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P A H O Scientific Publication no 587, Washington, DC: 2002, ISBN 92-75-31587-6. Available in paper and CD ROM.
This important publication of the Pan American Health Organisation (PAHO) analyses the health situation and trends in the region of the Americas. This edition, presented in two volumes in the centennial of PAHO, is the latest of this quadrennial publication. The accompanying CD ROM is in both English and Spanish languages.
The leitmotif of the first volume is inequalities in health throughout its eight chapters, presenting a regional perspective on the current health situation. Volume 1 describes the current status and trends in health promotion, environmental health, disease prevention and control, availability of health resources and technology, and external cooperation in health viewed in the context of globalisation, health sector reform, and other macro-political processes. The general changes and the main determinants of the evolution of general health indicators is discussed in Regional Health Analysis (chapter 1), in which instead of applying the widespread used Gini coefficient to analyse the influence of economy on health a comparison between the upper and lower quintiles of income is given. Macrodeterminants of health in sustainable human development is the objective of chapter 2. They are analysed using a human development index (combining life expectancy, literacy, and gross domestic product) and taking into account well known facts such as globalisation, poverty, ethnicity, and sex. Chapter 2 covers the health system reforms undertaken in the region, emphasising the importance of public health functions. The promotion of health is analysed in chapter 4, where a collection of different actions carried our by municipalities and schools is given; it also looks at the main causes of morbidity and mortality by age groups, food and nutrition, and lifestyle. The influence of environment on health is offered in chapter 5, detailing water and sanitation, solid waste, housing, pesticide and pollutants, and work conditions. Chapter 6 reviews prevention and control of common diseases in the region, giving vaccines a wide coverage. Chapter 7 is dedicated to health resources and technology, mainly focused in two points, provision of health care services and scientific production in health. The last chapter deals with the characteristics and trends of external cooperation in health, not only among countries of the region but also with international organisations (such as the World Bank and OECD) and other countries.
Volume 2 presents the most up to date health situation analysis for each of the 48 countries and territories of the Americas. A brief description of the health care organisation of each country is enclosed, detailing the main changes undergone during the past years.
The book is a useful tool for teachers in public health and every professional interested in what is happening around us, in a region where strong differences remain (even in areas that are close). Those concerned with health inequalities will find its reading stimulating with numerous examples.
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