MIDDLE AMERICA AND CARIBBEAN

Trends in Middle America and Caribbean depend heavily on what happens in Mexico and Cuba, as they have the predominant populations, but survey data are scarce in these countries. Underweight prevalences are generally fairly low, and the impression from existing data is that they fell more rapidly in the '80s than in the '90s. In Jamaica, for example, the improvement was rapid from 1985 to 1989, but the prevalence increased since then, as shown in Figure 7. The calculated average trend in underweight is shown in Panel 6B, essentially static in the 1990s.

Although average GNP per caput grew substantially in the last ten years, poverty levels (estimated for Latin America and the Caribbean together) remained at around 23%, which may explain the persistent underweight in the '90s. Another possible reason that underweight may not have fallen in response to economic growth is that while the average relationship shows a steep slope below around $700 GNP/caput/year, this slope is much less pronounced above that, and nearly flat around $2,000; in other words, at relatively low prevalences and higher GNP, economic growth does not appear to translate to any great extent into lower underweight.⁷

Food availability stayed at nearly 3000 kcals/head/day, indicating that food security should not be a major constraint to further improving nutrition in the region. The health indicators equally show reasonable access to health services and safe water. Girls' secondary education is more than 50%, and total fertility rate is approaching three. In general the conditions exist for further improvement in nutrition in the near future.

Figure 7. Trends in prevalence of underweight children from repeated national survey results, 1985-1995