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The fall of Communism in the late 1980's had disastrous consequences for the economy of one of the world's last Communist countries, Cuba. Situated just 90 miles (145 km) south of the United States, the United States had placed an economic embargo on its island neighbor, and Cuba had curried economic favors from the old Soviet Union as a diplomatic irritant and military threat to the USA. But with the changes to the Soviet economy begun under perestroika under Mikhail Gorbachev, and then the collapse of the Soviet Union, Cuba lost its patron, and a large part of its trade.
Before 1989, Cuba had trade with the Soviet Union that brought its economy food and oil roughly $8.5 billion per year. After Russia left the Soviet Union and began to develop a capitalist economy, Cuban trade with Russia fell to just $750 million per year. The late Venezuelan leader Hugo Chavez subsidized the Cuban economy with several billion dollars worth of oil, but the Venezuelan assistance amounted to less than 10% of the former level of trade with the Soviet Union, and came at the cost of Cuba's sending many of its doctors to Venezuela and the rest of South America.
Cuba's economic crisis at first had profound effects on medical care
An estimated 800,000 Cubans were not able to get asthma medicine. During the years 1988 through 1990, many Cubans gave up plans to expand their families. There were 9 abortions for every 10 births. And in the late 1980's, over 50,000 Cubans suffered optical neuritis, causing loss of sight, because they were not able to find even minimal meat and fortified flour containing B vitamins.
As the Cuban economy stabilized, however, it turns out that there were several areas of public health that actually benefited. A recent report in the British medical journal BMJ tells us that:
- The average Cuban lost 5.5 kilos (11 pounds) of body fat in the late 1980's due to the inability to obtain food, and
- The rate of diabetes in the Cuban population fell from 1.8% just before the economic crisis to just 1% five years into the economic crisis.
- The rate of heart disease deaths in the Cuban population fell from 120 deaths for every 10,000 people per year just before the crisis, to 80 deaths for every 10,000 people 5 years into the crisis, a reduction of about 33%.
- The rate of obesity fell from 15% to 6%.
It took from 1989 until 2011 for the Cuban economy to recover sufficiently that most Cubans once again were able to obtain adequate calories, carbohydrates, fat, protein, and vitamins in their diets. As Cuba received more fuel from abroad, Cubans were more able to take buses for local travel and farming required far less manual labor. However, as Cubans began to eat more, some of the diseases associated with overweight rebounded, too.
- The rate of diabetes fell 53% during the economic crisis, and then rose 140% as the economy recovered.
- The rate of deaths from heart disease did not increase as people got more to eat, but did not fall with the introduction of new technology, either.
- Four times as many Cubans were obese in 2011 than in 1996.
It's worth noting, however, that even now, Cuba's rates of diabetes and heart disease are less than 1/6 of the rates of diabetes and heart disease of the American state with the economy most similar to Cuba's, Mississippi. Mississippi suffers shortages of many things, but there has not been, at least in nearly 150 years, any kind of food shortage in the Mississippi. Could a food shortage actually be a good thing?