The Health in the Americas+ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. In some cases, the values of the indicators may differ from the most recent data available in the country.
Environmental and social determinants of health
In 2000 the total population of Aruba was 89 101 inhabitants; by 2023 this figure had risen to 106 277, representing a 19.3% increase. Regarding the country’s demographic profile, in 2023 people over 65 years of age accounted for 16.9% of the total population, an increase of 9.9 percentage points compared to the year 2000. in 2023, there were 112.3 women per 100 men and 107.3 older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country’s population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 67.4% of the total population of the country in 2023 (71 665 people). When we add these figures to the potentially passive population (16 698 under 15 years of age and 17 914 over 65 years of age), the result is a dependency ratio of 48.3 potentially passive people per 100 potentially active people. This ratio was 43.2 in 2000.
Life expectancy at birth in 2023 was 76.9 years, lower than the average for the Region of the Americas and 3.3 years higher that in 2000.
Figure 1. Population pyramids of Aruba, years 2000 and 2023
Between 2000 and 2010, the average number of years of schooling in Aruba decreased by 2.8%, reaching an average of 8.4 years in the latest year for which information is available. The literacy rate was 99.5% in 2020. In men, this figure was 99.4%; in women, 99.6%.
In 2017, 97.2% of the population had an internet connection, representing a considerable increase from 2000, when 15.4% of the population had an internet connection.
Maternal and child health
Between 2000 and 2019, infant mortality in Aruba decreased from 5 to 1 deaths per 1000 live births, a decrease of 80.0% (Figure 4). The percentage of low-weight births (less than 2500 g) decreased from 7.7% to 7.3% between 2009 and 2020.
Regarding the immunization strategy, measles vaccination coverage was 92.0% in 2022, a decrease of 3.0 percentage points from 2000.
In relation to fertility, it is estimated that in 2023 women had an average of 1.2 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 70.4% decrease, from 44.9 live births per 1000 women aged 15 to 19 years in 2000 to 13.3 in 2023. In 2020, 100.0% of births were attended by skilled birth personnel. Between 2000 and 2019 the percentage of pregnant people who received antenatal care remained unchanged at 100%.
Figure 2. Infant mortality per 1000 live births, 1999–2019
In 2021, there were 6 new cases of tuberculosis per 100 000 population in Aruba.
In 2020, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 38.5 per 100 000 population.
The health situation and the COVID-19 pandemic
In Aruba in 2020, there were a total of 5 442 cases of COVID-19, representing 51 088 per million population. In 2021, there were 14 330 identified cases, equivalent to 134 526 per million population. In 2020, there were 49 deaths directly caused by COVID-19 in people diagnosed with the disease, or 460 per million population; in 2021, 132 deaths were reported, or 1 239 per million. In 2020, Aruba ranked 14th in the Region of the Americas in terms of the number of deaths from COVID-19, and 16th in 2021, with a cumulative 1699 deaths per million population over the two years (Figure 3).
As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 73.6% of the territory's population. As of 20 April 2022 (latest available data), 77.3% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and two types of COVID-19 vaccine have been used to date.
Figure 3. Cumulative COVID-19 deaths in the Region of the Americas, to July 29th, 2023
Measures to achieve universal health coverage
In response to these health priorities, the Government of Aruba has developed a National Multi-Sectoral Action Plan for Non-Communicable Diseases (2020–2030), with the following 10-year goal: "By 2030, increase the protective factors for NCDs, while reducing the modifiable risk factors, using an evidence-based approach through multi-sectoral actions to enable sustained behavior change with a particular focus on prevention." The guiding principles include a commitment to universal health coverage, health equity, and multisectoral solutions (health in all policies). Implementation is driven by four strategic goals: (1) establishing effective leadership and governance for the implementation of a Strategic Multi-Sectoral Action Plan for the prevention and control of noncommunicable diseases; (2) strengthening noncommunicable disease surveillance, monitoring, evaluation, reporting, and decision-making as part of the national information systems for health; (3) reducing noncommunicable disease risk factors, promoting protective factors, and addressing the social determinants of health; and (4) strengthening the integration of preventative and curative services for the effective management of noncommunicable diseases, including self-management. Equitable access to health care is a central aspect of the associated Aruba National Strategic Plan (2020–2022), which advocates for equitable and direct access to basic services, including health. It specifically aims to address the needs of populations in situations of vulnerability in society, including strengthening mental health support, and child protection frameworks.
Challenges related to population health
The health systems in the Dutch Caribbean largely mirror that of the Netherlands. The general practitioner is the first point of contact and is the cornerstone of primary health care. In Aruba, the responsibility for ensuring quality health care and developing legislation, guidelines, and policy falls within the remit of the Ministry of Health, while the Netherlands oversees the operations of the hospitals and other clinical services provided on the island. Aruba's population is aging, and the increasing proportion of older adults is predicted to continue. In 2020, the proportion of Aruba's population aged 65 and older was 15.0%. This proportion is predicted to rise further to 22.3% by 2040, and to 26.1% by 2060. Over the period 1999–2017, noncommunicable diseases were the leading cause of death in Aruba. Overall, the top four causes of death were cardiovascular diseases, cancers, diabetes, and chronic respiratory diseases. In women, the top four causes of death were cerebrovascular disease, diabetes, ischemic heart disease, and breast cancer, while the top four for men were ischemic heart disease, cerebrovascular disease, heart failure, and diabetes. Morbidity data in Aruba remain less accessible, with self-reported information available from the population census. The 2010 census recorded one chronic health condition reported by about 32% of the population; with about 50% of persons over the age of 65 reporting at least one chronic condition.
COVID-19 pandemic response
The negative social and economic shocks of the COVID-19 pandemic highlighted frailties within Aruba's healthcare system. With the Dutch Government a plan is being developed to address preparedness and response capacity. With the Dutch Government, Aruba is working on a "kingdom-wide" plan to address the preparedness and response capacity among the islands. For Aruba, the guiding document Repositioning Our Sails: Aruba's Mission Driven Model for Economic Recovery & Resilience documents the political and civic commitment for structural reforms and the goals for sustainable, stable, and resilient economic recovery. It sets out the long-term economic aspirations, and details shorter-term benefits, for example, increasing the robustness of the healthcare system. The plan's development is complemented by Pan American Health Organization (PAHO) technical cooperation activities centered on health systems and services. The activities are aimed at strengthening policy development and facilitating the identification, reporting, and management of the COVID-19 response.