PEDRO ROSSO EUGENIO ARTEAGA
Over the last two decades, Chile's main health indicators--infant mortality, maternal mortality rate, and life expectancy--have improved to the extent that currently they are the best in South America and are comparable to those of Cuba and Costa Rica. The causes of these changes have not been clearly identified, but they are generally attributed to major societal events during the 1970s and 1980s and in the previous decade. These changes include a steep increase in basic education coverage, consistency in the government's health policies despite dramatic political changes, a steady yet modest increase in family income, and a significant improvement in the quality of housing and sanitation in low-income areas.
The improvements in Chilean health indicators and resulting demographic shifts have conferred on the country a mortality profile characteristic of the so- called epidemiological transition. Currently, cardiovascular diseases constitute the leading cause of death, followed by cancer--a profile similar to that of the industrialized countries. In contrast with the industrialized countries, however, morbidity caused by infectious diseases such as typhoid fever, hepatitis, tuberculosis and others, remains high.
Chilean interest in public health has a long tradition. It began during the 1920s as a component of government action on social problems. At that time, a progressive government passed some of the world's most advanced labor and social laws, including various health benefits for workers and their families. In the 1950s the organization of a national health service, inspired by the British and Israeli models, helped create a vast network of ambulatory clinics and small hospitals (less than 100 beds) in small towns. The national health service developed several preventive medicine programs designed to protect the health of mothers and infants.