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

CITIES, HEALTH AND WELL-BEING NOVEMBER 2011

DEMOCRACY, STATE AND MARKET: Factors affecting in territorial inequality and health’s people.

Chile 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

Región Metropolitana de Santiago  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%

Factors that determine the health status of people Biological Factors, 15% Environment 10% Social System, 50% Health system, 25% Fuente: Canadian Institute for Advanced Research

Poverty in Chile (1990 – 2006)

Tasa por 1000 NV 1,0 1,5 2,0 2,5 3,0 3,5 4,0 4,5 5,0 1990 1991 Mortalidad Materna, Chile 1990-2006 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Infant and Maternal Mortality. 2003 2004 2005 Tasa por 1000 NV 2006 11 13 15 17 5 7 9 Health National Service 1990 1991 1992 Mortalidad Infantil, Chile 1990-2006 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Social inequalities 14 Promedio 1996 Promedio 2006 12 Años Promedio de Estudio 10 Average years schooling 8 13.1 (1996 – 2006) 6 10.9 4 9.1 9.7 8.2 2 6.2 7.0 7.8 9.2 11.8 0 Quintil 1 Quintil 2 Quintil 3 Quintil 4 Quintil 5 80 Proporción de población (%) Año 1996 Año 2006 75.1 72.6 60 workforce/ Gendre 40 (1996 -2006) 42.7 33.2 20 0 Hombres Mujeres

Income distribution for quintiles Chile 1996 -2006 100% 90% 80% 47.8 50.9 51.0 70% 60% 50% 20.7 40% 18.9 19.9 30% 14.3 13.8 13.5 20% 11.0 10.5 10% 10.1 6.2 5.5 5.9 0% 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

Infant Mortality Rate / Mother’s education 2005 – 2007 Social health 16 14 12 8.1 TMI x 1.000 NV 6.1 10 8 4.4 3 3.1 1.4 1.7 6 1.5 1.1 1.1 1.3 4 0.7 5.6 5.5 2 4.1 4.1 4 3 0 Hasta 3 años 4- 6 años 7-9 años 10-12 años 13 y más años Total Educación de la madre TM Post Neonatal TM Neonatal Tardía TM Neonatal Precoz

"Bad or very bad health for quintil 30 15-29 años 30-44 años 45-64 años 65 y más años Proporción de población (%) 25 20 15 10 5 0 I II III IV V Total Quintil de ingresos Hypertension and Diabetes Mellitus Rate / Education level 60 54.6 50 Hipertensión Diabetes 40 28.3 30 21.7 20 10.2 10 2.7 1.2 0 Universitario Secundario Básico Level education

TERRITORIAL INEQUALITY AND HEALTH

INCOME DISTRIBUTION MAP Región Metropolitana Concentration occurs in only 5 City hall of the region that hosting the 10.29% of the total population

CONTRAST WEST EAST

CONTRAST WEST EAST

CONTRAST WEST EAST

CONTRAST EAST WEST

Population Density Región Metropolitana de Santiago

Quality of Education Región Metropolitana de Santiago

GREEN AREAS/POPULATION

N ° PHARMACIES/ 10.000 PEOPLE Privated

TEST COVERAGE OF PREVENTIVE HEALTH. State

MORTALITY RATE/ RESPIRATORY SYSTEM DISEASE

MORTALITY RATE/ DIGESTIVE SYSTEM DISEASE

MIXED VARIABLES PRODUCE

SOCIAL CAPITAL TERRITORY

HOW WE ARRIVE TO THESE LEVELS OF INEQUALITY?

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 )

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)

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

New concept of social policy 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 housing policy Neighborhood Recovery Program Housing Recovery Program Improving social housing Main component: Citizen Participation

Neighborhood Recovery Program

Neighborhood Recovery Program

Improving social housing Expansion or improvement project: Room - Living room - Bathroom Kitchen – laundry - roof Montos de las Intervenciones 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)

Factors shape the territorial reality DEMOCRACY MARKET STATE

¿WHAT IS THE PERFECT RELATIONSHIP BETWEEN THESE 3 FACTORS? Point of balance ? Resultados en Salud 10 9 8 7 Democracia 6 5 Mercado 4 Estado 3 2 1 0 0 2 4 6 8 10 12 Magnitud

CENTURY CHALLENGE XXI BETTER DEMOCRACY STATE RESPONSABILE REGULATED MARKET A new human architecture