142nd APHA Annual Meeting and Exposition

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Descriptive and comparative analysis of health status and health care delivery in Haiti and Dominican Republic. Are there lessons to be learned?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Pilar Martin, MD, MPH, MHSA , School of Allied Health and Life Sciences _ MPH Program, University of West Florida, Pensacola, FL
Michael A. Melchior, PhD, MPH , International Health Connection, Miami, FL
Brian Kunkle, PhD, MPH , International Health Connection, Miami, FL
Karlyn Guirand-Emile, MPH, CHES , International Health Connection, Miami, FL
Bree Agustin, MPHc , School of Allied Health and Life Sciences, University of West Florida, Pensacola, FL
Ronald Brown, MPHc , School of Allied Health and Life Sciences, University of West Florida, Pensacola, FL
Background: Haiti and the Dominican Republic (DR) are neighboring countries.  Despite having a similar size population, geography, climate and natural resources, both health status and health care delivery are very different. These differences are relatively new, as they started to diverge in the 1950’s.

Method: Secondary data from 2006-2009  from PAHO, WHO, and Ministere de la Sante Publique were analyzed.  Descriptive analyses were conducted to identify the magnitude of differences.

Results: This study found continued, wide, health inequalities existing between the two countries. Below are the most important findings. Life expectancy in Haiti is 61 years compared to 73 for DR. The proportion of the population with access to  safe drinking water is 58% for Haiti and 95% for DR. Infant mortality rate for Haiti is 60/1,000 live births and 25/1,000 in DR.  Adult mortality for Haiti is 282/1,000 population and 209/1,000 for DR. The number of physicians  is  3/10,000 population  for Haiti and  20/10,000 for DR. The number of dental personnel are near 0/10,000 population for Haiti and 8/10,000 for DR. Hospital beds number 8/10,000 population for Haiti and 20/10,000 for DR. The percentage of external expenditure out of total health care costs is 65.8% for Haiti and 1.7% for DR. 

Discussion: This study shows the large disparities in social and health indicators between the two countries. Few indicators are available using age-adjusted rates.  However, considering these constraints, the study presents clear levels for Haiti to achieve in public health and health care delivery.

Learning Areas:

Epidemiology
Provision of health care to the public
Public health or related public policy

Learning Objectives:
Describe the difference in health status and access to health services between Haiti and Dominican Republic Identify the social factors that contribute to the different health outcomes in both countries

Keyword(s): Health Assessment, Epidemiology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an assistant professor in PH with more than 9 years experience in graduate teaching
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.