My study trip to Cuba

 

Golden Age Cubans, 100 years old and above. Cuba, un lugar para vivir. Cuba, a place to live!

In January 2013, I had the wonderful opportunity to spend one week in Cuba and learn about its healthcare system, thanks to the CUNY Institute for Health Equity and Professor Marilyn Aguirre-Molina. Since the end of the Cuban Revolution in 1959, Cuba has prioritized healthcare. As a result, Cuba has made great strides in improving the health of its people and has moved from largely fighting diseases of poverty (parasitic and infectious disease), to diseases of development (heart disease and cancer). Not a small feat in a country with limited financial resources and perhaps more importantly, a limited means to access medical equipment and pharmaceuticals (due in large part to the U.S. embargo). Many Cubans we met during the trip credited the embargo with leading to much of Cuba’s innovation and ability to “do a lot with a little.”

I am particularly interested in exploring ways to increase access to preventative and primary care, and making comparisons between countries is useful in identifying best practices to inform health policy creation, analysis and implementation. In the United States, we spend 19 times more on health per capita than in Cuba, yet experience slightly worse health outcomes. Why is that? 

Figures from 2009 unless otherwise indicated. 

Cuba

U.S.

Life expectancy at birth M/F (in years)

76/80

76/81

Probability of dying under 5 (per 1000 live births)

6

8

Probability of dying between 15 and 60 years of age M/F (per 1000 population)

120/78

134/78

Total expenditure on health per capita      (Intl $, 2010)

431

8,362

World Health Organization: http://www.who.int/countries/cub/en/http://www.who.int/countries/usa/en/.

My greatest lesson from my trip to Cuba is learning about a system that first and foremost attempts to support the well-being of all people, a concept very much lacking in our own healthcare debates in the U.S. Participating in this unique opportunity to speak directly with healthcare workers and educators of public health personnel allowed me to appreciate how integrating medicine and public health, engaging local communities and including health in all policies contribute to achieving better health outcomes. By focusing on prevention and utilizing a community-based approach, Cuba is able to control costs and provide personalized comprehensive care to all of its citizens. In future blog posts, I will describe my experiences with various aspects of the Cuban healthcare system, and how despite their struggling economy, Cuba is able to achieve health outcomes comparable to those of developed nations.
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