Education improves health situation in Puerto Rico

The health situation of people in Puerto Rico is improving markedly as a result of better promotion and education efforts, according to Dr. Johnny V. Rullán, secretary of health of Puerto Rico.

Speaking at the Pan American Health Organization (PAHO), Rullán said reforms in the health sector giving greater access to health facilities were combined with a "Health Recommends" campaign for better nutrition, physical activity, smoking cessation, and stress relief to improve health indicators.

The Health Department convinced restaurants, including fast-food places, to offer heart-healthy menus showing a red heart next to the healthy items, Rullán recounted. The restaurants found that sales of those items increased strikingly and the department received a distinguished public health service award for its health promotion efforts, he said.

"We don't believe in health fairs because they're usually one-shot efforts. Instead, we've launched wellness programs in 300 communities," using applied field epidemiology, electronic health information, and much better data collection and integration to focus on solving the most prevalent health problems, he said.

With a population of 3.8 million, Puerto Rico achieved a reduction in infant mortality from 19 deaths per 1,000 live births in 1980 to 9.2 deaths per 1,000 last year, and its average life expectancy is now 76 years, he said. However, women's life expectancy is eight years higher than men's, which has not risen over the past 30 years, he noted.

The leading causes of death in Puerto Rico are heart disease, cancer, diabetes, hypertensive diseases and accidents. These rankings led health officials to launch health promotion and prevention efforts to reduce the top four causes, and to launch its Healthy People 2010 program along with disease management efforts focusing on asthma, diabetes, hypertension and heart problems, Rullán said.

The department is also closely tracking health expenditures and linking them electronically with health status indicators, with the aim of computerizing all health information, he said. "We're asking doctors to get rid of their pencils because that data creates an island," Rullán said. "We want to have all the information in electronic form," he said.

PAHO, established in 1902, works with all the countries of the Americas to improve the health and quality of life of their peoples. The oldest public health organization in the world, PAHO also serves as the Regional Office for the Americas of the World Health Organization.