PAN AMERICAN HEALTH ORGANIZATION

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Contribuciones de las distintas Organizaciones y
Agencias Internacionales y de Cooperación a la SSO
OPS El Salvador, 29-30 Abril 2004

• PAN AMERICAN HEALTH ORGANIZATION
• Pan American Sanitary Bureau, Regional Office of
  the
• WORLD HEALTH ORGANIZATION

DR. LUZ MARITZA TENNASSEE Sustainable
Development and Environmental Health
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Globalization Strengths and weaknesses
Beneficial effect
Adverse effect
57 annual growth trade and world production
Harder competition developing countries
Global market provides benefit of scale
Home markets are put under pressure
Higher efficacy and quality
Compromising health and safety standards
Unphysiological time schedules, sleep debt,
vigilance problems
Elimination of time dimension from global market
lt costs of storage, high flow of production
Tight deadlines, psychological stress. physical
overload
unconventional work hours, source of flexibility
human labour
Adapt to global market
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Environmental Workers Health
Occupational Health and Safetya high priority
in the global, international and national agenda
Kofi A. AnnanSecretary General United Nations

• Protect the health and safety of workers
• Strengthen and promote ILO and WHO programmes to
  reducr occupational deaths, injuries and
  illnesses.
• Link occupational health with public health
  promotion

Johannesburg Summit 2002
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UN Millennium Development Goals Relation to
Workers Health
CONTRIBUTION
GOALS

• Synergy with Labor Ministers, Private Sector,
  NGOs Unions to Create and Maintain a Healthy
  Workplaces

• Eradicate Extreme Poverty and Hunger

• Basic Skills for Women to Utilize Housing and
  Working Facilities

• Promote Gender, Equality and Empower Women

• Improvement in Working Conditions to promote and
  protect parental Health

• Reduce Child Mortality and Improve Maternal Health

• Through Promotion in the Workplace and healthcare
  Sector

• Combat HIV/AIDS

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UN Millennium Development Goals Ensuring
Environmental Sustainability
Integrate the Principles of Sustainable
Development into Country Policies and Programs
and reverse the loss of Environmental Resources
TARGET

• Regional Plan on Workers Health/Health
  Workplaces Initiatives
• Linkages between Health and Labor PAHO/ILO

CONTRIBUTION
By 2020 to have achieve a significant improvement
in the Lives of at least 100 million slum
Dwellers phase out and eradication
TARGET
Creation of Healthy, Safe and Decent Workplaces
CONTRIBUTION
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SITUATION ANALISIS IN THE AMERICAS INEQUITIES
INSTITUTIONAL DISPERSION - REFORMS
EAP 351 million (gt 50 Americas
population). - 69 million below poverty
line. - 52 Informal Sector ( women,
children, migrants, indigenous) - 49 women
- 24 million children work. 36 Injuries /
minute 5 Million injuries / year 5 Million
injuries / year 90,000 Fatal Injuries / year
Morbidity Traditional occupational illnesses,
along with cancer, asthma, depression,
cardiovascular, musculoskeletal , immunological,
and nervous system, and re-emerging diseases. 9
- 12 of GDP in LAC 30 Receives Occupational
Health Services (formal sector)
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The Workers Health Plan
Driving Forces Globalization, Integration, Technol
ogical Change Reform of the State, Inequities
ACTION Health Policies and Legislation
Quality of the Work Environment Promotion of
Workers Health Comprehensive Workers Services
Pressure Technology Transfer, Non- traditional
Expoprt Production Increase Maquila
State Workforce Composition, Migration,
Precarious L.M, Poverty Feminization
Exposure (Environmental) Psychosocial,
Ergonomic, Chemical, Biological, Safety Physical
Effect Lost workdays, Occupational Accidents
Diseases, Lower Productivity, Social Costs
DPSEEA Model
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Economic impact
The Breakdown of Costs for Work-related Injuries
and Diseases
Injuries 14
Heart diseases 16
Musculoskeletal 40
Respiratory diseases 9
Nervous Central System 8
Others 13
Other diseases include cancer, skin diseases and
mental disorders
Source ILO, 1999
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The Regional Workers Health Plan
III Summit of the Americas 2001

• XII Inter-American Conference of the Ministers
  of Labor
• October 2001- Septiembre 2003
• Declaration and Plan of Action (OAS, ILO, PAHO,
  IDB, WB, ECLAC)
• Workers Health

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Agreement PAHO - ILOExtend Social Protection
and Health Coverage within Excluded
Groups(ESPHC)
Approved by Directive Council
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THE CHALLENGE

• Magnitude of the Problem
• Total population of Latin America and the
  Caribbean 500 million.
• 27 of the population lacks access to permanent
  and basic health services (125 millon).
• 46 of the population does not have health
  insurance either public or private
  (230 millon).

