This paper considers the elements that determine the health situation in any country: the
specific hazards to health, the health services, and the general determinants which influence
both the hazards and the services. The expectation of life—the best single measure of the
health situation—is presented for each country of the Americas as representing the resultant
of these determinants. The changing pattern of disease in the Americas—the emergence of
noninfectious diseases as the major problems—is documented, and the need for …

The present health situation in the Americas must be described in terms of a spectrum rather
than a fixed point because of the great variation between countries. The position which any
country occupies in the health situation spectrum is based on the interaction of a number of
determinants, each of which also exists on a spectrum or continuum. These determinants
include the specific hazards to health: infectious and noninfectious diseases, injuries,
occupational and environmental hazards and addictions; the determinants of these specific …