ALCOHOLISM IN LATIN AMERICA

For the purposes of this discussion. the name Latin America will be used in reference to that part of the Americas that extends from Mexico south to the Antarctic. Excluding the area's former and current British, American, and Dutch possessions, the region includes 21 independent countries and five overseas French territories. At present. its total population is about 300 million. With an average annual growth rate of 2.9Yc. this number is expected to double before the end of the century. It is pertinent to note here that Latin America, as a whole, qualifies among the regions of the world that are a t early stages of social development. Allowing for some subregional differences. its demographic and social characteristics are, by and large, typical o f the developing countries. Such conditions must be considered when attempting to approach and evaluate any health problem that affects its population. For instance. close to 50%) of Latin Americans are still living dispersed or isolated in small rural communities of less than 2000 people.' O n the other hand, the industrial development process is provoking active internal migrations, and the large urban centers of the region are growing a t an alarming pace. SHo Paulo, Brazil offers a good example: its population has doubled in less than 20 years. There are a t present 15 cities with more than one million inhabitants on the Continent. Understandably, s ixable sectors of such urban agglomerations are poorly organized. poorly serviced, and present rather high degrees of social pathology. The distribution by age groups in the Latin American population shows differences from that of more developed areas. FIGUKE 1 indicates that 42% of Latin Americans are less than 15 years old. whereas this age group amounts to only 29% of the total population in North America. The older age groups (above 45 years), on the other hand. have a larger representation in the latter (30 vs 14%). This finding is consistent with the higher birthrate and shorter life expectancy observed in Latin Arne rica. 1-here are clear indications that overall health and sanitary conditions are poorer in this Continent than in the more developed regions. In 1972, infective and parasitic diseases were responsible for 19% of all deaths. whereas in North America. this figure was less than 1%. This situation is more easily understood when one considers that in 1973. a mere 39.5% of the urban and 4.3% of the rural inhabitants of Latin America were registered as receiving the services of water and sewerage systems. The general conditions of poverty in which the people of the Continent live become evident when examining child mortality and malnutrition rates. In 1972. 35.15$, of all deaths in Latin America were individuals under 5 years of age, as compared to only 4.1% in North America. In the same year, the ratio of deaths due to avitaminoses and other nutritional deficiencies was I i 100,000 in Canada and the