health situation in the americas Basic Indicators 2012 Age-adjusted mortality rate from external causes per 100,000 pop (10-49 years), 2008 14.9 - 42.8 42.9 - 54.5 54.6 - 74.0 74.1 - 136.2 no data N Regional Office of the World Health Organization Office of the Assistant Director Health Surveillance and Disease Prevention and Control Health Information and Analysis 110th ANNIVERSARY preface On a yearly basis since 1995 the Regional Core Health Data Initiative of the Pan American Health Organization/World Health Organization (PAHO/WHO) presents the most recent information on health indicators in the Region of the Americas. On the 110th anniversary of PAHO/WHO, this publication highlights the mortality due to external causes (EC); those causes of death different from natural causes and recognized as avoidable such as suicides, homicides and accidents. From the data reported by the countries, it is estimated that over 5.5 million people died from EC in the Region between 1999 and 2009. Three and a half million deaths (64%) occurred among the young and adult population (10-49 years old) with an average of 319,000 deaths per year; 84% of the deaths happened among males, five times more deaths among men than women. The most frequent causes were homicides (33%) and land transport accidents (26%). On the cover, we have included a map that shows the distribution of mortality from all EC of the countries in the Region in 2008. Furthermore, based on the importance of the mortality profile from EC, we have included a time series analysis from homicides and land transport accidents by sex for eight subregions. It is important to recognize the efforts that several countries are conducting by implementing prevention programs on violence and injury, including the strengthening of information systems to quantify the events. Given the complexity of determinants and the role of different social sectors, it is fundamental that PAHO Member States continue their work within the commitments that have been acquired through instruments such as the PAHO Resolution CD 48/20 “Preventing Violence and Injuries and Promoting Safety: A Call for Action in the Region", 2008, and the "Plan of Action for Road Safety", 2011. The information presented in this brochure has been compiled, processed and reviewed by PAHO/WHO technical staff in collaboration with staff from the ministries of health and the planning and statistics offices in the Americas. For more information, including basic indicators and their definitions, please visit the website of the PAHO/WHO Regional Health Observatory at www.paho.org/rho Mirta Roses Periago Director For this publication: Latin America includes Mexico, the Central American Isthmus, the Latin Caribbean, the Andean Area, Brazil, and the Southern Cone. ”Latin America and the Caribbean” comprise Latin America and non-Latin Caribbean. Brazil and Mexico are being shown separately due to their population size. demographic indicators 3 1 2 annual births total crude average population birth rate (thousands) (1,000 pop) (thousands) 4 annual deaths average (thousands) 5 annual pop growth (%) 6 total fertility rate (child/woman) 7 urban population (%) 8 dependency ratio (100 pop) 9T 9M 9F life expectancy at birth (years) 2012 2012 2012 2012 2012 2012 2012 2012 2012 total male female The Americas 953,686 16.2 15,547.2 6,517.1 1.0 2.1 80.5 51.6 76.4 73.5 79.2 North America Bermuda Canada United States of America 350,535 69 34,675 315,791 13.5 11.4 11.3 13.7 4,745.2 0.8 392.8 4,350.7 2,915.7 0.5 267.5 2,646.7 0.9 0.6 0.9 0.9 2.0 2.0 1.7 2.1 82.4 100.0 80.8 82.6 50.1 49.9 45.1 50.7 79.0 80.8 81.2 78.8 76.4 77.6 78.9 76.2 81.5 84.1 83.5 81.3 Latin America & the Caribbean 603,151 17.8 10,802.0 3,601.4 1.1 2.2 79.4 52.4 74.8 71.8 77.9 Latin America 595,972 17.8 10,685.3 3,549.7 1.1 2.2 79.6 52.4 74.8 71.8 77.9 Mexico 116,147 18.5 2,158.3 557.6 1.1 2.2 78.4 53.5 77.2 74.8 79.6 Central American Isthmus Belize Costa Rica El Salvador Guatemala Honduras Nicaragua Panama 44,012 324 4,794 6,264 15,138 7,912 5,955 3,625 24.8 24.0 15.3 20.0 31.5 25.8 22.8 19.1 1,103.1 7.9 73.8 125.5 483.7 206.0 136.7 69.5 228.9 1.2 20.9 41.3 81.5 37.8 27.8 18.4 1.8 2.0 1.4 0.6 2.5 2.0 1.4 1.5 2.9 2.7 1.8 2.2 3.8 3.0 2.5 2.4 57.5 44.6 65.1 65.3 50.2 52.7 57.9 75.8 67.0 60.8 44.4 60.6 82.4 66.9 61.2 54.3 73.7 76.3 79.5 72.5 71.5 73.6 74.4 76.4 70.5 74.9 77.1 67.7 68.0 71.3 71.4 73.9 76.9 77.8 82.0 77.1 75.1 75.9 77.5 79.1 Latin Caribbean Cuba Dominican Republic French Guiana Guadeloupe Haiti Martinique Puerto Rico 36,547 11,249 10,183 243 465 10,256 408 3,743 17.8 9.6 20.9 24.0 13.2 25.7 11.6 12.9 652.1 107.6 213.9 5.9 6.2 265.6 4.7 48.2 272.8 85.1 60.8 0.9 3.4 90.2 3.3 29.2 0.7 0 1.2 2.5 0.4 1.3 0.3 0 2.3 1.5 2.5 3.1 2.1 3.2 1.8 1.8 70.9 75.2 70.2 76.6 98.4 54.6 89.0 99.0 54.4 41.8 58.3 59.2 53.4 65.5 51.6 51.3 73.1 79.3 73.8 76.7 79.9 62.5 80.6 79.3 70.8 77.4 71.2 73.4 76.1 61.1 77.3 75.4 75.3 81.3 76.6 80.5 83.6 63.9 83.7 83.2 Andean Area Bolivia (Plurinational State of) Colombia Ecuador Peru Venezuela (Boliviarian Republic of) 132,289 10,248 47,551 14,865 29,734 29,891 19.9 25.8 18.9 19.8 19.6 19.8 2,647.8 266.3 902.8 296.1 585.2 597.4 733.0 73.3 264.5 75.8 163.3 156.1 1.3 1.6 1.3 1.3 1.1 1.5 2.4 3.2 2.3 2.4 2.4 2.4 78.6 67.2 75.6 68.0 77.6 93.7 54.4 66.9 51.5 56.3 54.9 53.3 73.9 67.1 74.0 75.9 74.3 74.7 70.9 64.8 70.4 73.0 71.7 71.8 77.0 69.4 77.7 78.9 76.9 77.7 Brazil 198,361 15.0 2,978.3 1,270.8 0.8 1.8 84.9 46.8 74.0 70.7 77.4 Southern Cone Argentina Chile Paraguay Uruguay 68,616 41,119 17,423 6,683 3,391 16.6 16.8 14.0 23.7 14.5 1,146.2 692.1 245.3 159.6 49.2 486.6 318.2 100.4 36.7 31.4 0.9 0.9 0.9 1.7 0.3 2.1 2.2 1.8 2.9 2.0 88.8 92.6 89.3 62.4 92.7 52.8 54.4 45.2 61.4 56.2 76.7 76.1 79.3 72.8 77.3 73.3 72.4 76.2 70.8 73.7 80.1 79.9 82.4 74.9 80.7 Non-Latin Caribbean Anguilla Antigua & Barbuda Aruba Bahamas Barbados Cayman Islands Curaçao Dominica Grenada Guyana Jamaica Montserrat Saint Kitts & Nevis Saint Lucia Saint Vincent & the Grenadines Sint Maarten (Dutch part) Suriname Trinidad & Tobago Turks & Caicos Islands Virgin Islands (UK) Virgin Islands (US) 7,179 15 89 108 351 288 53 146 73 109 758 2,761 5 51 162 104 39 534 1,351 46 31 105 16.2 12.9 16.2 12.8 15.2 12.2 12.2 13.6 15.6 16.8 17.4 