RESUMO
Doctors have played an important role in the development of health institutions in Latin America. However, they are not the only profession that has had a voice in these matters. There are also other factors influencing the development of ministries of health. This issue has gone unnoticed in the literature. This article suggests that it is possible to identify two distinct trends in the creation of health ministries in Latin America. The first, of an early nature, was seen principally in Central America and the Caribbean in countries dependent on or under the influence of the United States which, from the 1880s, promoted health Pan-Americanism. The second trend, which became apparent from 1924, was characterised by the emergence of ministries in a context of institutional breakdown and the appearance of new actors (military or populist leaders). This second trend was first seen in Chile in 1924. This article analyses the creation of the Ministerio de Higiene, Asistencia y Previsión Social (Ministry of Hygiene, Assistance and Social Security) in Chile in 1924 and its subsequent development through to 1931. The analysis looks at the health measures adopted, the context in which this occurred and the debates triggered by the ministry's process of institutional development, based on parliamentary discussions, presidential speeches, official statistics, legislation, documents prepared by key actors and the press of the time.
RESUMO
Following Salvatore and the WHO, in this article, we provide the first long-term estimates of malnutrition rates for Chile per birth cohort, measured through stunting rates of adult males born from the 1870s to the 1990s. We used a large sample of military records, representative of the whole Chilean population, totalling over 38 thousand individuals. Our data suggest that stunting rates were very high for those born between the last three decades of the nineteenth century and the first two decades of the twentieth century. In addition, stunting rates increased from the 1870s to the 1900s. Thereafter, there was a clear downward trend in stunting rates (despite some fluctuations), reaching low levels of malnutrition, in particular, from the 1960s (although these are high if compared to developed countries). The continuous decrease in stunting rates from the 1910s was mainly due to a combination of factors, the importance of which varied over time, namely: Improved health (i.e., sharp decline in infant mortality rates during the whole period); increased energy consumption (from the 1930s onwards, but most importantly during the 1990s); a decline in poverty rates (in particular, between the 1930s and the 1970s); and a reduction in child labour (although we are less able to quantify this).