Abstract
ObjectiveWe describe trends in life expectancy at birth (LE) and between-country LE disparities since 1965, in Latin America and the Caribbean.Methods & FindingsLE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity) and 23% (relative disparity) in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America.ConclusionsLE in Latin America and the Caribbean is exceeding ‘minimum standard’ international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity between Caribbean countries suggests that public health interventions should be tailored to individual countries to be most effective. Between- and within-country disparity monitoring for a range of health metrics should be a priority, first to guide country-level policy initiatives, then to contribute to the assessment of policy success.
Highlights
Two cornerstones of public health policy—improving the average health of a population and reducing disparities in health [1]–imply that progress towards these goals is being actively monitored
Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response
The World Population Projections (WPP) 2012 revision was released in June 2013 and is the source for all data used in this article [30]
Summary
Two cornerstones of public health policy—improving the average health of a population and reducing disparities in health [1]–imply that progress towards these goals is being actively monitored. To facilitate the public health goal of monitoring and reducing disparities, the US has developed infrastructure including the Health Disparities Act (2000), which in turn allowed the creation of the National Institute on Minority Health and Health Disparities (NIMHD). The NIMHD has funded a 5-year program (NIH number: U24MD006959) to explore and compare for the first time health disparities among African-descent populations in the Caribbean and the US. This partnership between the Sullivan Alliance [16] and The University of the West Indies [17] is using published work, Caribbean health databases, and open-access data to build an evidence-based picture of Caribbean health disparities. It is anticipated that with the creation of a comprehensive disparities situation analysis for the region, priorities for public health both regionally and on a country-level can be based on contextually relevant evidence
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