17.9 11.6 13.9 14.4 14.4 13.1 17.8 14.3 17.4 10.7 10.9 116.2 0.2 1.4 1.4 5.3 3.5 0.6 2.0 1.1 1.8 13.2 49.6 0.1 0.7 2.3 1.5 0.5 9.5 19.3 0.8 0.3 1.1 51.7 0.1 0.5 0.9 2.0 2.4 0.3 1.2 0.6 0.9 4.4 19.8 0.0 0.4 1.2 0.7 0.2 3.9 11.1 0.1 0.2 0.8 0.5 2.1 1.3 1.4 1.1 0.4 2.2 0.7 0.2 0.5 0.2 0.4 0.5 0.8 0.4 -0.3 1.5 0.9 0.3 3.2 2.4 -0.5 2.0 1.8 2.0 1.8 1.9 1.7 1.9 2.1 2.1 2.2 2.2 2.3 1.3 1.8 1.8 1.9 2.1 2.3 1.6 1.7 1.2 1.8 44.8 100.0 29.9 47.0 84.5 44.9 100.0 … 67.3 39.5 28.5 52.2 14.4 32.1 16.9 49.7 … 70.1 14.0 94.1 40.8 95.6 49.5 46.6 47.5 42.2 40.9 40.4 41.0 50.5 49.0 51.7 55.8 55.9 48.1 42.8 47.3 47.4 34.2 52.3 38.6 36.3 33.3 55.0 73.0 81.0 75.7 75.9 75.9 74.5 80.8 77.6 76.2 73.3 70.3 73.4 73.4 74.8 77.0 74.4 77.4 70.9 70.4 79.3 78.0 79.5 70.2 78.4 73.7 72.9 72.7 72.3 78.1 75.4 73.2 70.8 67.2 70.9 75.2 72.5 74.3 72.5 75.2 67.8 66.9 76.5 76.7 76.4 75.9 83.6 77.8 79.0 78.9 76.8 83.5 80.0 79.3 76.1 73.5 76.0 71.6 77.3 79.9 76.4 79.8 74.2 73.8 82.1 79.2 82.7 BI 1-9: countries under 300,000 pop: US Census Bureau, otherwise: UN Population Division estimates. Both agencies are continuously reviewing population projections taking into account the latest census. BI 2-9: lineal interpolation of UN data. mortality indicators 10 maternal mortality ratio (100,000 lb) ratio maternal year deaths The Americas North America Bermuda Canada United States of America 67.1 6,069 9.0 9.0 … 34 34 … 2009 2008 11 maternal mortality ratio estimated (1) (100,000 lb) 2010 12 infant mortality rate (1,000 lb) rate 14 13 under-five mortality (1,000 lb) 62 12.4 infant deaths 148,722 20 … 12 (9-16) 21 (18-23) 6.3 1.3 5.1 6.4 28,324 1 1,911 26,412 7.4 2.0 5.8 7.5 rate 13.6 year 2010 2008 2009 15 registered deaths < 5 due to ADD (%) ARI (%) 2.1 4.9 1.1 0.3 1.2 1.6 1.5 1.6 year 2008 2009 2009 17 16 mortality ill-defined and unknown under-registration (%) causes of death (%) c2009 c2009 3.6 7.1 1.5 3.3 0.9 1.6 1.7 6.7 3.0 1.6 Latin America & the Caribbean 69.4 6,035 81 15.6 120,398 17.3 2.7 6.9 5.0 10.4 Latin America 69.1 5,962 80 15.5 119,034 17.3 2.8 6.9 5.0 10.4 2.5 6.7 2.1 0.5 8.0 6.0 1.3 5.6 12.0 … 4.9 9.8 16.7 7.7 3.0 14.6 27.1 … 10.0 7.1 6.5 0.9 0.9 15.6 7.1 … 2.1 3.5 19.0 19.0 14.8 24.7 12.7 … 34.9 14.4 2009 2009 1.7 1.4 2.2 2.4 1.8 … 1.5 4.4 6.0 3.8 4.9 … 4.0 1.5 2009 2009 2.5 0.8 4.3 9.4 9.4 … 11.3 0.7 20.6 50.9 8.3 7.2 … 9.9 3.8 8.8 … 7.7 10.7 12.8 5.6 2009 2010 2010 2009 2.8 … 2.2 9.4 … 0.6 23.7 … 21.9 17.4 42.3 11.1 Mexico 51.5 992 2010 50 (44-56) 14.1 27,236 16.8 Central American Isthmus Belize Costa Rica El Salvador Guatemala Honduras Nicaragua Panama 116.4 55.3 23.0 83.7 158.2 74.0 … … 610 4 17 83 344 162 … … 101 2010 53 (33-88) 2011 40 (31-50) 2010 81 (55-120) 2008 120 (110-140) 2010 100 (64-160) 95 (54-170) 92 (75-110) 18.9 20.1 9.1 … … 24.3 … 13.4 7,162 145 666 … … 5,441 … 910 … 22.7 10.4 … … … … 17.8 Latin Caribbean Cuba Dominican Republic French Guiana Guadeloupe Haiti Martinique Puerto Rico 73.8 40.6 106.3 16.4 … … … 11.0 291 54 231 1 … … … 5 211 2011 73 (60-87) 2011 150 (100-210) 2009 … … 350 (210-610) … 2009 20 (13-31) 17.7 4.9 26.9 10.9 a 8.7 … 9.3 8.0 6,962 … 653 6.0 5,842 … 66 a 13.3 44 … … … … … 357 8.8 Andean Area Bolivia (Plurinational State of) Colombia Ecuador Peru Venezuela (Boliviarian Republic of) 80.3 1,589 … … 72.9 510 92.6 203 93.0 442 73.0 434 2009 2010 2011 2009 98 190 (130-290) 92 (80-100) 110 (62-180) 67 (42-110) 92 (78-110) 17.3 … 20.1 … 16.0 14.4 18,157 … 9,580 … … 8,577 19.3 … … 20.7 21.0 16.9 2009 2009 2011 2009 3.2 … 3.1 2.5 2.6 4.3 Brazil 67.5 1,998 2010 56 (36-85) 16.2 48,277 18.9 2010 2.3 5.4 2010 7.0 6.4 2010 2010 2010 2011 67 77 (67-87) 25 (21-29) 99 (60-160) 29 (21-39) 11.5 11.9 7.4 16.9 8.9 b 11,240 12.3 8,961 13.8 8.7 1,862 … … 417 b 9.5 2010 2010 2008 2010 1.3 1.3 0.3 3.8 1.5 4.2 3.9 4.1 5.4 6.7 2010 2009 2010 2009 7.3 8.4 2.6 11.9 8.4 6.4 4.7 1.3 33.1 1.4 112 … … … 18.9 … 20.6 … 19.8 13.4 5.1 … 29.9 10.9 b … 20.0 12.0 14.3 22.3 … 20.3 … 6.0 … 2.2 … 8.9 … … 1.8 1.3 - 4.0 11.6 4.8 … 5.9 … 4.4 2.8 … 4.4 2.8 - 3.2 1.5 1.1 4.6 1.7 2.7 3.3 … 1.7 2.1 1.4 … 5.0 0.6 9.7 3.5 … 8.3 1.9 8.2 10.0 3.0 10.2 3.3 26.5 10.2 1.5 29.8 … 7.5 1.8 20.3 … … 10.0 8.2 34.4 7.6 1.2 Southern Cone Argentina Chile Paraguay Uruguay 44.7 43.8 18.3 100.8 6.4 482 331 46 102 3 Non-Latin Caribbean Anguilla Antigua & Barbuda Aruba Bahamas Barbados Cayman Islands Curaçao Dominica Grenada Guyana Jamaica Montserrat Saint Kitts & Nevis Saint Lucia Saint Vincent & the Grenadines Sint Maarten (Dutch part) Suriname Trinidad & Tobago Turks & Caicos Islands Virgin Islands (UK) Virgin Islands (US) 100.9 … 130.9 58.0 … … 113.3 150.2 44.8 57.3 … 123.0 … … 73 1 7 2 … … 48 1 1 1 … 12 … … BI 11: (1) 95% confidence intervall. BI 12-13: (a) value 2010; (b) value 2011. BI 10, 12-13: country reported data to PAHO/WHO. 2010 2011 2009 2009 2010 2011 2011 2011 2010 2011 2011 2008 2011 2009 2011 2011 47 (28-75) 51 (19-140) … … … 24 (15-38) 280 (180-430) 110 (77-170) … … 35 (22-54) 48 (30-78) … 130 (89-190) 46 (26-84) … … … 1,364 … 20 5 100 46 4 … 28 20 b … 850 8 32 39 … 199 … 2 11 21.2 … 28.0 … 22.6 14.3 6.3 … 30.9 17.3 … 22.0 15.0 17.0 23.5 … 23.3 … … … 2010 2011 2011 2011 2010 2011 2011 2009 2009 2011 2009 2010 2010 2011 2011 2010 2008 2011 2011 2008 2011 2009 2011 2011 2009 2010 2009 2010 2009 2009 2010 2009 2010 2010 2009 2009 2010 2009 2010 2008 2008 2007 2010 2010 2009 2010 2010 2008 2010 2009 2008 2009 2009 2009 mortality indicators 18Tc 18Ta 18Mc 18Ma 18Fc general mortality rate (all causes) (1,000 pop) (2010) 18Fa total male female corrected adjusted corrected adjusted corrected adjusted 19Tc 19Ta 19Mc 19Ma 19Fc mortality rate from communicable diseases (100,000 pop) (2010) 19Fa total male female corrected adjusted corrected adjusted corrected adjusted 6.7 5.9 7.2 7.2 6.1 4.7 49.4 46.1 52.8 53.4 46.2 38.3 7.9 6.2 7.1 7.9 4.8 3.9 4.0 4.9 7.9 7.1 7.2 8.0 5.8 5.3 4.7 5.9 7.7 5.5 7.0 7.8 3.9 2.8 3.3 4.0 39.6 56.4 32.7 40.4 24.2 34.0 17.4 24.9 39.6 67.5 31.5 40.5 28.5 48.9 20.1 29.4 39.8 46.0 34.0 40.4 20.6 23.7 15.1 21.2 Latin America & the Caribbean 6.0 6.5 6.8 8.0 5.2 5.2 55.5 59.5 60.9 68.0 50.1 49.2 Latin America 6.0 6.5 6.8 8.0 5.2 5.2 55.4 59.5 60.9 67.9 50.1 49.2 Mexico 5.1 6.0 5.8 7.2 4.4 4.9 30.2 34.1 35.3 42.4 25.2 26.9 Central American Isthmus Belize b Costa Rica El Salvador b Guatemala b