Cuba

Cuba is an island nation located in the Caribbean Sea, about 90 miles off the coast of the United States. It was a Spanish possession for 388 years, winning independence in 1902 after a brief period of occupation by the United States in the aftermath of the 1898 Spanish–American War. Fidel Castro took power in 1959 and declared Cuba a Communist state, leading to a long-term embargo by the U.S. government, which is still in effect. The collapse of the Soviet Union in the 1990s ended subsidies and nearly destroyed the Cuban economy. Standards of living dropped dramatically in the immediate post-Soviet era, but are once again on the rise as Cuba normalizes relations with Latin America and makes inroads with the European Union.

Cuba is the most populous nation in the Caribbean, with an estimated population of 11.4 million people and an annual growth rate of 0.31 percent. The birth rate is 11.89 per 1,000 people, the death rate is 7.22 per 1,000 people, and the migration rate is negative, with minus 1.57 migrants per 1,000 people. Sev-enty-six percent of the population live in urban areas, and the overall population density is 102 people per square kilometer. As a Socialist country, most of the economy is state controlled, with 78 percent of the workforce employed by the state in its industries. Cuba's chief exports are sugar, nickel, tobacco, citrus, and coffee; a large oil field was discovered off the coast in 2005 but has not yet been developed. Per capita income is estimated at $1,170.

Despite economic downturns in the last decade, the average Cuban has a long and fairly healthy life, on par with much richer nations. At birth, life expectancy for Cubans is currently 75.11 years for males and 79.85 years for females, with healthy life expectancy at 67 years for men and 69.5 years for women. Infant mortality is low at 6.22 deaths per 1,000. Seven of each 1,000 children die before the age of 5.

Maternal mortality is also low, with 33 fatalities per 100,000 live births. All Cuban women have access to prenatal care, and 100 percent of births are monitored by a trained attendant. About 70 percent of women use birth control. The fertility rate is 1.66 children per woman.

Heart disease is the leading cause of death, followed by cancer, pneumonia, and accidents or violence. Diabetes has been on the rise, with an estimated 480,000 cases by 2000. In recent years, the country has embarked on a far-ranging program of education and early detection that it hopes will bring the problems under control, and diabetic care centers have been set up in each province.

Major infectious diseases are rare in Cuba. There is an active malaria and dengue fever eradication program in place, and animals are vaccinated for rabies. The National Immunization Program vaccinates children against 13 separate diseases. Prevalence of HIV/AIDS is estimated to be low, at 0.1 percent. About 3,300 Cubans were said to be living with the disease in 2003.

Under the dictates of Socialism, every Cuban has the right to free healthcare, and 99 percent of citizens have access to it. The World Health Organization [Page 463]estimates the country to have approximately 67,000 physicians and 84,000 nurses. There is a well-integrated network of hospitals and clinics throughout the country. Between 1996 and 2000, hospitals reduced the number of beds by 10,000 as more and more care was taken over by home healthcare workers and outpatient clinics.

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