Official Name: Republic of Chile
Capital City: Santiago
Official Language: Spanish
Surface: 538.66 km 2
PAHO Subregion: Southern Cone
UN 2 digits Code: CL
UN 3 digits Code: CHL
UN Country Code: 152


PAHO Basic Health Indicator Data Base

This is a multidimensional query tool that offers a collection of 108 indicators from 1995 to 2005. The system presents data and indicators on:
- demography
- socioeconomic
- mortality by cause indicators
- morbidity and risk factors
- access, resources and health services coverage.

Selected indicators are disaggregated into age groups, sex and/or urban/rural region. Generated tables can be exported and printed.

The data presented is updated annually with the latest country information.

    Chile is a unitary State with a democratic government.. The country is divided into 13 political-administrative regions. The estimated population in June 2001 was 15.4 million. The most densely populated area is the Santiago metropolitan region. The country has eight indigenous groups that make up 10% of the total population: Aymará, Atacameño, Quichua, Mapuche, Rapa Nui , Colla, Kaueskar, and Yámana. The reform of the health sector is one of the seven major changes proposed for the 2000-2006 period. The purpose of the reform is to guarantee the right to health for all Chileans, without discrimination; improve their levels of health; and reduce inequities owing to the socioeconomic status and geographical location.

    Demography: The demographic profile is in transition. Birth and mortality rates have declined in recent decades. In 1998, children under age 15 accounted for 28.8% of the population, the 15-64 years age group for 64.2%, and persons aged 65 and older for 7%. The dependency ratio was 35.8% in 1998. Life expectancy at birth in the 1995-2000 period was estimated at 75.2 years.

    Economy: The country experienced sustained economic growth until 1998, with GDP growing by 7.7% per year. Inflation was 4.7% in 1998 and unemployment rates were moderate. Due to the crisis of the international markets, growth turned negative in 1999 around -1.1% and unemployment rose significantly. Aggregate social and economic indicators for the country show clear improvements, expressed in a reduction in poverty levels from 39.3% in 1990 to 20.6% in 2000 and growth in per capita GDP of 46.9% between 1991 and 1999, when it reached US$ 4,492. However, inequity between social groups and regions persists. At the end of 2000, 10% of the wealthiest households captured 40.3% of the income, while the poorest 10 % obtained just 1.7%. In 1999, the literacy rate among people aged 15 or over was 95.5%. On average Chileans attended school for 9.9 years. Economically active population grew from 5,500,000 in 1996 to 5,738,470 in 1998.

    Mortality: In 1999, the mortality rate was 510.7 per 100 thousand population. In 1999, age adjusted mortality rates per 100,000 population for broad groups of causes were: diseases of the circulatory system (150.3), malignant neoplasms (124.2), communicable diseases (67.5), and external causes (57.6).

    Analysis by population group
    Children (0-4 years): In 1999, the infant mortality rate was 10.1 per 1,000 live births. There was a drop in early neonatal, neonatal, and postneonatal mortality. The leading causes of death were perinatal disorders, congenital anomalies, respiratory diseases, and injuries and poisonings. There were 461 deaths among children aged 1-4 in 1999, or 0.5% of the total, for a rate of 0.4 per 1,000 population. The leading cause of death was external causes, accounting for 33.4% of all deaths.

    Schoolchildren (5-9 years): The 5-9 years age group accounted for 0.3% of total deaths, making it the group with the lowest age-specific mortality rate (0.20 per 1,000 population). Deaths reported in 1999 were mainly due to external causes (39%).

    Adolescents (10-14 and 15-19 years): The mortality rate among adolescents between 10 and 19 years was 0.37 per 1,000 population. Injuries and neoplasms were the leading cause of death, 18% of the total. Analysis for specific rather than broad causes showed the first nine to be external causes, with suicide by hanging in fourth place for 56 deaths; 41 were young men.

    Adults (20-59 years): People between the ages of 20 and 60 years accounted for 53% of the country's total population. Adults between the ages of 20 and 44 have a mortality rate of 1.3 per 1,000 population. The leading cause of death was external causes. The mortality rate of the 45-59 years age group was 5.2 per 1,000 population. In 1998, the main cause of death was neoplasms contributing 30% of total deaths in this group, followed by diseases of the circulatory system (21%).