Honduras Nicaragua Panama b 5.1 4.8 4.1 6.5 5.1 … 4.7 5.1 6.9 7.4 4.9 7.4 7.6 … 6.6 6.0 6.0 5.6 4.6 7.8 6.0 … 5.4 5.8 8.4 8.8 5.5 9.5 9.3 … 8.0 7.1 4.3 3.9 3.5 5.3 4.2 … 4.0 4.4 5.5 6.1 3.7 5.6 6.2 … 5.5 4.9 64.3 76.0 19.7 73.2 86.9 … 34.9 60.8 77.6 105.6 21.4 80.1 110.2 … 42.1 67.2 73.3 89.6 23.2 83.1 98.3 … 41.4 72.9 76.3 129.6 26.6 98.8 131.8 … 50.9 83.6 55.6 62.7 16.0 64.3 76.1 … 28.5 48.4 64.1 82.4 16.5 65.3 92.3 … 33.9 51.5 Latin Caribbean Cuba Dominican Republic French Guiana b Guadeloupe b Haiti Martinique b Puerto Rico b 7.1 8.1 6.1 2.9 5.7 … 5.9 7.7 6.0 5.5 7.0 4.4 3.7 … 3.2 5.2 8.0 8.7 7.1 3.5 6.4 … 6.6 8.9 7.1 6.4 8.3 5.7 4.9 … 4.3 6.9 6.3 7.5 5.1 2.2 5.0 … 5.3 6.6 4.9 4.6 5.8 3.3 2.7 … 2.4 3.8 55.3 53.6 55.4 25.7 35.1 … 36.6 66.8 46.2 35.0 60.9 32.5 21.8 … 18.3 46.5 61.3 57.9 61.7 31.9 36.1 … 39.4 78.2 39.7 42.5 69.4 45.8 26.6 … 23.5 61.9 49.3 49.2 48.8 19.5 34.3 … 34.2 56.3 38.0 28.4 52.4 21.9 17.9 … 15.4 33.9 Andean Area Bolivia (Plurinational State of) Colombia b Ecuador Peru Venezuela (Boliviarian Republic of) b 5.3 … 5.5 5.1 5.5 4.7 6.5 … 6.9 5.9 6.8 6.0 6.1 … 6.4 5.8 6.1 5.8 8.0 … 8.5 7.0 8.0 7.6 4.4 … 4.7 4.4 4.9 3.6 5.2 … 5.5 4.8 5.7 4.5 59.1 … 39.0 51.9 120.4 33.8 72.0 … 46.4 58.7 149.6 42.0 66.6 … 46.4 57.4 130.2 39.6 79.4 … 58.1 68.5 173.9 51.4 51.7 … 31.9 46.4 110.6 27.9 59.1 … 36.0 49.5 127.5 33.2 6.5 7.1 7.5 8.7 5.6 5.6 62.1 66.9 67.5 78.4 56.9 56.6 Southern Cone Argentina Chile b Paraguay Uruguay b 7.0 7.8 5.4 5.4 9.3 5.8 6.1 4.8 7.1 5.8 7.5 8.2 5.9 5.9 9.9 7.4 7.9 6.1 8.0 7.7 6.6 7.4 4.9 4.9 8.6 4.7 4.8 3.8 6.2 4.4 67.7 85.5 32.8 55.1 55.1 54.6 64.8 28.3 69.9 36.0 68.3 84.5 35.5 61.6 56.0 68.0 81.2 36.4 81.0 45.1 66.9 86.3 30.2 48.4 54.1 44.3 52.8 21.5 59.1 28.9 Non-Latin Caribbean Anguilla Antigua & Barbuda b Aruba Bahamas a Barbados a Cayman Islands c Curaçao Dominica Grenada Guyana b Jamaica Montserrat Saint Kitts & Nevis Saint Lucia a Saint Vincent & the Grenadines Sint Maarten (Dutch part) Suriname b Trinidad & Tobago a Turks & Caicos Islands b Virgin Islands (UK) b Virgin Islands (US) b 6.7 4.4 4.3 6.0 5.6 8.5 3.3 … 8.1 7.7 6.1 … 7.8 6.9 6.4 7.9 … 5.4 7.9 1.5 3.5 6.3 7.6 4.1 4.7 4.8 6.3 6.7 3.0 … 6.4 7.7 9.6 … 8.9 6.6 5.8 7.8 … 6.4 8.8 2.1 3.7 4.5 7.6 5.6 4.9 7.4 6.3 8.7 4.0 … 8.3 8.3 6.8 … 9.0 7.9 7.3 8.5 … 6.1 9.3 1.7 4.2 7.7 10.0 5.4 5.8 6.9 7.9 8.6 4.0 … 7.6 9.1 12.1 … 9.1 8.3 7.1 9.3 … 8.0 12.6 2.5 4.7 6.3 5.8 3.3 3.8 4.8 4.9 8.3 2.5 … 7.8 7.1 5.2 … 6.7 5.8 5.6 7.2 … 4.6 6.5 1.3 2.8 5.0 5.8 3.1 3.9 3.4 5.1 5.4 2.1 … 5.2 6.4 7.6 … 17.0 5.0 4.6 6.3 … 5.1 6.3 1.8 3.0 3.1 59.2 6.8 44.4 39.2 62.9 93.8 21.4 … 46.7 64.0 75.2 … 39.1 24.0 50.1 99.8 … 55.6 52.1 22.0 34.6 23.4 64.1 8.0 46.5 32.8 65.8 70.8 19.9 … 33.9 64.9 102.9 … 41.5 20.9 46.8 96.3 … 63.1 55.1 34.8 37.2 15.8 66.9 14.0 58.9 38.3 76.0 87.5 17.5 … 40.9 69.8 90.1 … 28.1 60.3 107.9 … 65.2 57.5 24.1 42.9 33.9 81.9 16.2 65.7 38.6 84.5 84.4 17.7 … 36.4 78.8 134.6 … 29.4 57.6 116.2 … 80.5 70.1 40.0 53.0 24.6 51.8 31.2 40.0 50.4 99.8 25.1 … 52.6 58.1 60.1 … 78.3 20.0 40.4 91.5 … 45.9 47.1 19.8 26.8 14.2 50.4 29.8 29.3 50.3 61.2 20.8 … 29.0 51.2 76.7 … 182.7 12.1 38.1 78.8 … 49.3 44.9 28.9 24.1 9.0 The Americas North America Bermuda a Canada b United States of America b Brazil BI 18 - 28: (a) value 2008; (b) value 2009; (c) value 2007. mortality indicators 20Tc 20Ta 20Mc 20Ma 20Fc mortality rate from malignant neoplasms (100,000 pop) (2010) 20Fa total male female corrected adjusted corrected adjusted corrected adjusted 21Tc 21Fc 21Mc 21Ma 21Ta mortality rate from external causes (100,000 pop) (2010) 21Fa female male total corrected adjusted corrected adjusted corrected adjusted 22 23 24 corrected mortality rate (2010) (100,000 pop) (100,000 male pop) suicide 25 sex ratio homicide land transport male homicide (male to female) accidents 2010 129.3 109.8 135.8 127.4 123.0 97.2 69.0 66.3 107.9 106.9 31.0 27.3 8.3 16.5 33.1 7.4 187.1 154.3 211.2 184.5 119.6 94.5 124.7 119.1 198.5 156.5 224.4 195.6 142.4 110.3 146.5 142.0 176.1 152.3 198.3 173.7 102.9 85.5 108.3 102.3 57.3 40.1 46.4 58.5 49.0 40.6 35.1 50.5 78.5 64.4 60.0 80.5 70.6 65.9 49.5 72.9 36.8 17.2 33.1 37.2 27.9 15.2 20.9 28.7 11.9 1.5 11.5 12.0 11.7 25.2 7.3 12.2 8.0 2.5 8.6 3.7 3.2 3.8 93.8 103.7 97.3 118.1 90.4 93.7 76.5 77.5 127.0 130.5 27.3 26.9 6.0 19.7 49.5 9.8 93.8 103.7 97.2 118.0 90.4 93.7 76.5 77.4 127.0 130.5 27.3 26.9 6.0 19.7 49.5 9.8 60.8 73.7 60.4 79.5 61.2 70.2 60.5 62.9 100.7 106.3 21.3 21.8 4.3 14.4 39.1 9.8 65.1 51.1 90.5 80.1 50.9 … 56.4 80.1 93.7 93.8 103.7 97.5 90.2 … 88.1 97.5 62.9 97.0 59.8 113.6 96.4 120.4 69.4 91.8 47.8 90.3 … … 54.0 91.1 83.5 109.2 67.3 42.6 84.5 89.9 54.0 … 58.8 76.7 91.9 77.1 90.1 102.0 91.1 … 87.1 88.1 83.8 96.2 73.0 85.1 48.5 49.1 130.1 136.4 90.7 113.9 … … 60.7 67.9 60.7 62.9 141.6 122.8 76.1 226.3 156.3 … 98.9 102.6 168.6 145.1 77.6 247.9 205.1 … 112.2 106.7 28.0 24.6 20.1 42.9 28.3 … 23.3 18.3 31.0 26.6 19.9 43.2 34.0 … 26.2 18.9 6.5 4.9 6.7 10.2 3.6 … 10.4 5.5 10.7 16.7 13.1 24.5 2.1 … 14.3 13.0 67.5 49.1 18.3 143.4 77.3 … 23.6 42.5 8.8 7.6 7.9 8.2 8.6 … 10.1 10.1 142.8 198.0 86.6 47.9 125.7 … 168.1 135.2 116.6 137.6 106.0 87.0 83.3 … 92.8 91.1 162.0 226.3 93.5 59.4 152.6 … 196.8 159.0 139.1 167.0 117.8 126.2 112.1 … 123.3 118.0 123.7 169.4 79.6 36.4 101.7 … 143.0 113.2 97.9 113.2 95.1 61.2 62.4 … 71.8 71.2 67.7 47.1 97.2 66.2 47.2 … 24.6 56.7 108.1 76.9 147.5 80.6 84.6 … 43.9 106.0 105.3 62.6 157.4 99.9 82.3 … 39.2 102.1 38.8 50.2 35.3 28.4 24.8 … 19.5 19.5 30.4 31.1 37.0 34.4 17.3 … 12.5 14.7 9.2 13.8 4.6 6.2 8.5 … 6.4 8.8 18.6 8.5 33.2 11.1 12.4 … 7.2 11.4 23.9 6.7 36.1 16.0 7.4 … 4.2 48.0 7.5 2.7 9.7 4.5 6.0 … 3.0 17.0 86.6 … 91.8 74.6 99.7 71.1 112.9 … 120.7 92.2 128.0 95.6 84.3 … 88.0 72.4 96.5 72.2 121.5 … 130.6 96.4 134.7 106.8 88.9 … 95.5 76.8 103.0 70.1 107.1 … 114.4 89.5 123.8 87.3 101.3 103.3 … … 105.6 107.9 84.5 88.6 … … 102.9 103.4 175.6 … 185.8 136.2 … 179.3 180.2 … 191.7 145.0 … 179.6 27.9 … 27.8 32.5 … 25.9 29.0 … 28.8 33.3 … 27.1 5.5 … 6.6 7.9 … 2.6 22.8 … 19.5 28.4 … 25.4 82.4 … 109.2 36.8 … 63.3 13.1 … 11.3 10.7 … 17.1 101.0 110.7 106.8 129.1 95.2 96.7 82.7 82.1 137.1 136.8 30.0 29.7 5.6 25.1 54.1 9.8 138.0 143.0 133.5 78.2 219.3 118.1 118.5 120.0 112.4 144.0 148.1 154.6 140.2 76.8 256.6 147.4 149.0 145.0 119.4 197.7 128.3 131.8 127.0 79.5 184.6 