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REASON FOR ESPHC IN THE AMERICAS REGION

• Persistent economic, social, ethnic and cultural
  exclusion.
• The present social protection mechanisms are
  insufficient to give answers to new problems.
• It is necessary for the Reform Processes to
  contribute in the construction of socially
  inclusive societies for all its citizens.

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CONDITIONS FOR THE EXTENSION OF SOCIAL PROTECTION
IN HEALTH

• Access to Services
• Home Financial Security
• Quality of Health Services

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MANDATES OF THE ILO/PAHO/WHO RELATED TO THE
EXTENTION OF SOCIAL PROTECTION IN HEALTH

• PAHO/WHO
• Reduction in inequities in the access to health
  services and in their financing
• Universal access to health services in order to
  achieve the goal of health for all
• Poverty reduction and development goals of the
  millenium

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MANDATES OF THE ILO/PAHO/WHO RELATED TO THE
EXTENTION OF SOCIAL PROTECTION IN HEALTH

• ILO
• Promote opportunities for decent and productive
  work under conditions of freedom, equity, safety
  and human dignity
• Improve the coverage and effectiveness of social
  protection for all, including protection in
  health
• New consensus of social security

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First Hispanic ForumOctober 2000

• TOPICS
• Inequities
• Environmental Justice
• Migrant Workers
• Border Health
• ACTORS
• EPA, OSHA, NIOSH (public sector)
• NSC, 3M (private sector)
• National Alliance for Hispanic Health (NGOs)
• PAHO, ILO, NAALC
  (international organizations)

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Alarming Increases in Work Accidents among
Hispanics

• Hispanic population grew by
• 58 between 1990 and 200038.3 Million in the
  US, 3.8 Million in Puerto Rico
• 12.5 of the workforce is Hispanic. They bear 15
  of the total US fatal occupational injuries.
• Fatal occupational accidents have decreased
  overall, but risen alarmingly among the Hispanic
  labor force.
• In the US there has been a 40 increase in
  fatalities among Hispanic workers in the
  construction sector.

Work Related Fatalities are Projected to Keep
rising without preventive interventions
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NATIONWIDE NETWORK AN INVITATION TO JOIN AND
SUPPORT
Hispanic Forum
3M
US-Mexico BHA
NIOSH Communications Workshop
PAHO
Summit of the Americas-OAS
NSC Puerto Rico
OSHA
Interconnectivity and Support
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Border Issues
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Border XXI Program

• To improve the environmental health of
  U.S.-Mexico border communities by identifying and
  addressing those environmental conditions posing
  the highest human health risk
• 1983 La Paz agreement designated six work groups
  (Air, water, hazardous waste, contingency
  planning, pollution prevention and cooperative
  enforcement)
• 1996 Three groups were added natural r esources,
  environmental information and environmental and
  occupational health.

Development of Environmental Health Indicators
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Migrant Farm Workers

• Most farm workers have no insurance.
• 3 to 5 million of them are Hispanic.
• Most migrant workers are men in their 20s and
  send their earnings home to their families in
  Mexico, Guatemala, Honduras, El Salvador or
  Haiti.
• Most live in poor housing and unsanitary living
  conditions.

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Healthy Work Place Initiative
Central America Andean Region
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ILO

• CONTENT
• Best Practices
• Databases
• Softwares
• Global Links
• DECIDES
• Long-Distance Education

http//www.cepis.ops-oms.org
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Current Occupation for Men by Hispanic Origin in
the US 2000
Hispanic
Non-Hispanic White
Technical, sales
Source Current Population Survey, March 2000,
PGP-4
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Current Occupation for Women by Hispanic Origin
in the US 2000
Hispanic
Non-Hispanic White
Technical, sales
Source Current Population Survey, March 2000,
PGP-4
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Percent Unemployed by Hispanic Origin and Sex in
the US 2000
(Population 16 years and over in the labor force)
Percent
Source Current Population Survey, March 2000,
PGP-4
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Percent Unemployed by Hispanic Origin and Sex in
the US 2000
(Population 16 years and over in the labor force)
Percent
Source Current Population Survey, March 2000,
PGP-4
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Percent Below Poverty Level in 1999 by Age and
Hispanic Origin in the US
Percent
Source Current Population Survey, March 2000,
PGP-4
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ECONOMIC BURDEN OSH
171
170
180
154
160
140
120
100
80
67
60
33
40
20
0
ALZH
OSH
AIDS
CANCER
CIRCUL
NIOSH/CDC
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SocialInjusticeSyndrome
Unemployment
Homicides Suicides Violence
Occupational Cancer
Alcoholism and Substance Abuse
Reproductive Problems
Occupational Stress
Infectious Diseases
Musculoskeletal Disorders
Poisoning
Accidents and Injuries
Cardiovascular Diseases
Hearing Loss
Respiratory Problems