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Mortality Decline in Cuba, 1900–1959: Patterns, Comparisons, and Causes

Published online by Cambridge University Press:  05 October 2022

James W. McGuire  and
Laura B. Frankel
James W. McGuire
Affiliation:
Wesleyan University
Laura B. Frankel
Affiliation:
Wolfson College, University of Oxford
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Abstract

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Revolutionary Cuba since 1959 has outpaced most other Latin American countries at raising life expectancy and reducing infant mortality. Pre-revolutionary Cuba from 1900 to 1959 did even better, however, outperforming all other Latin American countries for which data are available. Pre-revolutionary Cuba became Latin America's unlikely champion of mortality decline despite experiencing slow economic growth and high income inequality, a record that is inconsistent with the “wealthier is healthier” interpretation of mortality reduction. It also achieved this distinction despite being ruled by governments that are sometimes portrayed as corrupt, personalistic, patronage-ridden, subordinate to U.S. business interests, and neglectful, at best, of the exploited and downtrodden. We attribute pre-revolutionary Cuba's rapid mortality decline to its health care system's accessibility to a large fraction of the poor and to features of the island's history, geography, labor union movement, and political system that contributed to this accessibility.

Resumen

Resumen

Desde 1959, Cuba revolucionaria ha superado a casi todos los países latinoamericanos en el incremento de la expectativa de vida y la reducción de la mortalidad infantil. Sin embargo, desde 1900 hasta 1959, Cuba pre-revolucionaria fue más exitosa aún, superando a todos los países latinoamericanos con los que se cuenta información. Cuba pre-revolucionaria se convirtió en el campeón latinoamericano del declive de la mortalidad a pesar de sufrir un lento crecimiento económico y una alta inequidad en el ingreso; un récord que es inconsistente con la interpretación “más rico, más saludable” sobre la reducción de la mortalidad. A su vez, Cuba alcanzó esa distinción a pesar de haber estado bajo gobiernos en muchos casos tildados de corruptos, personalistas, manejados por el patronazgo político, subordinados a intereses norteamericanos, y negligentes, en el mejor de los casos, de los explotados y de los oprimidos. Atribuimos este rápido declive de la mortalidad en Cuba pre-revolucionaria a un alto nivel de acceso al sistema de salud por un gran segmento de los pobres, y a las características de la historia de la isla, su geografía, su movimiento obrero y su sistema político.

Type
Research Article
Information
Latin American Research Review , Volume 40 , Issue 2 , June 2005 , pp. 83 - 116
Copyright
Copyright © 2005 by the University of Texas Press

Footnotes

*

The Harvard Center for Population and Development Studies and a Christian A. Johnson Endeavor Foundation Research Apprenticeship at Wesleyan University provided generous support for this research. We are particularly grateful for comments and suggestions by Juan Carlos Albizu-Campos Espiñeira, Lorena Barberia, Arachu Castro, Sergio Díaz-Briquets, Jorge Domínguez, Susan Eckstein, Julie Feinsilver, Richard Garfield, Steven Levitsky, Carmelo Mesa-Lago, and Michael Reich; by the LARR editors; by three anonymous LARR referees; and by participants in a March 2003 seminar at the Harvard Center for Population and Development Studies, a March 2003 panel at the Latin American Studies Association meeting in Dallas, and a December 2003 seminar at the David Rockefeller Center for Latin American Studies at Harvard. We also thank the staff of the Interlibrary Loan Office at Wesleyan University for helping us to obtain research materials. The authors take responsibilty for any error of fact or interpretation.

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