100.9 98.3 103.0 108.1 107.7 49.6 45.7 48.1 71.8 60.7 47.7 43.6 45.5 75.7 52.7 76.3 70.0 75.9 107.8 90.2 75.8 69.3 74.2 114.2 84.5 23.8 22.4 20.9 35.2 33.2 20.9 19.4 18.2 36.7 23.4 8.9 7.3 12.7 5.6 15.4 14.0 11.8 13.0 29.5 14.4 9.9 7.6 9.6 25.2 8.6 6.9 6.1 8.4 8.4 5.2 97.7 115.1 80.6 137.7 106.4 179.2 64.3 … 178.5 145.6 52.6 … 19.5 110.2 109.0 113.2 … 65.6 106.9 19.5 76.1 103.1 106.8 112.4 89.6 104.3 123.9 146.1 56.4 … 143.2 144.8 85.1 … 33.2 108.8 101.4 113.1 … 80.6 121.4 32.1 81.6 66.0 105.6 181.7 100.7 143.0 107.3 203.4 78.9 … 234.2 161.7 46.2 … 39.0 116.5 124.4 147.6 … 69.8 116.2 14.5 78.6 119.5 140.2 181.4 120.8 129.4 156.9 202.7 71.0 … 212.0 171.7 95.4 … 60.0 129.3 123.8 164.0 … 96.7 174.4 27.9 92.5 80.2 89.9 52.5 62.3 132.9 105.5 156.5 50.3 … 121.9 129.2 58.7 … 104.0 93.1 77.9 … 61.3 98.2 24.7 73.8 88.5 88.4 55.8 65.8 90.0 107.5 115.7 42.5 … 92.9 122.9 81.9 … 92.5 81.5 76.0 … 69.0 95.8 37.9 74.9 56.7 76.9 77.9 13.5 12.7 37.4 39.0 60.2 52.0 60.2 59.8 28.9 26.0 47.1 44.8 … … 75.5 72.1 39.0 39.6 86.3 102.0 … … 39.1 49.3 80.2 79.7 35.1 31.7 50.9 50.4 … … 79.1 83.5 102.8 96.7 29.3 30.1 31.1 29.1 93.7 101.8 124.5 28.0 58.9 108.8 101.8 48.1 70.1 … 117.1 57.0 131.1 … 78.0 132.5 48.7 83.3 … 118.5 173.6 43.4 57.2 167.3 128.8 26.5 62.3 98.4 103.3 44.4 68.7 … 114.6 59.3 159.6 … 111.4 129.9 49.5 82.6 … 128.5 165.1 47.5 52.1 200.3 30.8 17.8 16.4 20.5 10.9 25.1 … 33.2 20.6 40.8 … 28.0 22.1 15.6 … 39.4 36.0 14.8 6.7 28.3 30.6 18.8 13.4 20.0 8.7 22.5 … 27.2 19.3 47.0 … 28.9 14.9 14.2 … 40.8 34.2 14.1 8.4 22.9 12.4 6.7 1.2 0.4 … 2.7 20.8 … 4.0 4.8 … 25.2 15.0 2.4 8.4 15.3 13.5 2.3 18.2 14.1 1.1 25.7 … 9.6 5.6 15.8 … 16.0 4.8 … 21.4 20.4 9.8 6.9 15.0 39.1 8.1 42.3 30.6 4.4 … 38.1 14.3 … 48.2 3.8 22.7 … 10.7 79.3 9.6 95.6 7.1 … 10.3 6.4 0.7 … 6.9 3.8 … … 3.1 11.7 … 4.0 9.7 … 27.0 73.4 63.6 91.8 54.6 53.1 … 30.9 61.1 mortality indicators 26Tc 26Ta 26Mc 26Ma 26Fc 26Fa mortality rate from diabetes mellitus (100,000 pop) (2010) total male female corrected adjusted corrected adjusted corrected adjusted 27Tc 27Ta 27Mc 27Ma 27Fc mortality rate from ischemic heart diseases (100,000 pop) (2010) 27Fa total male female corrected adjusted corrected adjusted corrected adjusted 28Tc 28Ta 28Mc 28Ma 28Fc 28Fa mortality rate from cerebrovascular diseases (100,000 pop) (2010) total male female corrected adjusted corrected adjusted corrected adjusted 30.9 32.2 29.5 33.4 32.3 31.1 82.9 67.5 92.9 88.1 72.7 50.3 42.5 38.4 39.3 42.0 45.6 35.3 22.2 32.6 20.6 22.4 13.7 17.1 11.1 14.0 23.0 21.5 21.7 23.1 16.5 14.8 13.8 16.8 21.4 43.1 19.5 21.6 11.3 18.2 8.8 11.6 123.7 95.0 106.6 125.6 69.3 55.4 55.3 70.8 136.7 116.6 120.1 138.5 94.0 83.6 75.5 96.0 111.1 74.7 93.3 113.0 49.1 36.3 38.1 50.3 41.9 41.6 41.9 41.9 22.6 22.2 20.4 22.8 34.4 52.2 34.9 34.3 23.3 35.8 21.2 23.5 49.2 31.6 48.8 49.2 21.7 13.7 19.5 21.9 36.3 43.5 33.5 43.8 38.9 43.2 57.5 66.4 66.1 84.5 49.2 51.0 42.9 48.1 42.4 53.5 43.4 43.7 36.0 43.3 33.5 43.5 38.7 43.0 57.3 66.1 65.9 84.1 49.0 50.9 42.8 47.9 42.3 53.2 43.3 43.5 71.7 89.6 69.6 93.0 73.7 86.6 60.7 74.0 68.7 93.1 53.0 57.6 27.8 33.8 26.8 36.4 28.9 31.7 29.0 42.6 16.5 31.5 29.1 … 37.6 25.1 46.3 78.8 19.1 39.2 53.9 … 63.8 31.4 24.1 31.2 15.1 23.4 25.3 … 31.2 20.0 41.2 61.6 18.8 32.5 49.1 … 56.6 26.7 33.7 53.6 17.9 38.9 32.7 … 43.9 30.3 50.6 95.7 19.2 44.1 58.1 … 69.8 35.4 41.4 36.7 55.3 53.0 25.1 … 51.2 55.5 60.6 68.4 63.6 61.6 46.9 … 86.3 69.3 45.2 39.2 63.8 55.4 27.7 … 52.5 63.0 72.2 76.9 80.4 72.5 55.8 … 98.3 84.2 37.9 34.2 46.6 50.7 22.8 … 50.0 47.9 50.8 60.7 48.1 53.2 39.5 … 76.0 55.3 25.4 29.5 25.9 20.6 19.0 … 30.2 51.4 38.0 57.1 29.4 23.4 35.2 … 50.5 64.1 24.5 30.5 26.4 18.1 18.7 … 28.6 48.9 40.2 61.9 33.4 23.0 37.4 … 52.9 66.5 26.3 28.4 25.4 22.9 19.4 … 31.7 53.9 36.2 52.2 25.9 23.7 33.6 … 48.4 61.8 31.8 23.8 25.8 9.3 29.3 … 25.8 74.7 26.9 16.2 31.8 17.9 16.7 … 12.4 49.1 29.4 18.0 25.0 5.3 26.4 … 25.3 80.1 26.9 13.3 31.4 9.9 18.6 … 14.9 60.3 34.2 29.7 26.5 13.3 31.8 … 26.2 69.8 26.9 18.8 32.0 23.8 14.9 … 10.6 40.1 114.3 147.7 96.4 5.3 23.1 … 22.7 90.8 94.8 94.9 117.6 10.3 15.2 … 11.9 56.8 126.6 114.1 159.0 114.3 108.5 136.4 9.7 21.0 30.5 23.1 … … 31.6 20.0 106.1 77.8 102.0 136.3 84.2 0.9 16.5 … 15.0 76.6 76.9 77.1 99.0 2.1 8.7 … 5.8 40.1 69.8 87.0 65.2 15.1 47.2 … 50.5 38.8 58.8 55.4 79.3 28.9 27.6 … 24.8 23.0 69.0 83.5 66.9 16.8 48.1 … 59.8 36.1 63.4 59.5 84.1 35.2 34.5 … 36.9 25.4 70.4 90.4 63.3 13.3 46.3 … 42.4 41.2 54.4 51.6 74.3 23.2 21.8 … 15.6 20.9 21.8 … 17.6 31.9 14.4 30.9 29.7 … 24.2 40.4 19.1 43.5 20.1 … 14.5 28.5 14.6 30.1 29.6 … 22.3 38.4 20.8 45.2 23.5 … 20.5 35.4 14.2 31.7 29.5 … 25.6 41.9 17.5 41.7 53.8 … 72.9 15.8 23.4 72.5 74.7 … 101.7 19.7 31.0 102.7 61.6 94.2 … … 80.1 125.9 18.7 25.3 27.0 39.1 88.3 133.7 46.1 … 65.9 12.9 19.7 56.6 58.2 … 82.3 14.6 23.8 74.9 31.8 … 37.0 25.9 23.1 35.1 43.5 … 51.2 32.2 29.7 50.7 30.4 … 33.0 24.9 24.0 35.6 46.0 … 51.6 33.5 33.2 56.0 33.1 … 40.9 27.0 22.1 34.6 41.1 … 50.5 30.8 26.4 45.7 30.8 34.3 26.8 33.0 34.7 35.0 56.1 62.0 65.5 79.5 47.0 47.2 55.6 61.3 56.2 69.7 55.0 54.5 21.5 19.9 19.2 37.7 20.8 19.9 15.7 17.0 57.3 12.5 20.8 20.1 19.1 29.6 19.9 22.0 19.3 19.8 47.4 14.9 22.1 19.6 19.3 46.0 21.5 18.4 13.1 14.7 66.2 10.8 48.1 48.0 43.0 50.2 72.3 41.3 37.1 37.8 75.9 43.0 57.4 56.8 52.6 59.2 86.6 59.0 54.7 53.9 94.1 65.6 39.2 39.5 33.7 41.0 58.9 27.4 23.7 24.6 58.7 26.4 49.5 47.1 47.9 49.7 85.8 41.7 35.9 41.2 75.9 47.1 48.3 46.7 47.2 48.1 75.1 49.7 44.8 49.0 79.0 54.3 50.6 47.5 48.6 51.4 95.7 35.5 29.2 35.2 72.9 41.9 63.1 89.9 28.0 28.5 41.8 52.1 38.3 36.0 19.0 26.4 73.6 72.9 … … 35.4 31.4 79.0 89.7 43.3 86.5 … … 233.9 208.2 84.3 93.0 50.0 48.7 51.1 56.8 … … 29.5 41.1 111.2 163.2 14.3 17.8 27.9 21.1 67.2 65.7 35.6 23.7 29.9 103.2 … 72.0 106.8 49.1 … 352.5 64.0 53.9 74.0 … 28.9 102.4 4.9 33.6 54.9 67.8 56.1 36.5 16.1 31.6 64.2 … 44.8 93.1 74.7 … 955.2 61.8 42.3 68.6 … 32.0 101.3 7.2 37.1 30.7 79.9 27.1 54.9 46.9 49.5 56.4 42.8 … 50.8 77.0 79.0 … 195.4 50.1 37.6 100.8 … 44.6 121.2 9.8 31.1 105.0 96.5 25.2 61.3 35.9 60.9 44.8 37.7 … 38.1 76.3 137.1 … 229.1 46.6 31.4 96.0 … 54.5 141.6 13.7 31.8 65.1 92.8 28.0 58.9 72.5 49.7 70.0 65.7 … 38.1 84.5 89.6 … 233.9 52.2 38.5 85.2 … 57.5 143.7 14.5 50.0 131.5 133.4 25.2 73.5 66.9 70.6 69.3 63.7 … 34.2 93.2 177.0 … 216.6 54.4 37.1 98.1 … 77.1 209.6 20.4 51.2 86.4 67.4 70.1 26.3 26.6 51.2 