    The elderly (60-years and older): The mortality rate in the 65-79 years age group was 31.5 per 1,000 population. Neoplasms was the leading cause of death, followed by diseases of the circulatory system and diseases of the respiratory system.

    Workers' health: In 1998, work-related accidents led to a loss of 3.3 million working days. Every day about 822 workers experience work-related accidents. Close to 2 million workers have no access to any kind of occupational health protection, and a large percentage have only limited protection, particularly temporary, workers, unskilled and laborers.

    Health of the indigenous population: There is a high concentration of indigenous groups in 39 of the country's "communes" and a significant presence in 26. Standard-of-living indicators are lower in these "communes" than in other parts of the country, and an association between poor areas and indigenous areas is high. Infant mortality rates for the Atacameño are up to 40 deaths per 1000 live births higher than the national average, and life expectancy for the Aymará is up to 10 years less.

    Analysis by type of health problem

    Vector-borne diseases : The last malaria epidemic occurred in March 1945, and no autochthonous cases have been reported since then. The country is free from the presence of the mosquito Aedes aegypti. Chagas' disease is endemic in rural and peri-urban areas in the region of Tarapacá and Libertador General Bernardo O'Higgins, with 850,000 people exposed. Mortality from the disease increased until 1985 and stabilized over the last five years at about 55 cases a year. There is no report of Dengue, plague, or schistosomiasis in Chile .

    Diseases preventable by immunization:
    The last case of poliomyelitis occurred in 1975. In 1999, reporting of acute flaccid paralysis was 25% higher than it had been in 1998. In 1996, the last case of diphtheria was reported. In 1993, one measles case was reported, and in the following three years, no cases were confirmed. Subsequently, there were localized outbreaks and sporadic cases of measles, totalizing 58 in 1997, 6 in 1998 and 31 in 1999. In 2000, a country-wide mass vaccination campaign against measles was carried out in the country. The highest incidence rate of pertussis in 19 years (20 per 100,000 population) was reported in 1999, and in 2000, the incidence rate was 73% higher than it had been in 1999 (6.4 and 3.7 per 1,000 population, respectively). Sporadic cases of tetanus and neonatal tetanus occurred at a constant incidence of 0.1 per 100,000 population over the last decade. In the years 1997, 1998.1999, 2000, no case of neonatal tetanus was reported. The expanded program on immunization has had very good results against mumps with the MMR vaccine. In 1999, the morbidity rate was 15 per 100,000 population. Although the incidence of rubella had declined due to the introduction of the MMR vaccine, there was an unexpected increase in the number of cases in 1997 (28 per 100,000) and 1998 (31), which dropped to 11 in 1999, and to 4.9 in 2000. Since June 1996, vaccinations against Haemophilus influenzae type B has been gradually increasing, which has continued to a drop in morbidity in children under five years of age. National vaccination coverage of infants under 1 year with BCG, anti-measles, Hib, OPV1, OPV2, OPV3, DPT1, DPT2 and DPT3 was 91% in 1998 and 96% in 1999.

    Intestinal infectious diseases: In 1998, there was an outbreak of cholera in San Pedro (Atacama), with 23 cases. The incidence rates of typhoid and paratyphoid fever were in clear decline. The lowest rate (5 per 100,000 population) was reported in 1999.

    Chronic communicable diseases: Morbidity from tuberculosis dropped from 52 per 100,000 population in 1989, to 22 per 100,000 in 1999.

    Acute respiratory infections: Influenza outbreaks generally occur in the cold months, with surges every three or four years. In 1999, 131 deaths from influenza were reported (0.9 per 100,000 population), for an increase of 62% over the previous year (81 deaths). The population aged 65 years and older accounted for 89% (117) of total deaths.

