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Health Status Comparison by Countrys Income Level A countrys health status is characterized by several different components culture! norms! values! politics! economics and the environment! to name a fe"# I chose to specifically compare the health of mothers and children in $l Salvador %lo" income&! 'amaica %middle income& and (ermany %hi)h income&! because a nations future lies in the hands of the upcomin) )eneration# *he components mentioned play a role in the health status of each of five areas compared+ fertility rates! maternal mortality rate! infant,child mortality rate! immunization rates and healthy life e-pectancy#

Countries $l Salvador 'amaica (ermany

:aternal :ortality 9ate 1#0 per "oman /52 per /00!000 2#. per "oman /#24 per "oman 24#4 per /00!000 /. per /00!000

8ertility 9ate

Immunization 9ates 420 for 07. years of a)e 2.0 /2721 months 240 for 07. years of a)e

Infant or Child :ortality 9ate 2. for every /000 12 for every /000 . for every /000

Healthy ;ife $-pectancy :ale .5 8emale 32 :ale 34 8emale 33 :ale 50 8emale 54

Fertility Rates A healthy replacement population )ro"th level is considered 2#. or less fertility rate or /0 )ro"th rate# $l Salvador! havin) 1#0 fertility rates can e-pect its population to double in appro-imately 12 years# *his is of )reat ma)nitude for a country "ith small land space+ $l Salvador is the smallest country in Central America# *heir population no" sits at rou)hly 3!45.!000 "ith 12/ persons per 6m 2# *his has lar)e implications "hen resources are scare in this lo"7income country# Althou)h 'amaica and $l Salvador do not differ much in economy! )ro"th rates continue to decline for 'amaica#

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<ne hypothesis "ould be this countrys hi)h levels of emi)ration! about /4!000 in 2004# *he population bein) counted on the island of 'amaica is less because they are spread to other areas of the "orld# (ermany on the other hand has the second lo"est birth rate in $urope but the hi)hest elderly population! /5#.0+ e-pected to rise by 2010 to 23#40 of the population# =ith lo" birth rates and hi)h elder population there may not be enou)h people of "or6force a)e to sustain the )ro"in) elderly population# *his may put a strain on social services and,or family income# Maternal Mortality Rates :aternal mortality rates continue to be hi)h in countries "here pre,post7natal care and hospital assisted labor is lac6in)# =hether the cause is cultural norms! education or a bro6en healthcare system! "omen in $l Salvador die at a rate of /52 per /00!000# *he elevated rates of maternal mortality may be due in )reat part to the urban7rural divide# Appro-imately .40 of the population lives outside metropolitan areas "here one can e-pect healthcare not to be up to par "ith "hat is available in the capitol city# =omen in rural areas receive less prenatal care and labor at home is more common# *he poor economic development of the country has also not allo"ed for medical advancement as seen by .40 of deaths attributed to healthcare mismana)ement! misdia)nosis! procedures performed by un>ualified personnel! belated patient referrals and shorta)e of e>uipment# 'amaica has made )ains in their maternal mortality rates by increasin) the number of births assisted in a hospital settin) to 24#20# *he maternal mortality rate still remains relatively hi)h! even thou)h 'amaica is increasin) the percenta)e of "omen receivin) pre,post7natal care they are only avera)in) 4#4 visits in the nine months of pre)nancy# *he improvements made in the

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decreasin) of maternal mortality rates have been due to the development of re)ional committees convened to investi)ate deaths thus! improvin) preventative interventions and treatment# :aternal mortality rates in (ermany are very lo" compared to 'amaica and $l Salvador due to "omen utilizin) health services especially durin) childbearin) periods# (ermany also has hi)h per capita health e-penditure! /0#20 of (?@ and 520 covered by public funds# *his )ives citizens e>ual access to health services# Immunization Rates All three countries have ade>uate immunization rates! "hich si)nificantly reduce infant mortality from communicable diseases# $ven thou)h there has been )lobal intervention to provide lo"7income countries "ith immunizations! $l Salvador is still missin) //0 of its 07. year old population# *he urban7rural divide may be to blame for the population bein) missed! there are not enou)h clinics set up in rural areas to offer immunizations in a timely manner# 'amaica and (ermany have e-cellent immunization rates! "hich provide the fe" they missed "ith herd immunity# Infant or Child Mortality Rates As a result of ade>uate immunization rates in all three countries! mortality rates in children from communicable diseases are almost none-istent# In the case of $l Salvador! children are dyin) from )astrointestinal issues due to poor sanitation# <nly 3.#.0 in rural areas had runnin) "ater compared to 40#20 in urban areas# ;ac6 of sanitary facilities in rural areas "as astonishin)! 440 had no facilities# =hile immunizations protect from communicable diseases they do not protect from environmental patho)ens# 'amaicas infant mortality rate is due to HIA! "here it is the

