Chile

The Health in the Americas+¹ 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 Chile was 15 351 799 inhabitants; by 2023 this figure had risen to 19 629 590, representing a 27.9% increase. Regarding the country’s demographic profile, in 2023 people over 65 years of age accounted for 13.5% of the total population, an increase of 5.5 percentage points compared to the year 2000. In 2023, there were 101.5 women per 100 men and 74.1 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 68.4% of the total population of the country in 2023 (13 417 153 people). When we add these figures to the potentially passive population (3 568 144 under 15 years of age and 2 644 294 over 65 years of age), the result is a dependency ratio of 46.3 potentially passive people per 100 potentially active people. This ratio was 53.4 in 2000.

Life expectancy at birth in 2023 was 81.2 years, higher than the average for the Region of the Americas and 4.3 years higher that in 2000.

Figure 1. Population pyramids of Chile, years 2000 and 2023

Between 2004 and 2017, the average number of years of schooling in Chile increased by 9.1%, reaching an average of 10.6 years in the latest year for which information is available. The unemployment rate in 2022 was 7.8%. Disaggregated by sex, the rate was 8.4% for women and 7.3% for men. The literacy rate was 99.1% in 2021. In men, this figure was 99.0%; in women, 99.2%. In addition, 10.8% of the population were below the national poverty line in 2020, a decrease from 36.0% in 2000. In 2020, 0.7% of the population was living in poverty, defined as the percentage of the population with an income of less than US$ 1.90 per day; this is below the regional average of 3%. 

During the period 2000-2021, the country improved its score on the Human Development Index, with an increase of 12.1% (from a score of 0.763 to a score of 0.855); during the same period, the index rose 13.5% internationally and 9.4% in Latin America (Figure 2).

Figure 2. Human Development Index in the Region of the Americas, 2021

In 2021, public expenditure on health accounted for 5.17% of gross domestic product (GDP) (Figure 3) and 15.47% of total public expenditure, while out-of-pocket spending on health accounted for 28.87% of total health expenditure.

Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2020

Digital coverage

In 2021, 90.2% of the population had an internet connection, representing a considerable increase from 2000, when 16.6% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2019, infant mortality in Chile decreased from 8.9 to 6.5 deaths per 1000 live births, a decrease of 27.0% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 5.6% to 6.7% between 2003 and 2020.

Regarding the immunization strategy, measles vaccination coverage was 94.0% in 2022, a decrease of 3.0 percentage points from 2000.

The maternal mortality ratio for 2020 was estimated at 15.0 deaths per 100 000 live births, a reduction of 53.8% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated that in 2023 women had an average of 1.5 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 65.3% decrease, from 61.3 live births per 1000 women aged 15 to 19 years in 2000 to 21.3 in 2023. In 2020, 99.9% of births were attended by skilled birth personnel.

Figure 4. Infant mortality per 1000 live births, 1995–2020

Figure 5. Maternal mortality per 100 000 live births, 2000–2020

Communicable diseases

In 2021, there were 13 new cases of tuberculosis per 100 000 population in Chile. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 1.5 (1 in women and 2.2 in men).

In 2020, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 23.0 per 100 000 population. The age-adjusted mortality rate for HIV was 2.5 per 100 000 population in 2019. It should be noted that during the 2000-2019 period this indicator decreased by 17.1%. There were no reported cases of human rabies in the country in 2020.

Noncommunicable diseases and risk factors

In Chile in 2023, the prevalence of tobacco use among people aged 15 and older was 27.2%. In the same age group, the prevalence of overweight and obesity was 63.1% in 2016.

Also in 2016, 26.6% of the population reported insufficient physical activity.

In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 20.9%, a decrease of 5.8 percentage points compared to 2000 (26.7%). The prevalence of diabetes mellitus, which stood at 8.7% in 2000, increased to 10.5% in 2014.

Mortality

In 2019, the adjusted rate of potentially avoidable premature mortality in Chile was 139.1 deaths per 100 000 population, a decrease of 30.6% compared to the rate of 200.3 in 2000. This meant that in 2019 the rate in the country was 38.6% lower than the average rate reported for the Region of the Americas as a whole. Among potentially preventable premature deaths, the rate for preventable causes was 79.1 per 100 000 population in 2019, which is 42.3% lower than the regional average rate; and the rate for treatable causes was 60 per 100 000 population, below the regional average of 89.6. 

The overall age-adjusted mortality rate was 4 per 1000 population in 2019, a decrease of 29.8% compared to 2000 (5.7 deaths per 1000 population).

When deaths are categorized into three main groups, it is observed that, in 2019, the age-adjusted mortality rate from communicable diseases was 29.5 per 100 000 population (36.7 per 100 000 in men and 23.6 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 328.9 per 100 000 population (403.8 per 100 000 in men and 271.2 per 100 000 in women). The rate of age-adjusted mortality from external causes was 38.4 per 100 000 population (61.2 per 100 000 in men and 16.6 per 100 000 in women), including road traffic accidents (13.5 per 100 000 population), homicides (3.9 per 100 000 population), and suicides (8 per 100 000 population). In 2000, the percentage distribution of causes was 79.1% for noncommunicable diseases, 10.9% for communicable diseases, and 10.1% for external causes; in 2019, the percentages were 85.1%, 7.1%, and 7.8%, respectively (Figure 6).