    Zoonoses: Between 1996 and 1999, rabies did not alter its epidemiological pattern, which is marked by permanent presentation in the insectivorous bats and sporadic cases in domestic animals. In this period, there was one case of human rabies. Trichinosis took the form of sporadic family outbreaks. The rate in 1999 was higher than in 1998 (0.3 per 100,000 population). With regards to human echinococcosis, the number of notified cases fell slightly from 343 in 1996 to 313 in 1999

    Emerging and re-emerging diseases : Ninety-five percent of hantavirus pulmonary syndrome cases occurred in southern Chile , mainly affecting rural areas. During 2000, 23 cases were confirmed, 17 in 1999, and 31 in 1998. Meningococcal disease has been endemic since the 1950s, with approximately 500 cases a year. It affects slightly more men (54%) and children under the age of 5.

    HIV/AIDS and sexually transmitted infections: Because of its prevalence in urban areas, mainly affects people with access to health care and education. Men who have sex with men are the main victims. Between 1984 and 2001, 2,479 deaths were reported. The incidence rate reached 280 per million inhabitants, and it has been rising systematically over the years. Since the start of the epidemic, 90% of victims have been men and 10% women, but there has been a relative increase in cases among women. The total rate of notified sexually transmitted infections is 71, 6 per 100,000. The rates per 100,000 population reported in 1999 were 14.7 for syphilis, 14.2 for Condyloma acuminatum, and 10.9 for gonorrhea.

    Diseases of the circulatory system: These diseases are the leading cause of death, accounting for 27% of the total. They are also an important source of morbidity and disability.

    Malignant neoplasms: Neoplasms are the second leading cause of death, accounting for 22% of the total. There is a greater prevalence of cancers of the digestive organs.

    Accidents and violence: Since 1995, accidents have been the fourth leading cause of death. In 1997 the rate was 57 per 100.000 population. The risk is higher for men than women. Suicides accounted for 10.5% of deaths from injuries.

    National health policies and plans: The policies and plans defined for the period 2000-2006 established strategic goals: (a) stress the importance of citizen health rights, (b) reform the finance system; (c) prepare a program for equitable access to health services; (d) modernize the social safety net for health; (e) improve health guarantees in the public sector; (f) develop a government health promotion policy; (g) monitor respect for the rights of members of the private health insurance plans (ISAPRES); and, (h) institutionalize the quality of care. The Ministry of Health's short-term goals (2000-2002) were to provide timely access to care, respect the health rights of citizens by adhering to the patients' bill of rights, and create a national program of user participation.

    Health sector reform strategies and programs: To advance reform, the Government established an interministerial committee in 2000. The basic proposal establishes a guaranteed plan that is binding on the public insurer (FONASA) and the private insurers (ISAPREs) and assures effective and timely treatment of the most frequent, most serious, and most costly diseases. Priority is placed on primary care, and the family and community health teams will be strengthened. In structural terms, the reform is intended to create a solidarity fund, financed by government contributions and three-sevenths of the mandatory health care quotas, which will finance a guaranteed plan for the members of FONASA and the ISAPREs.

    Health system: The Ministry of Health is the lead agency in the sector. It formulates and establishes health policies and issues general standards and plans and supervises, monitors, and evaluates compliance with them. The Health Services, FONASA, the ISAPRE Authority, the Public Health Institute, and the Central Supply Clearinghouse (CENABAST) report to the Ministry. There is also an Environmental Health Service in the Santiago metropolitan region. The Public Health Institute is responsible for regulating drugs and medical inputs. The health services system is mixed. Public insurance is provided through FONASA, which receives contributions from its members and transfers from the national government to cover the indigents and to carry out public health programs. The private sector is represented by ISAPREs, which are health insurers. Services are delivered by public and private suppliers. The vast majority of primary care establishments depend on "communes", and the hospitals are under the direction of the Health Services. There are a series of clinics, centers, laboratories, and pharmacies managed by private individuals or companies. FONASA covers 63% of the population and the ISAPREs 23%. The remaining 14% is covered by other private plans (such as the armed forces plan) or has no insurance at all. Organization of health regulatory actions: Health care is regulated by rules that form part of the Ministry of Health's programs. The programs define coverage, frequency of contacts between users and services providers, and the responsibilities of the different levels in the system. The Health Services Directorates are responsible for regulating public and private health care establishments located in the territory of the respective Health Service. Health supplies: The drug market is governed by a series of regulations on standards for products and distribution and sales chains and is affected by factors such as the significant market share of generic drugs, the large presence of national laboratories, and the existence of the Ministry of Health's Central Supply Clearinghouse. There are no price controls on medications. Generic drugs account for 38% of the total pharmaceutical market. Food quality: A new regulation governing food safety has been promulgated. There is also a control and hygiene program with national coverage and coordination, which is supported by the national network of bromatological laboratories.

