How Well Has Cuba Managed To Improve Health Outcomes? (part 2)

In a recent post, I pointed out that life expectancy in Cuba was high largely as a result of really low rates of car ownerships.  Fewer cars, fewer road accidents, higher life expectancy. As I pointed out using a paper published in Demography, road fatalities reduced life expectancy by somewhere between 0.2 and 0.8 years in Brazil (a country with a car ownership rate of roughly 400 per 1,000 persons). Obviously, road fatalities have very little to do with health care. Praising high life expectancy in Cuba as the outcome Castrist healthcare is incorrect, since the culprit seems to be the fact that Cubans just don’t own cars (only 55 per 1,000). But that was a level argument – i.e. the level is off.

It was not a trend argument. The rapid increase in life expectancy is undeniable, so my argument about level won’t affect the claim that Cubans saw their life expectancy increase under Castro.

I say “wait just a second”.

Cuba is quite unique with regards to car ownership. In 1958, it had the second highest rate of car ownership of all Latin America. However, while the rate went up in all of Latin America between 1958 and 1988, it went down in Cuba. During that period, life expectancy went up in all countries while there were substantial increases in car ownership (which would, all things being equal, slow down life expectancy growth). Take Chile and Brazil as example. In these countries, the rate went up by 6.9% and 8.1% every year – these are fantastic rates of growth. During the same period, life expectancy increased 25% in Chile and 19% in Brazil compared with Cuba where the increase stood at 17%. In Cuba, the moderate decline in car ownership (-0.1% per annum) would have (very) modestly contributed to the increase of life expectancy. In the other countries, car ownership hindered the increase. (The data is also from the WHO section on Road Safety while the life expectancy data is from the World Bank Database)

This does not alter the trend of life expectancy in Cuba dramatically, but it does alter it in a manner that forces us, once more, to substract from Castro’s accomplishments. This increase would not have been the offspring of the master plan of the dictator, but rather an accidental side-effect springing from policies that depressed living standards so much that Cubans drove less and were less subjected to the risk of dying while driving. However, I am unsure as to whether or not Cubans would regard this as an “improvement”.

Below are the comparisons between Cuba, Chile and Brazil.


The other parts of How Well Has Cuba Managed To Improve Health Outcomes?

  1. Life Expectancy Changes, 1960 to 2014
  2. Car ownership trends playing in favor of Cuba, but not a praiseworthy outcome
  3. Of Refugeees and Life Expectancy
  4. Changes in infant mortality
  5. Life expectancy at age 60-64
  6. Effect of recomputations of life expectancy
  7. Changes in net nutrition
  8. The evolution of stature
  9. Qualitative evidence on water access, sanitation, electricity and underground healthcare
  10. Human development as positive liberty (or why HDI is not a basic needs measure)

8 thoughts on “How Well Has Cuba Managed To Improve Health Outcomes? (part 2)

  1. I’m going to have to dig into the Demography article, but I have a hard time believing automobile ownership decreases life expectancy. I’ll grant you that many people die on the road, but automobile ownership and improved transportation infrastructure also increases the ease of transporting the sick to hospitals. There is probably a (literal) congestion effect where having too many cars leads to higher death rates because ambulances can’t get to and from the hospital quickly enough.

  2. Yes it does, all else being equal, if I don’t drive I don’t have accidents. There are probably forces that car ownership increases life expectancy, but it will be twice removed and probably not causal in the sense that being richer means better food (which raises LE) but also means more cars.

    • Eh- Mind if I get back to you on this in a few weeks? I want to play with the numbers myself.

  3. Also, its worth pointing out that Cuba has a low fatalities rate per 1,000 persons but that’s because it has few cars. It has the highest rates of fatalities per car though!

  4. There is also the consideration that with fewer cars, people walked more instead of driving. There is a relationship between physical exercise and life span. Cubans walking more might be one of the reasons why Cuba’s life span was as high as it was.

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