Figure 6. Proportional mortality in Chile, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019 the adjusted mortality rate from prostate cancer was 20.2 per 100 000 men; lung cancer, 17.4 per 100 000; and colorectal cancer, 12.8 per 100 000. In women, these values were 11.8 deaths per 100 000 for breast cancer; 9.3 per 100 000 for lung cancer; and 9.7 per 100 000 for colorectal cancer.

The health situation and the COVID-19 pandemic

In Chile in 2020, there were a total of 608 973 cases of COVID-19, representing 31 284 per million population. In 2021, there were 1 197 521 identified cases, equivalent to 61 519 per million population, while in 2022, there were 2 769 119 reported cases, equivalent to 142 256 cases per million population. In 2020, there were 16 608 deaths directly caused by COVID-19 in people diagnosed with the disease, or 853 per million population, while in 2021, 22 507 deaths were reported, or 1156 per million. There were 21 979 total deaths in 2022, or 1120 deaths per million population. In 2020, Chile ranked seventh in the Region of the Americas in terms of the number of deaths from COVID-19, 20th in 2021, and second in 2022, with a cumulative 3129.75 deaths per million population over the three years (Figure 7). 

According to estimates by the World Health Organization,  there were a total of 14 575 excess deaths in 2020, or 75.5 per 100 000 population. A total of 24 122 deaths were estimated in 2021, for an excess mortality rate of 123.7 per 100 000.

As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 93.7% of the country’s population. As of 20 April 2022 (latest available data), 91% of the population had completed the vaccination schedule. The vaccination campaign began on 20 December 2020, and four types of COVID-19 vaccine have been used to date.

Figure 7. Cumulative COVID-19 deaths in the Region of the Americas, to July 29th, 2023

Prospects

Measures to achieve universal health coverage

The current government, whose term began in 2022, established in its plan the determination to move towards a universal and unified health system, bringing greater equity in health care for all the country's inhabitants. Specifically, the measures embodied in the plan include creating a universal health fund to ensure the financial sustainability of the health system, along with access to health care when needed; strengthening the national health system to improve the quality and timeliness of public health care services; extending universal primary health care to the entire population; developing a digital health strategy; financing investments for health infrastructure and equipment, and for free access to certain medicines; creating a national observatory to monitor efforts to reduce gaps in human resources for health; addressing the need for an intercultural approach to health; and prioritizing comprehensive cancer and mental health care.

Challenges related to population health

Today, Chile's main challenge is to reach an agreement, within the framework of reforming the Chilean Constitution, on a vision of a health system that meets the country’s needs, while promoting the transformations necessary to make that approach progressive and sustainable. The proposal for reforming the Constitution, which was submitted to a public plebiscite in September 2022, enshrines the right to health and the existence of a universal, public, and integrated State-controlled national health system. Such a health system should respect the principles of equity, solidarity, interculturality, territorial relevance, decentralization, efficiency, quality, timeliness, a gender approach, progressivity, and non-discrimination.  The proposal also envisages that the funds for financing this health system should come from nation’s general revenues and from mandatory solidarity contributions. 

In the end, the plebiscite rejected the proposed text of the new constitution and, as of the time of this report, a public debate on implementation of a new constitutional process is underway. The government is proposing to implement the reforms pursuant to the new constitutional mandate, and includes in its government program, among other reforms, the creation of a unified health fund.

COVID-19 pandemic response

Efforts to respond to the pandemic include the following initiatives:

• Strengthening health system governance, drawing on the participation of local authorities and in consultation with experts, in order to facilitate timely and effective decision-making. 
• Development of a new version of the Step-by-Step plan,  which establishes the health measures most appropriate to the communes, taking into consideration numerous factors. 
• Promotion of risk communication and intersectoral actions, particularly in relation to the education sector and to professional settings and workplaces.
• Continuation of the successful program for vaccinating the population and use of a “mobility pass.” 
• Continuing efforts on a variety of key plans and programs, such as the Protected Borders plan.  
• Prioritizing health care for conditions not linked to COVID-19, by strengthening primary care services and hospitals, in order to reduce access problems caused by the pandemic.
   

Measures to reduce inequalities in health

Public policies are focused on reducing inequalities, through a cross-cutting approach that encompasses various dimensions. In terms of income, for example, two initiatives have been proposed: increasing the minimum wage and creating a universal basic pooled pension for older people. 

Another important factor for reducing inequalities between the various population groups concerns the territorialization approach and regionalization process, involving the transfer of competencies and financing to regional governments, in areas such as transport and mobility, as well as digital infrastructure and internet access.

National strategy to address inequalities in health

Reducing inequities and inequalities in health encompasses all objectives of the national strategy, in a cross-cutting and comprehensive manner. Equity is therefore a key axis of all of the policies prioritized in the National Health Strategy 2021–2030.  Through a cross-cutting approach, each health service provided, and each prioritized policy and/or strategy will come with guaranteed improvements in access, timeliness, and quality of health care. 

The sources of the interagency indicators used in this profile can be found in this table.

For the latest data on health indicators for the Region of the Americas, be sure to visit the PAHO Core Indicators portal.