Uruguay - Country Profile

By PAHO/OPS, 31 August, 2022

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 Uruguay was 3 266 206 inhabitants; by 2024 this figure had risen to 3 386 588, representing a 3.7% increase. Regarding the country’s demographic profile, in 2024 people over 65 years of age accounted for 16.% of the total population, an increase of 3.0 percentage points compared to the year 2000. In 2024, there were 106.2 women per 100 men and 87.7 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 65.7% of the total population of the country in 2024 (2 223 696 people). When we add these figures to the potentially passive population ( 619 508 under 15 years of age and 543 385 over 65 years of age), the result is a dependency ratio of 52.3 potentially passive people per 100 potentially active people. This ratio was 59.8 in 2000.

Life expectancy at birth in 2024 was 78.3 years, higher than the average for the Region of the Americas and 3.6 years higher that in 2000 (74.7).

Figure 1. Population pyramids of Uruguay, years 2000 and 2024

Between 2003 and 2019, the average number of years of schooling in Uruguay increased by 0.4%, reaching an average of 9.0 years in the latest year for which information is available. The unemployment rate in 2023 was 8.4%. Disaggregated by sex, the rate was 9.5% for women and 7.4% for men. The literacy rate was 99.1% in 2022. In men, this figure was 99.4%; in women, 98.9%. In 2022, 0.2% of the population was living in poverty, defined as the percentage of the population with an income of less than US$ 2.15 per day; this is below the regional average of 2.6%.

During the period 2000-2022, the country improved its score on the Human Development Index, with an increase of 10.1% (from a score of 0.754 to a score of 0.83); during the same period, the index rose 14.6% internationally and 11.2% in Latin America (Figure 2).

Figure 2. Human Development Index in the Region of the Americas, 2022

In 2021, public expenditure on health accounted for 6.93% of gross domestic product (GDP) (Figure 3) and 22.42% of total public expenditure, while out-of-pocket spending on health accounted for 15.44% of total health expenditure.

Figure 3. Domestic general government health expenditure as percentage of gross domestic product, 2021

Digital coverage

In 2021, 90.1% of the population had an internet connection, representing a considerable increase from 2000, when 10.5% of the population had an internet connection.

Health situation

Maternal and child health

Between 2000 and 2021, infant mortality in Uruguay decreased from 14.1 to 6.2 deaths per 1000 live births, a decrease of 56% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 7.7% to 8% between 2000 and 2019.

Regarding the immunization strategy, measles vaccination coverage was 96.0% in 2022, an increase of 7 percentage points from 2000. The incidence of low-weight birth ranged from 7.7 in 2000 to 7.8 in 2020, an increase of 1.3%.

Figure 4. Infant mortality per 1000 live births, 1995–2021

The maternal mortality ratio in 2020 was estimated at 18.6 deaths per 100 000 live births, representing a 29.9% reduction compared to the estimated value in 2000 (Figure 5). In relation to fertility, it is estimated that in 2024 women had an average of 1.4 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 62.6% decrease, from 67.1 live births per 1000 women aged 15 to 19 years in 2000 to 25.1 in 2024. In 2022, 100.0% of births were attended by skilled birth personnel. Between 2000 and 2020 the percentage of pregnant people who had four or more consultations for antenatal care increased from 79.8% to 96.6%.

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

Communicable diseases

In 2022, there were 33 new cases of tuberculosis per 100 000 population in Uruguay. In 2019, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 1.7 (0.7 in women and 2.8 in men).

In Uruguay in 2022, the prevalence of tobacco use among people aged 15 and older was 20.5%. In the same age group, the prevalence of overweight and obesity was 67.6% in 2022. It should be noted that during the 2000-2019 period this indicator decreased by 12.3%.

Noncommunicable diseases and risk factors

In Uruguay in 2023, the prevalence of tobacco use among people aged 15 and older was 19.9%. In the same age group, the prevalence of overweight and obesity was 62.9% in 2016.

Also in 2016, 44.8% 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 20.7%, a decrease of 8.1 percentage points compared to 2000 (28.1%). The prevalence of diabetes mellitus, which stood at 8.2% in 2000, increased to 9.5% in 2014.

Mortality

In 2019, the adjusted rate of potentially preventable premature mortality in Uruguay was 218 deaths per 100 000 population, a decrease of 18.2% compared to the rate of 266.4 in 2000. This meant that, in 2019, the rate in the country was 3.8% 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 133.3 per 100 000 population in 2019, which is 2.8% lower than the regional average rate; and the rate for treatable causes was 84.7 per 100 000 population, below the regional average of 89.6.