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leadin) cause of death for /74 year olds# HIA transmission education for both healthcare providers and mothers has been slo" to arrive on the island# Since 2004 bi))er strides have been made in the care and treatment of HIA7infected children and a decrease in mother7to7child transmission# In the case of (ermany! the country enBoys the lo"est infant mortality rate in $urope# *his is due to antenatal services perceived as the most important services in health care# It may be ar)ued that too much money is spent on e-cessive and unnecessary testin) "hich may be the reason "hy they spend /0#20 (?@ on healthcare# Healthy Life E pectancy Healthy life e-pectancy in each country is attributable to the causes discussed above# (ermany spends a hi)h percenta)e of health care thus! )ivin) their citizens a lon)er >uality of life# 'amaican citizens are more li6ely to die of homicide or violence for males and HIA,AI?S for females# *hese t"o causes shrin6 the healthy life e-pectancy considerably# :en still account for fe"er visits to a health clinic! "hile "omen are much more prone to ac>uirin) HIA at a rate of / in /0# *he lo" healthy life e-pectancy rate in $l Salvador is attributable to their lo" economic status! poor health care system and lo" educational level# <verall males live a relatively lo" healthy life e-pectancy# *his can be credited to a country "here a /07year7old child is considered of "or6in) a)e thus increasin) "or6place inBuries# *hese three countries vary )reatly in their rates of health "ith one country enBoyin) a rich healthcare system "hile another suffers from poor health outcomes# 8rom a )lobal standpoint! small but si)nificant interventions can be made to assist

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countries to improve their health outcomes# 8or instance! better sanitation can be used to prevent some of the deadly preventable diseases in the t"o lo"est economic countries# An improvement in HIA,AI?S education could bump the healthy life e-pectancy of 'amaican citizens# @rovidin) trainin) to doctors and incentivizin) them to practice in rural areas could help reduce the rates or maternal mortality in $l Salvador# Health has a cast system all its o"n! "ith countries "ith hi)h economic standin) benefitin) from healthier citizens "hile those "ith lo"er trade and industry suffer from lac6 of basic health services therefore! are deficient in a healthy "or6force# If other countries enBoy >uality of life and health! I believe it is their moral duty to share their healthcare practice successes "ith other countries#

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References Allebec6! @# %2004&# @an American Health <r)anization %@AH<&! $l Salvador 7 Health in the Americas! 2005# 9etrieved September /4! 2002 from http ,,"""#paho#or),hia,archivosvol2,###,$l020Salvador020$n)lish#pdf for Allebec6! @# %2004&# @an American Health <r)anization %@AH<&! 'amaica7 Health in the Americas! 2005# 9etrieved September /4! 2002 from http ,,"""#paho#or),HIA,archivosvol2,paisesin),'amaica020$n)lish#pdf =orld Health <r)anization %2004&# $l Salvador =orld Health Statistics 2003# =orld Health <r)anization# 9etrieved September /4! 2002! from http ,,"""#"ho#int,countries,slv,en, =orld Health <r)anization %2004&# (ermany =orld Health Statistics 2003# =orld Health <r)anization# 9etrieved September /4! 2002! from http ,,"""#"ho#int,countries,deu,en, =orld Health <r)anization %2004&# 'amaica =orld Health Statistics 2003# =orld Health <r)anization# 9etrieved September /4! 2002! from http ,,"""#"ho#int,countries,Bam,en, =orld Health <r)anization $urope %2003&# Hi)hli)hts on health in (ermany 2004# 9etrieved September /4! 2002 from http ,,"""#euro#"ho#int,document,e44.25#pdf

Health Status Comparison