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Anonymous Cuban , Professional 0000
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� Dear Editor, I would like to accept the invitation to comment the interesting and thought-provoking editorial, The health of nations by Professors McKee and McMichael.[1] � In my view, to help solve the cyclical and irregular national, regional, and global crises, physician�s primary life and health care and family medicine will need to use a broader bioecono-psychosocial approach in still poor, and in �medium class�-affluent countries. � The expertise achieved in modern sustainable human growth (MSHG), science, and technology, will guarantee higher living and health levels in the liberated countries of communism, as well as of colonialism, and even in the most advanced countries, overcoming the logical development crises of nature and society global secular trend. � Thanks to the MSHG, in 2005, of the world�s 6.3 billion inhabitants, about 60% have escaped from overall poverty, and nearly 50% of the world countries no longer live in closed repressive systems.[2] There is still stagnation and backwardness of the transition and developing countries. Although they are on the ways to being solved, rejecting the right and left wing dictatorships that have decelerated the progressive ideas and institutions, and the follow-up of the advanced countries� upward-trends from 1800-2008.[2-5] � By the way, the statistics handling in former USSR could have influenced in some measure in the life span setback detected, when social indexes stopped to be ideological targets, and its specific weight could be unfolded with the former Soviet physicians� help. � For instance, in the past Cuba smoking increased too much. In 1974, Cuba reached the 1st place in America and 6th world place, on highest women lung cancer age-adjusted death rates,[6] and 1st world lowest male:female ratio in coronary heart disease mortality in 1992-96,[7] but this is still invisible in our life span series.[8] In addition, it has been hidden to the world,� the improved life expectancy and infant mortality rate and their world places from 1900-58, and the world positions worsening [8-10] from 1959-2005 (table).�� � All the countries could study the singular experiences of the UK, pioneer of MSHG,[4] of Iceland, Norway, Australia, Canada, among other 19 top developed countries, and after look back from 100,000 BC to 1800, to understand well the MSHG�s thousands of gifts, to think more optimistically that most of the world will work for a brighter future.[2-5,10] � Very encouraging could be the study of Slovenia and Southeast China for transition countries, and of Cyprus, Taiwan, South Korea, Hong Kong, Singapore, three advanced provinces of India, United Arab Emirates, Chile, and Cuba�s both stages 1800-1958; 1959-2008, for developing countries.[2-5,9-10] Nowadays, excepting Cyprus, Taiwan, Slovenia, and Chile, the other countries suggested are still offenders against individual liberties/rights, so the quality of their long life and health is still mentally and socially ill. Nevertheless, the life and health of nations is a dynamic process. In this matter, a key issue is to trust in our human reserves of wisdom to conduct better our future growth. � Thank you. � References: � 1. McKee M, McMichael AJ. Editorial. The health of nations. Past performance is not a guide to future results. BMJ 2008;337:a2811.� http://www.bmj.com/cgi/content/extract/337/dec11_1/a2811?ijkey=3235bfce407b8ed3c01101336c34441081278540&keytype2=tf_ipsecsha 2. Sachs JD. The end of poverty. Economic possibilities for our time, 1st edn. New York: Penguin Press, 2005. 3. Fogel RW. The escape from hunger and premature death, 1700�2100: Europe, America, and the third world, 1st edn. New York: Cambridge University Press, 2004. 4. Clark G. A farewell to alms. A brief economic history of the world, 1st edn. Princeton: Princeton University Press, 2007. 5. Maddison A. Contours of the World Economy 1-2030 AD. Essays in Macro-Economic History. Oxford: Oxford University Press, 2007. 6. Segi M. Age Adjusted Death Rates for Cancer for Selected Sites in 51 Countries in 1974. Nagoya (Japan): Segi Institute of Cancer Epidemiology, 1979. 7. Lawlor DA, Ebrahim S, Davey Smith G. Sex matters: secular and geographical trends in sex differences in coronary heart disease mortality. BMJ 2001;323(7312):541�545. http://www.bmj.com/cgi/content/full/323/7312/541 8. Cuban Health Statistics Bureau. Annual Health Statistics Reports 1973-2007. Havana: Ministry of Public Health, 1974-2008. (In web site from 1995-2007) http://www.sld.cu/servicios/estadisticas/ 9. McGuire JW, Frankel LM. Dimensions and determinants of mortality decline in pre-revolutionary Cuba. Harvard Center for Population and Development Studies. Working Paper Series. vol. 14 no. 6. Cambridge, MA, 2004. http://www.globalhealth.harvard.edu/hcpds/wpweb/McGuire_wp1406.pdf 10. United Nations Development Program. Human Development Report 2007/2008. Fighting Climate changes: Human solidarity in a divided world, New York, NY: Palgrave Macmillan, 2007. � � Table � Life span and infant mortality. Cuba 1800, 1900, 1957, 2005. � ��
� *Author�s 1800 indexes and 1900 world places, own estimations with all the data at hand. �Main Sources: [8-10] � � Competing interests: None declared |
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