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HEALTH SITUATION IN CHILE Dr. María Inés Romero MD., MPH 2008.

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Presentation on theme: "HEALTH SITUATION IN CHILE Dr. María Inés Romero MD., MPH 2008."— Presentation transcript:

1 HEALTH SITUATION IN CHILE Dr. María Inés Romero MD., MPH 2008

2 General information Chile is a long, narrow country located at the south and west end of the american continent. It is divided into 17 Regions, from north to south, with different geographic, economic and social characteristics

3 Population characteristics and trend Demographic transition Mortality rate and Natality rate are decreasing Proportion of under 15 is decreasing as proportion of 65 and over is increasing Aging as a consequence

4 Censal history in Chile First census 1831 Total population:1.103.036 Last census 2002 Total population: 15.116.435

5 Demographic changes

6 Age distribution of deaths in women by causes. Chile 1909 y 1999 (World Health Report 1999. OMS)

7 Life expectancy 2005-2010 LE at birth: 78,5 years 75,5 years for men 81,5 years for women

8 Education Literacy rate is 96% No differences by sex Lower in rural areas 10 years is the average figure for school education

9 Urbanization 85% of the population live in urban areas 40 % of the population live in the Metropolitan Region When comparing rural and urban areas, there are differences in health, education and social indicators that suggest equity problems.

10 Poverty, CASEN 2006 13,7% of population under the line of poverty Poverty is decreasing: 39,3% in 1990 Still... Equity problems – Regions 2 & 9: 11,2 vs 29,7 – Urban / rural: 18,5 vs 20 – Male / female: 18,3 vs 19

11 Births and natality rates Natality rates have been decreasing since the ’60s from 35 births per 1.000 population to 22 during the ’90s. Natality rate 2005: 14,9 per 1.000 population (230.831 live births) 99% of births are performed by trained health professional

12 Deaths and mortality rates, 2005 86.107 deaths Crude mortality rate is 5,3 per 1,000 population Higher (5,8) in men compared to women (4,8) Swaroop Index is 84% (80 in men and 89 in women)

13 5 leading causes of death Cardiovascular diseases Malignant neoplasms Respiratory diseases External causes (injuries) Diseases of the digestive system

14 Mortalidad materna y por aborto, Chile, 1960-1998 Tasas por 100.000 nv 0 50 100 150 200 250 300 350 19601962196419661968197019721974197619781980198219841986198819901992199419961998 Tasas Años A borto Materna

15 Infant Mortality Rate Important improvement Improvement related to the betterment of socioeconomic situation and also related to health policy and specific interventions 2005: 7,9 – (5,2 neo / 2,7 postneonatal)

16 Infant Mortality Rate

17 Infant Mortality Rate due to measles

18 Infant Mortalidad Rate due to perinatal causes

19 Infant Mortality Rate due to diarrhoea

20 Infant Mortality Rate due to pneumonia

21 Infant Mortality Rate due to congenital malformations

22 INFANT MORTALITY Causes have changed from infectious diseases and malnutrition to perinatal and congenital Immunization preventable diseases Specific interventions: “high tech” for neonatal care, surgical correction of cardiac malformations, management of acute respiratory diseases Health education, high rates of coverage, breast feeding promotion

23 SELECTED ISSUES ABOUT SEXUALITY IN ADOLESCENTS Mean age at first sexual intercourse (Santiago) – Men16,6 – Women17,9 Less than 20% “protected” intercourse

24 SELECTED ISSUES ABOUT ADOLESCENT PREGNANCY Total fertility rate decreased in 52% from the ‘60s: – In women under 20 decrease is 16% – In women 40 years and over, decrease is 90% 16,2% of live births in mothers 20 years or younger – 0,5% in mothers 15 and younger – 18,4% in rural areas – 13,7% in urban areas 40% “unwanted pregnancy”

25 SELECTED ISSUES ABOUT ADOLESCENT PREGNANCY “Out of wedlock births” – Mothers all ages45,7% – Mothers 15 to 19 years80,1% – Mothers younger than 1595,1% Births to mothers less than 20 years – Income: Upper Quintil 2,7% – Income: Lower Quintil20,6%

26 SELECTED ISSUES ABOUT ADOLESCENT SUBSTANCE ABUSE Drinking problem (prevalence)20% Ilegal drugs use (1 or more)15% First time decreasing in age Epidemic increase in cocaine (”pasta base”) – Adictive – Direct impact in health

27 AIDS In Chile 1984 first case Up to december 2003: – 6.060 AIDS cases – 6.514 people HIV positive – 3.860 deaths 1997-2000: 2 drugs therapy 2001-2003: 3 drugs. 100% (AUGE)

28 Caracterización del VIH/SIDA en Chile Localización urbana y rural Predominio en hombres homobisexuales Tendencia a la feminización Tendencia a la heterosexualización Pauperización en mujeres y hombres Diagnóstico mayoritario en edad adulta Fuente: CONASIDA, Ministerio de Salud.

29 HIV / AIDS

30 Prevalence of chronic diseases (self report) 7%7% 5%5% 3%3% 4%4% 3%3% 2%2% 2%2% 3%3% 2%2% 2%2% 3%3% 0 1%1% 1%1% 12% 13% 7%7% 7%7% 5%5% 5%5% 6%6% 4%4% 3%3% 5%5% 3%3% 3%3% 4%4% 3%3% 3%3% 17% Hypertension Presb., astigmatism, miopía Cholelitiasis Chronic Respiratory diseases Hipercolesterolemia Depression Overweight/Obesity Diabetes Colon Irritable Arritmias y cardiopatías Ulcera péptica Problemas Ginecológicos Artritis Artrosis Otras Percentage of population Men Women

31 Health of adults Cardiovascular diseases – Ischemic heart disease – Brain Stroke Malignant neoplasms – Gastric Ca – Gallbladder Ca – Breast Ca – Cervix of the uterus

32 Hypertension Nacional: 33,7% Hombres: 36.7% Mujeres: 30.8%

33 High levels of Cholesterol Nacional: 35.4% Hombres: 35.1% Mujeres: 35.6%

34 Diabetes. Nacional: 4.2% Hombres: 4.8% Mujeres: 3.8%

35 Overweight, Obesity and Malignant Obesity

36 Overweight and Obesity according to educational level

37 Metabolic Syndrome. Nacional: 22.6% Hombres: 23.0% Mujeres: 22.3%

38 High and Very High Cardiovascular Risk. Nacional: 54.9% Hombres: 64.2% Mujeres: 46.2%

39 Symptoms of depression Last year. Nacional: 17.5% Hombres: 10.4% Mujeres: 24.3%

40 Chronic Respiratory symptoms. Nacional: 21.7% Hombres: 22.2% Mujeres: 21.3%

41 TOBACCO

42 NATIONAL HEALTH SURVEY Results of the NHS pointed out the need: – To strength/reinforce promotion and prevention strategies through sectorial and intersectorial activities – To achieve a wide and strong social commitment – To redirect health services towards a comprehensive management of chronic, non communicable diseases.

43 RISK AND PROTECTING FACTORS IN HEALTH Psicosocial determinants : Physical activity Risk and protecting behaviors in traffic and other accidents Nutrition, tobacco, alcohol, substances Sexual behavior SELF ESTEEM FAMILY AND SOCIAL Y SUPPORT CONTROL AND AUTOEFFICACY HOSTILITY LACK OF HOPE STRESS AND COPING VALUES AND BELIEFS

44 Sitios web útiles www.minsal.cl www.ine.cl www.injuv.cl www.conace,cl www.conasida.cl www.who.org www.paho.org www.unicef.org

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