49.8 23.7 15.7 49.2 52.6 43.7 28.3 21.0 17.1 … … 63.7 39.1 69.3 60.8 68.1 105.9 … … 156.7 337.3 48.0 42.3 36.8 25.8 116.8 90.9 … … 31.6 35.2 99.9 97.0 4.9 7.2 13.4 14.4 81.4 46.6 61.7 27.1 22.2 52.6 44.7 53.3 10.7 … 67.3 77.9 79.3 … 19.5 96.2 63.3 74.8 … 67.3 62.6 10.4 39.4 78.3 26.3 25.2 41.7 54.1 41.3 9.9 … 47.9 76.7 147.0 … 19.8 83.1 54.0 74.3 … 85.7 74.2 9.5 23.7 63.3 28.0 24.6 58.4 48.4 49.6 21.9 … 62.6 80.8 78.0 … 84.3 68.0 58.7 … 65.6 68.1 14.3 43.8 98.5 27.3 30.7 57.4 69.6 49.7 22.9 … 54.8 90.9 173.0 … 87.7 62.5 67.6 … 96.4 106.9 15.2 28.6 65.2 75.8 47.4 44.2 38.5 42.7 30.6 24.2 24.6 29.8 88.9 68.0 … … 53.6 38.7 92.7 91.8 46.3 79.5 … … 293.1 307.6 76.2 77.2 52.0 45.4 62.4 62.5 … … 29.2 36.4 106.7 124.3 4.3 2.4 24.2 27.0 42.2 27.1 60.0 65.1 26.3 25.1 20.0 20.8 47.3 32.7 41.0 43.0 56.7 35.7 … … 72.0 42.3 74.9 66.1 80.1 128.1 … … 39.2 110.4 108.0 80.6 58.8 46.2 89.5 76.7 … … 69.1 77.8 57.3 55.6 4.8 6.7 35.4 19.9 morbidity indicators 29 30 tuberculosis incidence rate (100,000 pop) 2010 total 1 SS+ 31 32 malaria malaria risk areas API pop (%) (1,000 pop) 33 malaria reported cases 34 dengue reported cases 2011 2010 2010 2010 678,634 The Americas 23.0 12.6 9.0 5.2 North America Bermuda Canada United States of America 3.6 1.5 3.9 3.6 1.2 1.5 1.1 1.2 - - Latin America & the Caribbean 34.2 19.2 14.2 8.2 676,943 Latin America 34.4 19.3 14.2 8.2 Mexico 17.3 11.1 0.3 Central American Isthmus Belize Costa Rica El Salvador Guatemala Honduras Nicaragua Panama 29.4 46.5 10.5 27.5 23.1 37.8 42.3 42.5 17.5 31.1 5.7 15.7 14.7 24.2 24.9 20.1 Latin Caribbean Cuba Dominican Republic French Guiana Guadeloupe Haiti Martinique Puerto Rico 55.2 7.3 39.9 … … 142.3 … 2.1 Andean Area Bolivia (Plurinational State of) Colombia Ecuador Peru Venezuela (Bolivarian Republic of) 36 37 35 sex ratio proportion of aids ghtt incidence rate aids cases low birthweight (% %) (100,000 pop) (male to (<2,500 g) (%) female) ayy 2010 2009-11, lay 2010 1,086,234 Cholera, 2011 country cases deaths BHS* 1 0 BRA* 1 0 CAN* 9 0 CHL* 1 0 DOM*** 20,851 356 HTI 340,311 2,869 MEX 1 0 USA** 42 0 VEN* 96 0 10.1 2.9 8.5 10.1 8.8 0.7 a 11.1 a 3.1 … 4.3 a 3.0 a 8.0 8.2 6.1 8.2 1,086,226 10.0 2.8 8.7 653,441 1,075,491 10.0 2.8 8.6 3.7 1,226 67,918 5.1 4.3 8.5 12.0 11.0 1.0 24.4 15.0 14.8 1.3 4.4 3.8 1.5 1.8 0 3.1 8.1 7.1 1.8 18,281 150 114 24 7,198 9,685 692 418 62,435 1,093 13,854 20,836 2,585 8,297 11,888 3,882 14.3 62.9 a 3.8 … 18.4 e 8.3 … 20.2 a 1.9 1.8 a 4.4 … 1.3 e 1.4 … 2.6 a 10.9 8.3 7.0 8.7 11.4 15.0 8.3 8.8 * imported ** 40 imported, 1 unknown *** 45 imported 31.5 4.1 21.7 … … 82.5 … 1.0 29.6 4.3 85.5 99.3 - 3.4 3.5 8.1 8.5 - 88,261 7 *, a 2,482 1,599 8* 84,153 7* 5* 9,039 … 2,342 667 101 … 275 5,654 … 6.8 … … … … … … … 5.0 … … … … … … 7.5 5.3 7.2 12.3 9.4 … 12.9 12.4 48.1 84.0 24.7 33.4 106.9 21.9 28.3 56.5 15.2 23.3 59.4 11.2 12.9 14.9 14.5 3.1 8.6 18.6 11.8 9.3 17.3 2.6 12.1 8.4 212,227 13,769 117,637 1,888 33,778 45,155 128,908 26,681 33,207 7,659 29,810 31,551 4.1 2.3 3.1 9.1 a 3.8 … 2.7 1.8 2.7 2.5 a 3.2 … 8.8 … 9.0 8.4 6.9 10.6 Brazil 38.2 19.5 25.8 b 13.1 b 333,339 764,032 17.6 1.7 8.4 Southern Cone Argentina Chile Paraguay Uruguay 18.8 18.0 13.9 35.3 20.7 10.1 9.8 6.7 20.4 10.9 0.6 0.5 3.5 - 0.2 0.4 0.1 - 107 72 3* 27 5* 43,159 213 1 42,945 - 3.7 3.0 4.2 5.0 7.5 3.5 2.8 6.0 2.3 2.6 6.9 7.2 5.8 … 8.3 country ARG BRA CAN CHL COL DOM ECU FRG GDL JAM MEX MTQ PAN USA cases 3 43 759 6 6 2 263 5 13 1 3 3 4 222 total 1,333 Non-Latin Caribbean Anguilla Antigua & Barbuda Aruba Bahamas Barbados Cayman Islands Curaçao Dominica Grenada Guyana Jamaica Montserrat Saint Kitts & Nevis Saint Lucia Saint Vincent & the Grenadines Sint Maarten (Dutch part) Suriname Trinidad & Tobago Turks & Caicos Islands Virgin Islands (UK) Virgin Islands (US) 19.4 6.8 6.9 5.7 9.0 2.1 8.0 3.5 11.0 3.7 94.4 4.7 4.0 5.6 14.4 7.9 37.0 16.3 13.9 3.4 … 10.7 6.9 3.8 5.5 2.1 4.0 3.5 11.0 3.7 43.1 2.8 4.0 5.6 7.7 7.9 24.8 10.1 6.9 3.4 … 10.9 92.6 14.9 - 4.0 32.8 6.9 - 23,502 1* … 1* 2* 1* … 1* 22,935 12 * 1* 1* 2* 1* 544 … … … - 10,735 9 7 3,423 213 751 2 1,731 40 87 1,285 500 4 47 758 47 172 369 1,243 14 33 … 18.2 … 76.4 20.7 8.0 … 2.7 17.6 19.4 … 19.5 12.2 16.2 31.7 … … 5.2 29.3 a … 1.6 … … … 1.3 2.5 0.3 … -c 1.7 1.5 … -d 2.0 1.7 2.0 … … 1.7 … … … 12.6 17.0 6.0 7.7 12.1 11.0 9.6 … 11.0 10.0 10.2 13.9 … 12.5 10.1 … … 14.0 … 8.7 5.0 9.5 8 1 7 1,691 … … 1,691 * BI 29: 1 new and relapse cases. BI 31-36: (a) value 2009; (b) refers to Amazonas Region; (c) 2;0; (d) 1:0; (e) value 2011; (*) imported cases. BI 33: refers to moderate and high risk except SLV, HTI, ARG, GUY (total population at risk). total 361,313 3,225 Measles, 2011 cases imported or related to importation Yellow Fever Fever, 2011 country cases deaths BOL 2 2 PER 13 6 total 15 8 Sourc So Source: urcee: PAHO/WHO Technical Projects. As of 15 June 2012 resources, access & coverage indicators 38 39 40 human resources per 10,000 pop physicians nurses dentists c2009 c2009 c2009 41 hospital beds per 1,000 pop 2009-11, lay 42A 42B national health expenditure as a % of GDP public 2011 private 2011 44 health care by trained personnel (%) 43 antenatal at birth (at least 4 visits) 90.8 95.5 97.4 99.0 … 97.4 99.4 99.0 100.0 99.3 2.1 87.3 3.9 2.1 25.4 1.7 1.7 3.0 2 11.8 7.0 18.6 20.1 9.9 3.0 … 13.4 8.5 10.1 19.1 5.1 9.0 2.0 … 12.3 3.4 0.4 8.7 8.1 1.7 0.3 … 2.8 1.0 1.1 1.2 1.0 0.7 0.7 1.1 2.4 Latin Caribbean Cuba Dominican Republic French Guiana Guadeloupe Haiti Martinique Puerto Rico 41.0 66.3 14.9 17.5 26.4 … 26.2 … 51.8 94.7 2.9 48.7 61.2 … 81.7 … 6.0 10.3 1.9 2.0 4.3 … 4.3 … 3.5 5.1 1.7 2.8 5.8 … 4.1 3.0 Andean Area Bolivia (Plurinational State of) Colombia Ecuador Peru Venezuela (Bolivarian Republic of) V 13.3 4.9 16.5 16.9 9.3 … 8.0 5.5 8.0 6.5 9.5 … 1.4 0.7 … 2.3 1.2 … 1.3 1.1 1.4 1.6 1.5 0.9 Brazil 15.1 7.1 5.5 Southern Cone Argentina Chile Paraguay Uruguay 16.7 … 15.8 13.0 29.0 12.7 … 15.1 9.0 8.0 Non-Latin Caribbean Anguilla Antigua & Barbuda Aruba Bahamas Barbados Cayman Islands Curaçao Dominica Grenada Guyana Jamaica Montserrat Saint Kitts & Nevis Saint Lucia Saint Vincent & the Grenadines Sint Maarten (Dutch part) Suriname Trinidad & Tobago Turks & Caicos Islands Virgin Islands (UK) Virgin Islands (US) 10.6 8.5 … … … 13.0 27.0 … 17.0 7.6 6.9 10.4 … … 8.0 6.0 … 8.9 13.3 … … … 16.0 24.2 … … 27.5 42.0 59.0 … 51.0 43.9 10.1 8.0 … … 19.0 24.0 … 16.3 20.4 … … … year 47 48 45 46 immunization coverage (%) , 2011 49 contraceptive use (women, under 1 year of age 1 year of age all methods) DPT3 (%) MMR1 Polio3 BCG +Hib 2008-11, lay 94 94 96 94 64 95 98 95 g 95 e, f 94 96 99 g 94 e, f na na na na 92 87 98 g 92 e, f 62 54 … 62 93.7 93 93 96 94 66 87.3 93.7 93 93 96 94 66 3.1 4 85.8 97.4 97 97 99 98 37 1.0 b, 1 4.3 2 3.7 2 2.0 2 3.6 2 4.6 2 3.9 b, 2 1.3 3.1 4 6.7 4 4.9 4 3.2 4 4.5 4 2.7 4 78.9 67.6 … 94.7 87.0 b 100.0 75.3 d 84.9 … 52.3 … … 70.0 d 74.0 92.7 94.1 90 95 85 89 85 100 * 100 * 87 91 95 82 89 86 100 * 100 * 91 93 98 78 91 89 100 * 100 * 100 92 98 83 90 87 100 * 100 * 97 62 … 82 72 54 … .. 