Lessons from Cuba: Tailoring Public Health for Integrated Care

Health professionals from US institutions acted globally through travel to Havana to observe Cuba's health system and have returned ready to act locally by putting lessons learned into practice. Marazul Charters organized the one-week research program, with MEDICC (Medical Education Cooperation with Cuba) consulting. Issues related to health equity and community engagement were discussed with Cuban health care system leaders. The strengths and challenges of Cuba's integrated health care system will be reviewed and insights informing public health practice in the US will be identified. Data were collected from key informant interviews, as well as observations, and published public health statistics. The Cuban health care system derives its strength from focusing on intersectorial collaboration, incorporating social determinants of health in models of education and standards of care, resourcefulness, and tailoring to population needs. Several key indicators highlight the successes of a system founded on prevention and primary care, including low infant and AIDS-related mortality rates. Even with a seemingly comprehensive approach, Cuba's health care system faces several challenges. These include obesity and chronic disease rates on par with developed nations. The country's approach to respond to the fundamental question will be discussed: what type of system needs to be built in order to achieve optimal health for all citizens? Finally, an analysis of Cuban and US public health and medical systems show different health metrics in several areas. Moving forward, each respective country can inform key public health successes and challenges, bridging research and practice gaps to improve health outcomes.