CITIES, HEALTH AND WELL-BEING NOVEMBER 2011 DEMOCRACY, STATE AND - - PowerPoint PPT Presentation

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CITIES, HEALTH AND WELL-BEING NOVEMBER 2011 DEMOCRACY, STATE AND MARKET: Factors affecting in territorial inequality and healths people. Chile 16,5 millons people (2006) 15 regions 40% people live in Santiago Income per capita :

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CITIES, HEALTH AND WELL-BEING NOVEMBER 2011

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Factors affecting in territorial inequality and health’s people.

DEMOCRACY, STATE AND MARKET:

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16,5 millons people (2006)

 15 regions  40% people live in Santiago  Income per capita : US$15,800  Human Development Index: 0,854,

37 world ranking

Life expectancy: 77,9
illiteracy rate: 4,3
% population under poverty line : 13, 7
Social vulnerability : 40%
Gini Index : 0.571

Chile

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 Population: 7.000.000. Hab.  Surface: 15.000. kms2.  N °City hall: 52, Metropolitan Area: 36

Comuna de Lo Prado:

Population: 105.000. Hab.  Poverty: 15,5% Surface: 6.5 km2 . 16.000 pp/km  Social vulnerability: 45%

Región Metropolitana de Santiago

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Biological Factors, 15% Environment 10% Health system, 25% Social System, 50%

Fuente: Canadian Institute for Advanced Research

Factors that determine the health status of people

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Poverty in Chile (1990 – 2006)

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Infant and Maternal Mortality. Health National Service

Mortalidad Infantil, Chile 1990-2006 5 7 9 11 13 15 17

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Tasa por 1000 NV Mortalidad Materna, Chile 1990-2006 1,0 1,5 2,0 2,5 3,0 3,5 4,0 4,5 5,0

1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Tasa por 1000 NV

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6.2 7.0 7.8 9.2 11.8 8.2 9.1 9.7 10.9 13.1

2 4 6 8 10 12 14 Quintil 1 Quintil 2 Quintil 3 Quintil 4 Quintil 5 Años Promedio de Estudio Promedio 1996 Promedio 2006

Average years schooling (1996 – 2006)

Social inequalities

workforce/ Gendre (1996 -2006)

75.1 33.2 72.6 42.7

20 40 60 80 Hombres Mujeres Proporción de población (%) Año 1996 Año 2006

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Income distribution for quintiles Chile 1996 -2006

5.5 5.9 6.2 10.1 10.5 11.0 13.5 13.8 14.3 19.9 18.9 20.7 50.9 51.0 47.8

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Casen 1996 Casen 2000 Casen 2006 Quintil 1 Quintil 2 Quintil 3 Quintil 4 Quintil 5

0,571 (GINI), THE COUNTRY MOST INEQUITABLE FROM REGION MOST INEQUITABLE OF THE WORLD

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Infant Mortality Rate / Mother’s education 2005 – 2007 Social health

5.6 5.5 4.1 4.1 3 4 1.4 1.7 1.5 1.1 0.7 1.1 8.1 6.1 4.4 3 1.3 3.1 2 4 6 8 10 12 14 16 Hasta 3 años 4- 6 años 7-9 años 10-12 años 13 y más años Total TMI x 1.000 NV Educación de la madre TM Post Neonatal TM Neonatal Tardía TM Neonatal Precoz

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21.7 28.3 54.6 1.2 2.7 10.2

10 20 30 40 50 60

Universitario Secundario Básico Level education

Hypertension and Diabetes Mellitus Rate / Education level

Hipertensión Diabetes

5 10 15 20 25 30

I II III IV V Total Proporción de población (%)

Quintil de ingresos

"Bad or very bad health for quintil

15-29 años 30-44 años 45-64 años 65 y más años

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TERRITORIAL INEQUALITY AND HEALTH

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INCOME DISTRIBUTION MAP Región Metropolitana

Concentration occurs in only 5 City hall of the region that hosting the 10.29% of the total population

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CONTRAST

WEST EAST

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CONTRAST

WEST EAST

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CONTRAST

WEST EAST

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CONTRAST

EAST WEST

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Population Density Región Metropolitana de Santiago

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Quality of Education Región Metropolitana de Santiago

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GREEN AREAS/POPULATION

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N° PHARMACIES/ 10.000 PEOPLE Privated

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TEST COVERAGE OF PREVENTIVE HEALTH. State

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MORTALITY RATE/ RESPIRATORY SYSTEM DISEASE

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MORTALITY RATE/ DIGESTIVE SYSTEM DISEASE

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MIXED VARIABLES

PRODUCE

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SOCIAL CAPITAL TERRITORY

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HOW WE ARRIVE TO THESE LEVELS OF INEQUALITY?

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PLANNING POLICY DICTATORSHIP 1973-1990 1. Massive eradication 2. No equipment urban 3. Total lack of democracy 4. Social housing policy based on the spatial segregation 5. Irresponsabile State 6. Total market dominance (Health, Pension, Education, Transport)

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PLANNING POLICY Concertación 1990-2006

1. Value of the land, like unique factor 2. Extending coverage of housing 3. Low quality of social housing : 40 mt2. 4. No equipment urban policy 5. Market maintains dominance ( Example.Education) 6. Low power of organized community 7. Political draw garanteed in the parliament 8. Health . Reform AUGE (universal acces whit explicited guaranties)

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Beginning of the break: 2006 – 2010 “2 Examples. (Social, Urban)”

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Chile Grows with You Programe

1. Integrate health, education and social care, from conception 2. Education and parental habits 3. Healthy Eating for the mother 4. Early stimulation room for the newborn 5. Home Repair Grant 6. Support for the newborn and his family 7. Social protection programs for the family

City hall acts as a link to the social network

New concept of social policy

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New housing policy

Neighborhood Recovery Program Housing Recovery Program Improving social housing Main component: Citizen Participation

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Neighborhood Recovery Program

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Neighborhood Recovery Program

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Mejoramiento de Vivienda: 55 UF + 3 UF (US$ 2.360 State + US$ 130 family) Equipamiento y Entorno: 13 UF + 1 UF (US$ 558 state + US$ 43 family) Ampliación de Vivienda: 100UF + 5 UF (US$ 4.290 state + US$ 215 family)

Expansion or improvement project: Room - Living room - Bathroom Kitchen – laundry - roof

Montos de las Intervenciones Improving social housing

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Factors shape the territorial reality

MARKET

STATE

DEMOCRACY

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¿WHAT IS THE PERFECT RELATIONSHIP BETWEEN THESE 3 FACTORS?

1 2 3 4 5 6 7 8 9 10 2 4 6 8 10 12

Resultados en Salud

Magnitud

Point of balance ?

Democracia Mercado Estado

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BETTER DEMOCRACY STATE RESPONSABILE REGULATED MARKET

A new human architecture

CENTURY CHALLENGE XXI

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