142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Health and wellbeing: Qualitative impressions from a brief APHA-MEDICC trip to Cuba

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 12:30 PM - 12:42 PM

Scott Rhodes, PhD, MPH, CHES, FAAHB , Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
Background: The Cuban health system is highly structured, based in prevention, and has produced positive community health outcomes. Infant-mortality is lower and life expectancy is higher than in the US. Vaccination rates are among the highest in the world. The APHA-MEDICC delegation to Cuba in January 2014 was designed to increase understanding of the Cuban approach to health, healthcare provision, and equity.

Methods: Over the course of one week, total of 12 venues (e.g., polyclinics, provider training programs, and community-based organizations) were visited. Venues included multiple Cuban presenters and discussants and opportunities for dialogue.

Handwritten fieldnotes were maintained and analyzed using inductive qualitative content analysis to identify themes.

Results: Eleven themes, which characterize the Cuban system, emerged, including: extensive use of data to guide priorities; appreciation of inter-sectorality (all sectors contribute to, and are responsible for, health); focus on community health; local orientation to health (e.g., providers know individuals and families and conduct daily outreach, and volunteers are relied on to support efforts); and use of complementary medicine.

Challenges also emerged, including: limited ability to evaluate efforts (e.g., HIV prevention efforts among Cuban men who have sex with men [MSM]); racism; potentially reduced confidentiality of health records (particularly pertinent for those with HIV); decreased environmental health; increased access to unhealthy food contributing to obesity among well-resourced Cubans; and US embargo against Cuba.

Conclusions: The Cuban system has much to teach; however, more research is needed. Increased understanding will be facilitated by considering both culture and ideology to increase thorough understanding.

Learning Areas:

Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
List the steps in a systematic approach to qualitative data collection, analysis, and interpretation using fieldnotes; Describe the Cuban healthcare system, including successes, characteristics, and challenges; and Identify research gaps and potentials for further research.

Keyword(s): Community Health Programs, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am PI of multiple NIH- and CDC- research studies particularly focusing on HIV prevention within Latino and sexual minority communities. I have published >100 peer-reviewed papers on CBPR and HIV prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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