicken experience), lack of physical activity, smoking and excessive alcohol consumption,” explains World Bank Public Health Specialist, Carmen Carpio

Communicable diseases improving

But while NCDs have increased, the outlook is far from gloomy. Over the past two decades, Latin America has made substantial progress in newborn, nutritional and maternal health, leading to a decrease in premature death and disability from most communicable causes.

What’s more, in recent years the region has led the charge for improvements in Universal Health Care coverage, with nine countries highlighted in a set of case studies published earlier this year .

One such program is Argentina’s Plan Nacer, which has given uninsured pregnant women and children access to basic health services. So far, over a million women and children have benefitted from the program.

"This [Plan Nacer] is the only recourse available to vulnerable people," explains Marta Pereira, an Administrative Assistant at the La Victoria Centre in Buenos Aires. "We provide check ups for pregnant women and for children and we also go out to neighbourhoods and schools."

And with regards NCD, the report is keen to highlight that despite the increased burden, tangible progress is already being seen with cases of coronary artery disease and stroke decreasing between 1990 and 2010.

At the end of the day however, the report pulls no punches, laying much of the blame for the changing disease burden on preventable risk factors - poor diet, smoking and alcohol. While it would seem that Latin Americans are living longer, they are not living healthier.

Just as this is major concern for the region, so the World Bank has committed to tackling the main causes of burden of disease through a range of knowledge-sharing, convening and financing services, as Joana Godinho, World Bank Health Sector Manager clarifies below.

In September a regional study will be launched focusing on lessons learned from recent, multisectoral interventions to promote a healthy lifestyle and prevent chronic diseases. This will be followed in November by a regional event organized along with the Pan-American Health Organization. The event will bring together policy makers and experts to highlight the importance of these interventions, discuss the innate challenges involved in their implementation, as well as examining what implications these have for future policy-making.

The report is based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), a collaborative effort of researchers from 50 countries around the world led by IHME at the University of Washington in the United States and supported by the Bill & Melinda Gates Foundation.