Paul K. Drain and Michele Barry*
The U.S. trade embargo against Cuba, enacted after Fidel Castro's revolution overthrew the Batista regime, reaches 50 years in 2010. Its stated goal has been to bring democracy to the Cuban people (1), but a 2009 U.S. Senate report concluded "the unilateral embargo on Cuba has failed to achieve its stated purpose" (2). Domestic and international favor for the embargo is not strong (3). Many political and business leaders suggest changing U.S. policy toward Cuba, and President Obama eased travel and remittance restrictions of Cuban-Americans (4, 5). In light of such changes in sentiment and policy, and also the impending overhaul of U.S. health care, we review health consequences and lessons from "one of the most complex and longstanding embargoes in modern history" (2).
School of Medicine, Stanford University, Palo Alto, CA 94305, USA.
* Member of the Social Sciences Research Council Cuban Working Group of the American Council of Learned Societies.
* Author for correspondence. E-mail: firstname.lastname@example.org
The ‘top-ten’ countries (with lowest mortality) for both men and women had some surprises for both 1970 and 2010, although there was more consistency in the women’s league table. Australia moved from 44th place for male mortality in 1970 to 6th in 2010; while Paraguay, surprisingly at 5th in 1970, had dropped to 70th 40 years later. Other surprises were Cuba, at 3rd in 1970, and Costa Rica, at 10th—but both had also slid well out of the top ten to 36th and 30th respectively, by 2010. Greece had the lowest male mortality worldwide in 1970, yet by 2010 it was only 22nd in the league. Only Sweden, the Netherlands and Norway kept their top ten places in the male league over the 40 years. The top five countries today are, in order, Iceland, Sweden, Malta, the Netherlands, and Switzerland. Italy, Qatar, Australia, and Israel also moved into the top ten for 2010.
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