Recent epidemiological changes in South America
damaging the population’s health, other than the social problems typical to this habit. On the other hand, tobacco consumption by people over 15 years of age reaches 35.7% in Chile and 31.3% in Uruguay6. The morbidity burden by the NCDs can also be seen, for example, by the prevalence of hypertension in people over 25, which, age-adjusted, in 2008 got to 42.5/100000 inhabitants in Chile. The lowest is found in Peru, where it is 34.3/100000 inhabitants6. This disease is an important cause for hospitalization as it frequently causes serious consequences such as ischaemic heart diseases and cerebrovascular diseases6. On the other hand, following a global growing trend of obesity, Chile, Venezuela and Argentina lead the statistics with 29% of the population, a rate similar to more developed countries like the United States (31.8%)6. The pressure of NCDs on the health services, as they demand continuous attention and, in most cases, high complexity and high cost health care, is a factor that increases social inequalities in health in the subcontinent, because access to more advanced technologies isn’t equally distributed.
Evolution of the demographic, socioeconomic and health care indicators
In 2010, almost 83% of the South American lived in cities. This urbanization phenomenon was determined by a rural-urban migration process that began in the 1950s as a consequence of the model of political, social and economical development19. The life expectation at birth in the subcontinent has been increasing, so between 1980 and 2010, it went up from 65.1 to 73 years, which means an approximately eight years improvement in about three decades. In spite of this advancement, it still presents lower levels than developed countries, while an unequal distribution remains among the countries of the region. Although in Chile the life expectation at birth was 78.5 years in 2010, which is close to the level of developed countries, in Bolivia it is still 65.5 years. On the other hand, countries like Ecuador, Venezuela, Colombia and Brazil (the region’s emerging countries) are at an intermediate situation, with life expectations ranging from 74 and 75.9 years3. In the region as a whole, the population over 65 years, which was 14.7 million in 1990, has gone up to 27.7 million in 2010, which represents an 87.8% increase. Argentina and Uruguay have almost 15% of their population in this age group. In Bolivia and Paraguay, this group represents only 5% of its total population and over a third of it is under 15 years of age. These discrepancies are a reflection of the level of development of each country3.
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