Pan American Health Organization
Contribuciones de las distintas
Organizaciones y Agencias Internacionales y
de Cooperación a la SSO
OPS
El Salvador, 29-30 Abril 2004
PAN AMERICAN HEALTH ORGANIZATION
Pan American Sanitary Bureau, Regional Office of the
WORLD HEALTH ORGANIZATION
DR. LUZ MARITZA TENNASSEE
Sustainable Development and Environmental Health
PAHO-2K
Pan American Health Organization
Globalization: Strengths and weaknesses
Beneficial effect
Adverse effect
5–7 % annual
growth trade and
world production
Harder competition
developing countries
Global market provides
benefit of scale
Home markets are
put under pressure
Higher efficacy
and quality
Compromising health
and safety standards
Elimination of time
dimension from
global market
Unphysiological time
schedules, sleep debt,
vigilance problems
< costs of storage,
high flow of
production
Tight deadlines,
psychological stress.
physical overload
unconventional work
hours, source of
Adapt to global market
flexibility: humanPAHO-2K
labour
Pan American Health Organization
Environmental &Workers’ Health
Kofi A. Annan
Secretary General
United Nations
“Occupational Health and Safety:
a high priority in the global,
international and national
agenda”
• Protect the health and safety of workers
• Strengthen and promote ILO and WHO
programmes to reducr occupational
deaths, injuries and illnesses.
Johannesburg
Summit 2002
•Link occupational health withPAHO-2K
public
health promotion”
Pan American Health Organization
UN Millennium Development Goals
Relation to Workers’ Health
GOALS:
• Eradicate Extreme
Poverty and Hunger
CONTRIBUTION:
•Synergy with Labor Ministers, Private
Sector, NGOs Unions to Create and
Maintain a Healthy Workplaces
•Promote Gender, Equality
and Empower Women
•Basic Skills for Women to
Utilize Housing and Working
Facilities
•Reduce Child Mortality and
Improve Maternal Health
•Improvement in Working
Conditions to promote and
protect parental Health
•Combat HIV/AIDS
•Through Promotion in the
Workplace and healthcare
Sector
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Pan American Health Organization
UN Millennium Development Goals
Ensuring Environmental Sustainability
TARGET
CONTRIBUTION
Integrate the Principles of Sustainable
Development into Country Policies and
Programs and reverse the loss of
Environmental Resources
•Regional Plan on Workers’ Health/Health
Workplaces Initiatives
•Linkages between Health and Labor PAHO/ILO
TARGET
By 2020 to have achieve a significant
improvement in the Lives of at least 100 million
slum Dwellers – phase out and eradication
CONTRIBUTION
Creation of Healthy, Safe and
Decent Workplaces
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SITUATION ANALISIS IN THE AMERICAS
Pan American Health Organization
INEQUITIES – INSTITUTIONAL DISPERSION - REFORMS
• EAP: 351 million (> 50% Americas population).
- 69 million below poverty line.
- 52% Informal Sector ( women, children, migrants, indigenous)
- 49% women
- 24 million children work.
36 Injuries / minute
5 Million injuries / year
5 Million injuries / year
90,000 Fatal Injuries / year
•
Morbidity: Traditional occupational illnesses, along with cancer,
asthma, depression, cardiovascular, musculoskeletal ,
immunological, and nervous system, and re-emerging diseases.
9% - 12% of GDP in LAC
30% Receives Occupational Health Services (formal sector)
