|
Spain Health Conditions and Mortality
On a number of indicators of health care, Spain ranked
fairly
high among the advanced industrial countries. In both 1965
and
1981, the country had a better population-to-physician
ratio than
the average of the industrial democracies (800 to 1 versus
860 to
1, respectively, in 1965 and 360 to 1 versus 530 to 1,
respectively, in 1981). In 1983, with more than 115,000
physicians, Spain ranked sixth in the world in its ratio
of
inhabitants to physicians. Despite dramatic strides in
adding
nursing personnel (causing a decline in the
population-to-nurse
ratio of from 1,220 to 1 to 280 to 1 in less than 20
years), the
country remained near the bottom of the list of advanced
industrial countries on this scale. Spain also ranked
below most
other West European countries in per capita public
expenditures
on health care--only US$220 per person in 1983. In 1981
there
were in Spain slightly more than 1,000 hospitals and about
194,000 beds, or about 5.4 beds per 1,000 population.
As these figures suggest, the provision of health care
in
Spain was highly uneven. Even with a high ratio of doctors
to
inhabitants, the country had still not managed to
eradicate such
diseases as tuberculosis (more than 9,000 cases in 1983)
and
typhoid (5,500 cases); and there are still even a few new
cases
of leprosy reported each year. The root of this problem
seems to
be the maldistribution of the health care resources of the
state's welfare system. Hospitals in one area of the
country
might be seriously understaffed, while those in other
regions lay
virtually empty. By and large, the worst-served areas were
the
workers' suburbs near large cities. One press report cited
the
neighborhood of Vallecas, near Madrid, where a population
of
700,000 had no hospital at all and had only 3 doctors in
residence, who were reduced to seeing patients at the rate
of 1
per minute. A principal reason for understaffing was the
system
of multiple hospital assignments arranged by physicians to
augment their salaries. Although regulations prohibited
this
practice, many doctors arranged to be on duty at more than
one
hospital at a time, thereby reducing their effectiveness
in
meeting patient needs.
In terms of the causes of death, Spain fairly closely
resembled other advanced industrial societies, although
cancer
and heart disease appeared less frequently in Spain than
in more
industrialized countries. Of the nearly 290,000 deaths
registered
in 1980, almost half (45.8 percent) were due to a variety
of
circulatory system problems, principally heart attacks and
strokes. The single most prevalent cause of death was
malignant
neoplasms; about one-fifth (20.2 percent) of all deaths
were
caused by cancer of one sort or another. About one-tenth
(9.2
percent) of all deaths were occasioned by respiratory
ailments.
(Spaniards were the second heaviest smokers in the
European
Community--EC, after Greeks. About 40 percent of adults
smoked,
as did 50 percent of teenagers; the average 14-year-old
reportedly smoked 2,700 cigarettes a year.) About 2
percent of
deaths were caused by automobile accidents, and about 0.5
percent, by suicides.
In the third quarter of 1987, there were 112 cases of
acquired immune deficiency syndrome (AIDS) reported in
Spain,
bringing to 620 the total number of Spaniards afflicted by
this
disease. Although high, the Spanish figure was still less
than
half of that France, and it was far behind the more than
40,000
cases in the United States. Slightly more than half the
AIDS
victims contracted the disease through narcotics-related
practices; about one-fifth, from homosexual contact; and
about
one-tenth were hemophiliacs.
During the 1960s and the 1970s, Spain achieved dramatic
gains
in reducing infant mortality. Between 1965 and 1985, the
infant
mortality rate dropped from being the highest among the
industrial market economies, 38 per 1,000, to only 10 per
1,000
in 1985, which placed it ninth lowest in the world, on a
par with
other advanced industrial societies. The death rate for
children
less than one year old declined from slightly fewer than
13 per
1,000 in 1975 to fewer than 9 per 1,000 in 1979, and for
children
less than 5 years of age, it declined from 15 per 1,000 to
fewer
than 10 per 1,000 in the same period.
Spain also registered some improvement in food
consumption
during the 1960s and the 1970s, with per capita caloric
supply
growing by about 1 percent per year (from 2,844 in 1965 to
3,358
in 1985). In 1983 Spain ranked twenty-ninth in the world
in
calorie supply per capita. Spaniards daily consumed more
calories
than, or about the same number of calories as, the
residents of
Britain, France, Finland, Japan, Sweden, or Norway.
Data as of December 1988
|
