Abstract
Poor and deteriorating health, along with premature death, are the result of inequality in a society. In the Americas, the poorest and most vulnerable populations get sick or die because of their lack of access to health promotion and disease prevention, as well as health services and health care that meet their needs. In every country in the Region, studies with a breakdown by socioeconomic level, ethnicity, sex, age, and geographic location show that discrimination and exclusion are practiced at different levels and that the exercise of rights, especially the right to health, must be expanded if better outcomes, as measured by universally accepted indicators, are to be obtained.
In every case, even in countries where the level of well-being is among the highest, additional comprehensive efforts are needed. While their scale and nature will vary, special emphasis must be placed on the local level and most vulnerable populations to guarantee them the highest attainable standard of health (the right to health). As for social policy and intersectoral activities, it is imperative to emphasize those related to the development of basic infrastructure, such as sanitation and access to good-quality water; a good level of schooling for the entire population (especially women); strategies to guarantee a living wage for the poor population, especially women; and the promotion of gender equality, ethnic equity, and intercultural approaches.
Furthermore, in addition to the efforts to improve the health status of the population, specific emphasis and support are needed to improve health information. Without consistent, valid, and timely data and indicators, it is difficult to monitor regional, national, and local progress to guide decision-making on resource allocation and choose interventions that will result in better health. One alternative is the good use of estimates, whose limitation is that they do not reflect the situation in every country. There is an urgent need in our Region to promote the critical validation of information, develop suitable methodologies, and upgrade the existing technical capacity and structures to generate information on births and deaths and also to strengthen administrative registries, which are key components of PAHO's Regional Plan of Action for Strengthening Vital and Health Statistics.
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