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Pan American Health Organization
The Workers’ Health Plan
Driving Forces
Pressure
Globalization, Integration,
Technological Change
Reform of the State, Inequities
Technology Transfer, Nontraditional Expoprt
Production Increase
Maquila
ACTION
Health Policies
and Legislation
State
Quality of the
Work
Environment
Workforce Composition,
Migration, Precarious L.M,
Poverty Feminization
Promotion of
Workers Health
Exposure
(Environmental)
Psychosocial, Ergonomic,
Chemical, Biological,
Safety & Physical
DPSEEA
Model
Effect
Lost workdays,
Occupational Accidents
& Diseases, Lower
Productivity, Social
Costs
Comprehensiv
e Workers’
Services
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Pan American Health Organization
Economic impact
The Breakdown of Costs
for Work-related Injuries and Diseases
Injuries
14%
Heart diseases
16%
Musculoskeletal
40%
Respiratory diseases
9%
Nervous Central System
8%
Others
13%
Other diseases include cancer, skin diseases and mental disorders
PAHO-2K
Source: ILO, 1999
Pan American Health Organization
The Regional Workers’ Health Plan
III Summit of the
Americas 2001
XII Inter-American Conference
of the Ministers of Labor
October 2001- Septiembre 2003
•Declaration and Plan of Action
(OAS, ILO, PAHO, IDB, WB,
ECLAC)
Workers’ Health
PAHO-2Kof
Organization
American States
Pan American Health Organization
• Support in the Consolidated Programs Portafolio – XIII IACML
• Strategic Alliance Presentation to PAHO´s
Directing Council by XIII IACML TROIKA (Sept 2004)
• CARICOM Inter Ministerial Workshop on HIV/AIDS (Healthy
Workplace and Healthy Schools Initiatives)
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Pan American Health Organization
Agreement PAHO - ILO
Extend Social Protection and Health Coverage
within Excluded Groups
(ESPHC)
Approved by Directive Council
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Pan American Health Organization
THE CHALLENGE
Magnitude of the Problem:
Total population of Latin America and
the Caribbean: 500 million.
27% of the population lacks access to
permanent and basic health services
(125 millon).
46% of the population does not have
health insurance either public or private
(230 millon).
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Pan American Health Organization
REASON FOR ESPHC IN THE AMERICAS
REGION
 Persistent economic, social, ethnic and cultural
exclusion.
 The present social protection mechanisms
insufficient to give answers to new problems.
are
 It is necessary for the Reform Processes to contribute
in the construction of socially inclusive societies for all
its citizens.
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Pan American Health Organization
CONDITIONS FOR THE EXTENSION OF
SOCIAL PROTECTION IN HEALTH
Access to Services
Home Financial Security
Quality of Health Services
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Pan American Health Organization
MANDATES OF THE ILO/PAHO/WHO RELATED
TO THE EXTENTION OF SOCIAL PROTECTION IN
HEALTH
PAHO/WHO
• Reduction in inequities in the access to health services and
in their financing
• Universal access to health services in order to achieve the
goal of health for all
• Poverty reduction and development goals of the millenium
PAHO-2K
MANDATES OF THE ILO/PAHO/WHO
RELATED TO THE EXTENTION OF
SOCIAL PROTECTION IN HEALTH
Pan American Health Organization
ILO