52 10.5 c, 1 2.8 1, 3 … 2.1 b … … … … 4.6 4 … … 3.7 … … 98.9 100.0 … 85.8 … … … 98.0 98.2 99.9 96.9 99.1 99.3 … 99.9 100.0 2009 2009 87 100 * 84 … … 85 j … … 85 100 h 84 … … 79 j … … 92 99 100 * … na 82 j na … 77 100 * 88 … … 58 j … … 61 78 73 … … 32 … … 2.1 2 3.5 c, 2, 3 3.9 2 2.7 2 … 1.6 1.5 4.1 2.3 4 2.4 75.5 58.5 88.6 … 92.2 47.0 90.6 72.4 95.0 70.3 94.7 98.1 2011 2010 2010 2010 2011 86 82 85 100 * 91 78 86 82 85 100 * 91 78 90 90 83 100 * 91 95 90 84 88 94 96 86 … … 61 … 74 … 2.3 3.1 2 4.1 4 99.0 99.0 2010 100 100 * 100 * 100 * 87 6.2 … 6.0 … 7.0 3.5 4.5 2.0 1.3 3.0 6.2 b, 2, 3 5.0 2, 3 4.3 1 4.5 c, 2, 3 3.2 4 3.4 4 3.1 5.2 b 75.2 … … 70.3 91.0 98.8 99.4 99.8 94.9 99.0 2010 2010 2010 2011 91 93 94 76 95 91 93 93 75 95 95 100 * 91 76 99 92 95 91 77 95 50 43 … 79 77 2.2 2.0 … … 2.2 2.4 6.5 … 2.9 2.1 0.4 2.8 … … 1.6 1.9 … 1.0 2.2 … … … 2.4 2.1 2.1 2.8 3.1 6.6 2.7 … 3.8 3.5 2.0 1.8 5.8 4.8 1.6 2.7 … 3.1 2.1 0.7 1.8 … 2.7 c 0.6 … 3.2 4.3 4 … … 2.6 3.0 2.1 2.7 1.0 2.5 2.7 0.9 … 0.4 b 2.7 … … … 86.5 100.0 100.0 d … 86.0 89.0 92.5 … … … 95.7 … 100.0 … 99.0 c … … 67.0 … 92.0 … 95.2 c 93.3 100.0 100.0 100.0 99.0 100.0 100.0 … 100.0 100.0 95.8 90.1 100.0 100.0 98.5 98.8 … 93.0 … 92.0 100.0 99.3 92 100 99 … 95 91 75 b … 98 94 93 92 100 98 100 96 92 86 90 87 92 … 93 100 99 … 97 91 88 b … 100 * 95 93 93 100 99 100 96 95 86 91 88 92 … 99 100 na na na na 75 b … 100 * na 97 100 * 100 99 100 * 100 na na na 98 100 na 91 97 100 … 90 93 83 b … 99 100 * 98 88 100 100 * 91 100 * … 85 92 91 97 … … 87 … … … … … … … … 43 72 … … … … … 48 … … … … The Americas 20.7 43.1 4.3 2.4 North America Bermuda Canada United States of America 25.7 … 23.3 26.0 85.8 … 93.0 85.0 4.7 … 5.8 4.6 3.0 5.3 3.2 3.0 LLatin America & the Caribbean 17.2 13.9 3.9 Latin America 17.3 13.9 Mexico 22.0 Central American Isthmus Belize Costa Rica El Salvador Guatemala Honduras Nicaragua Panama 7.6 a, 2 7.9 2 9.9 b, 2 4.2 c, 1 3.1 1 … 2.9 1 4.6 2 1.7 b, 1 … 3.4 1 2.9 1 2.1 b, 1 2.5 b, 2 11.1 1 2.2 1 2.6 1 3.5 1 … … 3.2 2 2.4 b 1.6 1 1.4 1 6.9 a 3.3 4 5.6 b 2011 2010 2009 2010 2011 2011 2009 2010 2010 2010 2011 2009 2010 2008 2010 2010 2009 2010 2011 2011 2011 2011 2009 2010 2011 2011 2010 2011 2010 2011 2011 2008 B 42 - 48: (a) value 2008; (b) value 2010; (c ) value 2009; (d) value 2011; (e) value June 2010-July 2011 BI BI 42: (1) institutional expenditure; (2) functional expenditure; (3) includes 'obras sociales' (ARG), EPS (COL), ISAPRES (CHL), ARS (DOM), IAMC (URY); (4) includes private health insurance. BI 45-48: (f) children aged 19-35 months; (g) < 2 years of age; (h) polio 2, as per country schedule; (j) <1 year; (*) reported coverage > 100%. socioeconomic indicators 50T 50M 50F literate population (15+years old) (%) 2010 51 calories availability (Kcal/pc/day) total male female 2009 current value 52A 52B gross national income (US$ per capita), 2011 ppp value 53 annual GDP growth (%) 54 highest 20%/ lowest 20% income ratio 55T 55U 55R 56T 56U 56R population (%) using improved drinking water sources, 2010 sanitation facilities, 2010 2010-11 2008-11, lay total urban rural total urban rural The Americas 91.3 91.9 90.8 3,203 23,154 25,309 3.3 … 96 99 86 87 91 73 North America Bermuda Canada United States of America … … … … … … … … … … … … 3,659 2,716 3,399 3,688 48,164 … 45,560 48,450 47,994 … 39,830 48,890 1.8 -1.9 d 2.5 1.7 … … … … 99 … 100 99 100 … 100 100 95 … 99 94 100 … 100 100 100 … 100 100 99 … 99 99 Latin America & the Caribbean 91.3 91.9 90.8 2,935 8,582 11,753 4.3 16.7 94 98 82 79 84 60 Latin America 91.3 92.0 90.8 2,937 8,597 11,773 4.3 16.7 94 98 81 79 84 59 Mexico 93.1 94.4 91.9 3,146 9,240 15,120 3.9 11.4 96 97 91 85 87 79 Central American Isthmus Belize Costa Rica El Salvador Guatemala Honduras Nicaragua Panama 83.2 … 96.2 84.5 75.2 84.8 … 94.1 85.9 … 95.9 87.1 80.6 84.8 … 94.7 80.9 … 96.4 82.3 70.3 84.7 … 93.5 2,512 2,680 2,886 2,574 2,244 2,694 2,517 2,606 3,508 3,690 7,660 3,480 2,870 1,970 1,170 7,910 6,238 6,070 11,950 6,690 4,800 3,840 2,840 14,740 4.1 2.0 4.2 1.5 3.9 3.4 4.7 10.6 20.2 … 14.5 14.3 … 29.7 … 17.1 90 98 97 88 92 87 85 93 b 97 98 100 94 98 95 98 97 b 82 99 91 76 87 79 68 83 b 77 90 95 87 78 77 52 69 b 83 93 95 89 87 85 63 75 b 68 87 96 83 70 69 37 51 b Latin Caribbean Cuba Dominican Republic French Guiana Guadeloupe Haiti Martinique Puerto Rico 81.1 99.8 89.5 … … 48.7 a … 90.4 82.3 99.8 89.4 … … 53.4 a … 89.8 80.0 99.8 89.7 … … 44.6 a … 91.0 2,598 3,258 2,491 … … 1,979 … … 5,192 5,460 a 5,240 … … 700 … 16,560 c 5,325 … 9,490 … … 1,190 … … 3.3 2.1 d 4.5 … … 5.6 … -2.1 d … … 11.3 … … … … … 83 94 86 … … 69 … … 90 96 87 … 98 85 100 … 71 89 84 … … 51 … … 64 91 83 … … 17 … … 74 94 87 … 95 24 95 … 48 81 75 … … 10 … … Andean Area Bolivia (Plurinational State of) Colombia Ecuador Peru Venezuela (Bolivarian Republic of) 93.6 91.2 b 93.4 91.9 … 95.5 b 94.2 95.8 b 93.3 93.3 … 95.7 b 92.9 86.8 b 93.5 90.5 … 95.4 b 2,657 2,172 2,717 2,267 2,563 3,014 6,749 2,040 6,110 4,140 5,500 11,920 9,915 4,920 9,640 8,310 10,160 12,620 5.6 5.1 5.9 4.8 6.9 4.2 17.8 27.9 20.1 12.5 13.5 … 90 88 92 94 85 … 96 96 99 96 91 … 73 71 72 89 65 … 72 27 77 92 71 … 79 35 82 96 81 … 53 10 63 84 37 … 90.3 b 90.2 b 90.4 b 3,173 10,720 11,500 2.7 20.6 98 100 85 79 85 44 97.6 97.8 98.6 b 93.9 98.1 97.7 97.8 98.6 b 94.8 97.6 97.5 97.8 98.5 b 92.9 98.5 2,871 2,918 2,908 2,518 2,808 9,830 9,740 12,280 2,970 11,860 15,686 17,250 16,160 5,310 14,740 7.5 8.9 6.0 4.0 5.7 12.4 11.3 13.5 17.3 10.4 94 … 96 86 100 98 98 99 99 100 71 … 75 66 100 90 … 96 71 100 97 … 98 90 100 60 … 83 40 99 … … 99.0 96.8 … … … … … … … 86.6 … … … … … 94.7 98.8 … … … … … 98.4 96.9 … … … … … … … 81.6 … … … … … 95.4 99.2 … … … … … 99.4 96.7 … … … … … … … 91.4 … … … … … 94.0 98.4 … … … 2,760 … 2,373 … 2,750 3,021 … … 3,147 2,456 2,718 2,807 … 2,546 2,710 2,914 … 2,548 2,751 … … … 8,511 … 12,060 … 21,970 c 12,660 b 12,752 … 15,670 … 29,850 c 18,850 b 0.9 … -4.2 … 1.6 -5.3 e … … 1.1 1.1 4.4 c 1.3 … -0.1 0.7 … 4.1 c -1.4 … … … … … … … … … … … … … … … … … … … … … … … … … 94 … … 100 … 100 96 … … … 94 93 100 99 96 … … 92 94 100 98 … 98 … 95 100 98 100 96 … 96 97 98 98 100 99 98 … … 97 98 100 98 … 91 … … 100 … 100 … … … … 93 88 100 99 95 … … 81 93 100 98 … 85 … … … 100 100 96 … … 97 84 80 96 96 65 … … 83 92 … 100 … 86 … 98 … 100 100 96 … … 96 88 78 96 96 71 … … 90 92 98 100 … 85 … … … 100 100 … … … 97 82 82 96 96 63 96 … 66 92 … 100 … Brazil Southern Cone Argentina Chile Paraguay Uruguay Non-Latin Caribbean Anguilla Antigua & Barbuda Aruba Bahamas Barbados Cayman Islands Curaçao Dominica Grenada Guyana Jamaica Montserrat Saint Kitts & Nevis Saint Lucia Saint Vincent & the Grenadines Suriname Sint Maarten (Dutch part) Trinidad & Tobago Turks & Caicos Islands Virgin Islands (UK) Virgin Islands (US) … … 7,090 7,220 2,900 c 4,980 … 12,480 6,680 6,100 … 7,640 c 15,040 … … … … … 12,460 10,530 3,460 c 7,770 … 14,490 9,080 10,560 … 7,710 c 24,940 … … … BI 50-56: (a) value 2008; (b) value 2009; (c ) value 2010; (d) value 2009-2010, (e) value 2008-2009. preventable deaths: violence and accidents in the americas Figure 1: Age-adjusted mortality rate from homicide (10-49 years), 1999-2009, by subregions Rate per 100,000 pop 150 Andean Area Brazil Central America Latin Caribbean Mexico Non-Latin Caribbean North America Southern Cone 100 50 0 150 100 50 0 2000 2004 2008 legend: 2000 2004 2008 female 2000 2004 male 2008 2000 2004 2008 total Rate per 100,000 pop Figure 2: Age-adjusted mortality rate from land transport accidents (10-49 years), 1999-2009, by subregions Andean Area Central America Brazil Latin Caribbean 45 30 15 0 Mexico 45 Non-Latin Caribbean North America Southern Cone 30 15 0 2000 2004 2008 2000 2004 2008 2000 2004 2008 2000 2004 2008 Mortality data from homicides1 and land transport accidents2 among those in ages 10 to 49 years during 1999 to 2009 in the Americas were used for analysis. Within this population, nearly 1,153,800 and 925,700 people died from homicide and land transport accidents, respectively. Throughout the Region, the age-adjusted mortality rates3 from homicides remained relatively stable, varying from 21.0 per 100,000 pop in 1999 to 22.2 per 100,000 pop in 2009. However, significant subregional differences were observed during the study period (Figure 1). The highest rates were found in the Andean subregion, Brazil and Central America, with mean values of 56.4, 35.8, and 28.6 per 100,000 pop, respectively. In the Andean subregion, rates experienced a decrease starting in 2002 influenced by the rates in Colombia. In contrast, Central America had an increase that started in 2003, heavily influenced by El Salvador’s data. Noteworthy, rates in Mexico have risen sharply since 2008. On the other hand, North America and the Southern Cone had the lowest and very similar rates of 8.0 and 7.9 per 100,000 pop, respectively. The relative risk of dying by subregion was estimated4 using the Southern Cone homicide mortality rate as baseline. The likelihood of dying in the Andean subregion was 5.4 times greater with a 95% confidence interval (95% CI) of 4.6 to 6.5, in Brazil of 4.7 (95% CI, 3.9-5.6) and in Central America 4.0 (95% CI, 3.3-4.8). Compared to women, men had an average mortality risk 9.4 times higher in the Region (95% CI, 8.0-11.1). The age groups 20 to 29, 30 to 39, and 40 to 49 years had mortality rates with average values of 37.5, 25.0, and 16.1 per 100,000 pop respectively, with a statistically significant higher risk than the group of 10 to 19 years (13.6 per 100,000 pop). The highest age-adjusted mortality rates from land transport accidents (Figure 2) were observed in Brazil and the Andean subregion with mean values of 20.0 per 100,000 pop; in contrast, the lowest rates were found in the Latin Caribbean and the Southern Cone with mean values of 11.6 and 12.0 per 100,000 pop, respectively. Men showed higher death rates than women, with a risk 4.2 times higher (95% CI, 3.9-4.5). Mortality rates in the age groups 10 to 19, 20 to 29, 30 to 39, and 40 to 49 years had mean values of 11.9, 24.1, 19.6, and 19.3 per 100,000, respectively. Mortality from land transport accidents and homicides might be associated5 with economic, educational, political, social, and cultural factors. Also, they overburden the health care systems and pose a high cost on society, in addition to the suffering of the victims and their families6. In several countries of the Region the proportion of population in productive ages regarding the number of the youngest and the oldest are increasing, favoring their economic growth. The negative potential impact of these deaths over this “demographic bonus” is an important call to countries for action given the preventability of these outcomes. Notes and references: 1 Homicide = ICD-10: codes X85-Y09 2 Land Transport Accidents = ICD-10: codes V01-V89 3 Mortality rates may be underestimated due to data quality problems such as the proportion of deaths that have not been registered and the proportion of violent deaths and accidental deaths of unknown intention. 4 Based on Negative Binominal Regression Model that allows the estimation while accounting for the variation within the subregions. 5 Briceño-Leon R. Villaveces A., Concha-Eastman A.: Understanding the uneven distribution of the incidence of homicide in Latin America. International Journal of Epidemiology 2008; 37:751-757. 