    Prevention and control programs: The Ministry of Health's basic programs (children, women, adults, and oral health) have been designed to take a comprehensive approach, including promotion, prevention, treatment, and rehabilitation. The Ministry of Health has established specific prevention programs, including immunization, food supplements, control of respiratory diseases, prevention of traffic accidents, control of the Red Tide, and eradication of Chagas' disease. There are also programs that detect uterine cervix and breast cancer with coverage of 60% and 30%, respectively.

    Health analysis: The Public Health Institute carries out epidemiological surveillance in cooperation with the Ministry of Health's Epidemiology Department. Through the National Control Department, the Public Health Institute monitors the national system for control of pharmaceutical products, food, cosmetics, pesticides for sanitary and domestic use, and medical articles. Potable water and excreta disposal services: In 1998, 99% of the urban population had access to potable water through public systems, 90% had access to sewerage systems, and 4% to mainly septic tanks and soakaways. One percent of the urban population (115,000 people) had no water service, and 7% (853,000 people) had no adequate sewage disposal system. Pollution prevention and control: Studies indicate that metering equipment should be installed in the cities of Rancagua, Temuco, Valparaiso and Viña del Mar. Organization of individual health services: The public health network is comprised of ambulatory and hospital facilities offering services of different complexity. They include 196 general hospitals, 20 high-complexity hospitals, 526 primary care clinics, 1,840 rural health posts and medical stations, and 73 establishments of other kinds. There is one clinic for about 28,500 people (1 per 17,100 if only FONASA members are considered). There is one rural post for every 1,900 rural dwellers, considering only FONASA members, who represent an estimated 14.6% of the total population. The country has about 30,000 hospital beds or one bed per 5,000 people (or one per 3,000 FONASA beneficiaries). In 1998, there were approximately 1 million discharges from public hospitals. Acute treatment is provided by emergency services in hospitals and emergency primary care services. The main private hospital and clinics also offer emergency care. Auxiliary diagnostic and therapeutic services offered by the public and private sectors. In the public sector, the services are located in hospitals, and serve demand generated in ambulatory services and hospital.

    Human resources: The country had 17,467 physicians in 1998 (18 physicians per 10,000 population). It is estimated that just 8,000 of the country's 18,000 nurses worked in the public sector. In 2000, the public health sector employed 90,000 people, which indicates that administrative and service staff accounted for one-third of the total.

    Health research and technology: Health research is carried out primarily in universities and research centers. The Government, through the National Science and Technology Council, provides incentives for health research, that has targeted basic sciences and clinical areas more than public health. To promote essential research on the country's priority health problems, the Ministry of Health has developed a national research policy directed to health policies. Health sector expenditure and financing: In 1999, average per capita spending for the total beneficiary population of FONASA and ISAPREs was US$ 279 (US$ 245 for FONASA beneficiaries and US$ 362 for ISAPRE beneficiaries). The public sector is financed from government contributions, quotas, and copayments by members of the public system and operating system. In 1999, this distribution was 54%, 39%, and 7%, respectively; in 1990, the figures were 41%, 53 % and 6%, respectively. Direct contributions by municipalities, which average US$ 8.50 per capita in 1998, should be added to these figures. Spending on health accounted for 17.1% of public social spending in 1999. As a percentage of GDP, health spending rose from 2.0% in 1990 to 2.8% in 1999. Technical cooperation and external financing: In 2000, external technical cooperation was received for projects on the quality of life, mental health, epilepsy, measures of equity in health, and HIV/AIDS. Efforts were made to seek lines of work shared with the United Nations system, and between it and its national counterparts.