Promote opportunities for decent and
productive work under conditions of
freedom, equity, safety and human
dignity
Improve the coverage and
effectiveness of social protection for
all, including protection in health
New consensus of social security
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First Hispanic Forum
October 2000
Pan American Health Organization
TOPICS
• Inequities
• Environmental Justice
• Migrant Workers
• Border Health
ACTORS
• EPA, OSHA, NIOSH
(public sector)
• NSC, 3M (private sector)
• National Alliance for Hispanic
Health (NGOs)
• PAHO, ILO, NAALC, OEA
PAHO-2K
(UDSE and AICD)
Alarming Increases in Work Accidents among Hispanics
Pan American Health Organization

Hispanic population grew by
58% between 1990 and
2000:38.3 Million in the
US, 3.8 Million in Puerto
Rico

12.5% of the workforce is
Hispanic. They bear 15% of
the total US fatal
occupational injuries.

Fatal occupational accidents
have decreased overall, but
risen alarmingly among the
Hispanic labor force.

In the US there has been a
40 % increase in fatalities
among Hispanic workers in
the construction sector.
Work Related Fatalities are Projected to
Keep rising without preventive interventions
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NATIONWIDE NETWORK: AN INVITATION TO
JOIN AND SUPPORT
Pan American Health Organization
Hispanic
Forum
IDB
US-Mexico Chamber
of Commerce
3M
Hispanic Workers Safety
and Health
NIOSH
Communications
US-Mexico BHA
Workshop
Susan Harwood
Grants
PAHO
NSC
Puerto Rico
OSHA
Interconnectivity and Support
Summit of the
AmericasOAS
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Pan American Health Organization
Border Issues
PAHO-2K
Border XXI Program
Pan American Health Organization
“ To improve the environmental health of U.S.-Mexico
border communities by identifying and addressing
those environmental conditions posing the highest
human health risk”
1983 La Paz agreement designated six work groups (Air,
water, hazardous waste, contingency planning,
pollution prevention and cooperative enforcement)
1996 Three groups were added: natural
r esources,
environmental information and environmental and
occupational health.
Development of Environmental Health Indicators
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Pan American Health Organization
Migrant Farm Workers
•Most farm workers have no
insurance.
• 3 to 5 million of them are
Hispanic.
•Most migrant workers are men in
their 20s and send their earnings
home to their families in Mexico,
Guatemala, Honduras, El Salvador
or Haiti.
•Most live in poor housing and
unsanitary living conditions.
PAHO-2K
Pan American Health Organization
Healthy Work Place Initiative
HEALTH STANDARDS MAQUILA AND FLORICULTURE
CENTRAL AMERICA
(CIMBIOSE, IRET, U. San Carlos, U. de Leon, CCOHS)
HIGH-LEVEL INTER-AGENCY
COOPERATION (OAS, IDB, PAHO)
PAHO-2K
Pan American Health Organization
ILO
CONTENT:
•Best Practices
•Databases
•Softwares
•Global Links
•DECIDES
•Long-Distance
Education
http://www.cepis.ops-oms.org
PAHO-2K
Pan American Health Organization
PAHO-2K
Pan American Health Organization
Current Occupation for Men by Hispanic Origin in the US
2000
Hispanic
Non-Hispanic White
17%
22%
29%
19%
3%
9%
15%
21%
8%
15%
11%
31%
Precision production
Service
Managerial, professional
Technical, sales
Farming
Operators, laborers
PAHO-2K
Source: Current Population Survey, March 2000, PGP-4
Pan American Health Organization
Current Occupation for Women by Hispanic Origin in the
US 2000
Hispanic
23%
Non-Hispanic White
1% 5% 2%
16%
2%
15%
26%
42%
38%
35%
18%
Precision production
Service
Technical, sales
Farming
Managerial, professional
Operators, laborers
PAHO-2K
Source: Current Population Survey, March 2000, PGP-4
Percent Unemployed by Hispanic Origin
and Sex in the US 2000
Pan American Health Organization
(Population 16 years and over in the labor force)
10
7.7
8
6.8
6.2
6
4
3.6
3.4
3.3
2
0
Both Sexes
Male
Hispanic
Source: Current Population Survey, March 2000, PGP-4
Non-Hispanic White
Female
PAHO-2K
Percent Unemployed by Hispanic Origin
and Sex in the US 2000
Pan American Health Organization
(Population 16 years and over in the labor force)
10
7.7
8
6.8
6.2
6
4
3.6
3.4
3.3
2
0
Both Sexes
Male
Hispanic
Source: Current Population Survey, March 2000, PGP-4
Non-Hispanic White
Female
PAHO-2K
Pan American Health Organization
Percent Below Poverty Level in 1999 by Age and Hispanic
Origin in the US
50
40
30.8
30
22.8
20
10
20.4
18.5
8
9.4
7.1
7.6
0
All ages
Under 18
Hispanic
18 to 64
Non-Hispanic White
Source: Current Population Survey, March 2000, PGP-4
65 and over
PAHO-2K
Pan American Health Organization
ECONOMIC BURDEN OSH
180
171
154
170
CIRCUL
CANCER
160
140
120
100
80
60
67
33
40
20
0
OSH
AIDS
ALZH
NIOSH/CDC
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Pan American Health Organization
Unemployment
Homicides
Suicides
Violence
Occupational
Cancer
Reproductive
Problems
Occupational
Stress
Musculoskeletal
Disorders
Social
Injustice
Syndrome
Alcoholism and
Substance Abuse
Infectious
Diseases
Poisoning
Accidents and Injuries
Cardiovascular
Diseases
Hearing Loss
Respiratory
Problems
PAHO-2K