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/.