6 Pan American Health Organization. “Informe sobre el estado de seguridad vial en las Américas”. Washington DC, 2009. Spanish only. Accessed 31 August, 2012. (http://www.bvsde.paho.org/texcom/cd045364/SeguridadVialAmericas.pdf) technical notes & sources Technical notes: Maternal mortality ratio, infant mortality rate, and under 5 mortality (BI 10, 12, 13) are reported by countries; an increase may reflect an improvement in data coverage and quality. Certified deaths due to ill-defined and unknown conditions (BI 16) refer to death certificates issued in a given year for which the underlying cause of death was symptoms, signs, and other ill-defined and unknown conditions (ICD-10: R00-R99). Mortality under-registration (BI 17) is determined by subtracting from 1 the total deaths registered in a country-period divided by the corresponding total estimated deaths, obtained after applying the UN estimated crude death rates to the corresponding population estimates by the UN. Corrected mortality rates (BI 18–BI 28) are computed based on registered mortality data, applying a correction algorithm for mortality underregistration and a redistribution algorithm for deaths from ill-defined causes. The methodology used is presented in Health Statistics from the Americas, 2006 edition (http://www.paho.org/HSA2006). Observed rates are presented for two groups of countries. For countries with high quality data (proportion of under-registration and ill-defined causes of death under 10%) and for countries without inputs for correction. Ageadjusted mortality rates are computed by direct standardization to the WHO World Standard Population (http://www.who.int/healthinfo/paper31.pdf). Malaria risk areas population (BI 31) shows the proportion of the total population in a country living in high and moderate malaria transmission risk areas. Moderate risk: API between 1 to 10/1,000 pop; high risk: API > 10/1,000 pop. National Health Expenditure (BI 42AB): Public expenditure (BI 42A) corresponds to general government expenditure in the function ‘health’ (Division 07) of the Classification of the Functions of Government (COFOG); Private expenditure (BI 42B) is based on the weight of ‘health’ in the Consumer Price Index (CPI) of the country. For more information, visit: www.paho.org/Spanish/DPM/SHD/HP/nhexp-metodos.htm. Antenatal care visits by trained personnel (BI 43) refer to ‘four or more visits’. Two new countries are included, Curaçao and Sint Maarten (Dutch part); the Netherlands Antilles have been removed. The regional and subregional aggregates for rates, ratios and proportions are weighted averages, and sums for absolute numbers. Information presented in this publication supersedes that of previous editions and is under ongoing review. Users are advised not to compare data series between different editions. Data sources were defined to ensure comparability; therefore, statistics in this publication presented here can differ from national statistics. Map: Data from PAHO/WHO Regional Mortality Information System, 2012 and HSD/HA analysis. External causes of death (ICD-10:V01-Y89). Suggested citation: Pan American Health Organization/World Health Organization (PAHO/WHO), Health Information and Analysis Project (HSD/HA). Health Situation in the Americas: Basic Indicators 2012. Washington, DC, United States of America, 2012. Data sources: PAHO/WHO Country Representatives and National Authorities. Data provided by Member States through basic indicators online data entry tool. Washington DC, 2012. As of 15 June 2012. (BI 10, 12, 13, 37-41, 43, 44, 49) PAHO/WHO Technical Projects. Data provided through basic indicators online data entry tool. Washington DC, 2012. As of 15 June 2012. (BI 29-36, 38-40, 42 AB, 45-48) United Nations Population Division. World Population Prospects: The 2010 Revision, New York; 2011. (BI 1-6, 8, 9) U.S. Bureau of the Census. International Data Base. June 2012 release (http://www.census.gov/ipc/www/idb/). (BI 1-6, 8, 9) World Health Organization (WHO). World Health Statistics 2012. Geneva, 2012. (http://www.who.int/reproductivehealth/publications). (BI 11) United Nations Population Division. World Urbanization Prospects: The 2011Revision, New York; 2012. (BI 7) PAHO/WHO. Regional Mortality Information System; Washington DC; 2012. As of 15 June 2012. (BI 14-28) UNESCO. Institute for Statistics (UIS). Data Centre, UIS Estimates. Accessed 13 June 2012. (http://www.stats.uis.unesco.org). (BI 50) Food and Agriculture Organization (FAO), FAOSTAT, Rome 2012. Accessed 10 July 2012. (http://apps.fao.org). (BI 51) The World Bank. World Development Indicators 2012. Washington, D.C. Accessed 26 July 2012 (www.data.worldbank.org/data-catalog).(BI 52-54) WHO/UNICEF. Joint Monitoring Programme (JMP) for Water Supply and Sanitation. Accessed 21 June 2012. (http://www.wssinfo.org/datamining/tables.html). (BI 55-56) Symbols and abbreviations: (-) magnitude zero; (0) magnitude less than half the measurement unit; (...) data not available; (c) circa; (pop) population; (lb) live births; (lay) latest available year; (ppp) purchasing power parity; (GDP) gross domestic product; (ADD) acute diarrheal diseases: CIE-10: A00-A09; (ARI) acute respiratory infections: CIE-10: J00-J22; (SS+) sputum smear positive; (API) annual parasite index; (aids) acquired immunodeficiency syndrome; (DPT3-Hib3) diphtheria-pertussistetanus-Haemophilus influenzae type b, third dose; (Polio 3) oral polio vaccine or inactivated polio vaccine, third dose; (BCG) anti-tuberculosis vaccine (bacille Calmette-Guerin); (MMR1) measles, mumps and rubella, first dose; (n/a) not applicable; (BI) basic indicator. Country territory codes according to ISO 3166-1: Aruba (ABW), Anguilla (AIA), Argentina (ARG), Antigua and Barbuda (ATG), Bahamas (BHS), Belize (BLZ), Bermuda (BMU), Bolivia (BOL), Brazil (BRA), Barbados (BRB), Canada (CAN), Chile (CHL), Colombia (COL), Costa Rica (CRI), Cuba (CUB), Curaçao (CUW), Cayman Islands (CYM), Dominica (DMA), Dominican Republic (DOM), Ecuador (ECU), Guadeloupe (GLP), Grenada (GRD), Guatemala (GTM), French Guiana (GUF), Guyana (GUY), Honduras (HND), Haiti (HTI), Jamaica (JAM), Saint Kitts & Nevis (KNA), Saint Lucia (LCA), Mexico (MEX), Montserrat (MSR), Martinique (MTQ), Nicaragua (NIC), Panama (PAN), Peru (PER), Puerto Rico (PRI), Paraguay (PRY), El Salvador (SLV), Suriname (SUR), Sint Maarten (SXM), Turks and Caicos Islands (TCA), Trinidad & Tobago (TTO), Uruguay (URY), United States of America (USA), Saint Vincent & the Grenadines (VCT), Venezuela (VEN), Virgin Islands UK (VGB) and Virgin Islands US (VIR). PAHO/HSD/HA/12.01 For further information, visit the PAHO/WHO Regional Health Observatory web at www.paho.org/rho © Pan American Health Organization, 2012 y All rights reserved