Health, Equity and Social Exclusion in Latin America: The Cases of Argentina and Mexico

As a region, Latin America has performed relatively well in terms of basic health indicators, even during the crisis years of the 1980s. However, this apparent success belies profound and complex problems of inequity and solidarity, which are rooted in wider processes of political and social exclusion. This chapter provides a short regional overview of some of these issues. Given the complexity of the topic and the brevity of the paper, it is not possible to capture many variations in national experiences. For example, the paper makes no reference to countries such as Cuba, whose health profile and health care system bear little resemblance to the rest of the region. In order to support some of the paper’s generalisations, examples are taken from two countries -Argentina and Mexicowhich, though different, in many ways typify the key issues and problems faced by Latin America as a whole. The paper begins by briefly referring to the difficulty of conceptualising health, particularly with reference to exclusion and equity. It then examines equity and health from a number of different angles, including progress towards universal provision of formal services, geographical variations for different health indicators, the segmentation of health care systems, and the historical and political context within which these problems of equity occur. The concluding section looks at recent reform experiences, and finds little evidence that these issues are being effectively addressed.