The overall age-adjusted mortality rate was 5.5 per 1000 population in 2019, a decrease of 14.8% compared to 2000 (6.4 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 40.1 per 100 000 population (51.6 per 100 000 in men and 31.9 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 445.6 per 100 000 population (591.6 per 100 000 in men and 347.0 per 100 000 in women). The rate of age-adjusted mortality from external causes was 59.5 per 100 000 population (94.3 per 100 000 in men and 27.1 per 100 000 in women), including road traffic accidents (13.8 per 100 000 population), homicides (8.6 per 100 000 population), and suicides (18.8 per 100 000 population). In 2000, the percentage distribution of causes was 85.6% for noncommunicable diseases, 7.3% for communicable diseases, and 7.1% for external causes; in 2019, the percentages were 85.5%, 7.2%, and 7.3%, respectively (Figure 6).

Figure 6. Proportional mortality in Uruguay, 2000 and 2019

Cancer mortality

Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 26.9 per 100 000 men; for lung cancer; 46.2 per 100 000; and for colorectal cancer, 25.3 per 100 000. In women, these values were 26.6 deaths per 100 000 for breast cancer; 13.6 per 100 000 for lung cancer; and 16 per 100 000 for colorectal cancer.

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.

Country COVID-19 Perspective

The health situation and the COVID-19 pandemic

In 2020, Uruguay ranked 38th in the Region of the Americas in terms of the number of deaths from COVID-19, and 20th in 2022, with a cumulative 2178.0 deaths per million population for the two years (Figure 7).

According to estimates by the World Health Organization, total deaths in 2020 were fewer than expected for that year, while for 2021, an additional 5354 deaths were estimated, for an excess mortality rate of 156.3 per 100 000.

As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 85.8% of the country's population. As of 20 April 2022 (latest available data), 82% of the population had completed the vaccination series. The vaccination campaign began on 20 February 2021, and three 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

Since 2007, the Integrated National Health System (SNIS) has incorporated among its guiding principles universal coverage, equity, comprehensive care, continuity of care, and health promotion, with a focus on developing primary health care.
The financing system for ensuring the long-term sustainability of the SNIS relies on people's contributions to the National Health Insurance system, using a model in which contributions are based on income, and in which people are able to use health services according to their needs.
The care model is one of comprehensive care, within the framework of the primary health care strategy, aimed at achieving greater response capacity. This model ensures continuity of care and strives to satisfy the needs of those who use the health services.

Challenges related to population health

During 2022, responding to the COVID-19 pandemic and the many associated problems continues to be challenging. Efforts must be taken to resume the pre-COVID-19 agenda, which had to be partially cut back, particularly in primary health care services. Activities that were affected during the pandemic include the following:

Monitoring of patients with chronic conditions.
Health care for children and adolescents.
Health care for pregnant people.
The regular vaccination program, as established by the National Vaccination Program.
Screening.
Early diagnosis of degenerative diseases.
Specialist care for non-urgent outpatient consultations.
Coordinated surgeries.
Services related to mental health in general, and suicide prevention in particular.

COVID-19 pandemic response

Strengthening the health surveillance system has improved the capacity for timely responses. In addition, it has generated the information needed for decision-making and for implementing prevention and control measures adapted to changes in the course of the pandemic. Genomic surveillance, which is a source of new and valuable information, has also been incorporated,
As part of the response, the supply of health services has been adapted to the emerging epidemiological scenario, with the possibility of expanding primary care services through telemedicine, which, in addition to regular and intensive care services, has made it possible to identify strategies and procedures that can be used in similar contexts, i.e., in situations where the health care system is overloaded. Telemedicine has proven to be highly useful in improving patients’ access to health care. This is true particularly for health consultations, especially, when a face-to-face visit is not possible or when an in-person visit poses significant risks or obstacles (for example, when lengthy travel is required to reach the health facility). It also enables remote consultations and the use of tele-imaging; it can also be used for ongoing training of health personnel.

Measures to reduce inequalities in health

The current national strategy contains public policies to support the country's gradual process of recovery, by strengthening national capacities with an emphasis on reversing the socio-economic effects of the crisis (particularly in the most affected population groups).
The country's agenda on health inequalities focuses on a development model that includes key elements such as developing sustainable production systems and a green, circular economy; fostering the knowledge economy; implementing an integrated health care system; creating quality jobs with the full participation of women in the labor market and the elimination of gender gaps in pay; transforming the education system, with significant improvements in quality and equity; reforming the social security system; ensuring complete and effective equality between women and men in all areas related to public policies; eradicating gender-based violence; and protecting the rights and ensuring the social inclusion of the historically most disadvantaged population groups (people of African descent, people with disabilities, LGTBI [lesbian, gay, transsexual, bisexual, and intersex] people, and migrants, among others).

National strategy to address inequalities in health

Since 2015, the strategy of the Ministry of Public Health of Uruguay, after two public consultations on the matter, has included a list of National Health Objectives. This strategy is designed to reduce inequalities by identifying critical problems, recognizing health as a right to timely, quality care, and recognizing the effects of social determinants of health. Its implementation requires inter-institutional participation and joint action by various key stakeholders, particularly in developing regulations that address the entire spectrum of health in a comprehensive manner.
As part of the National Health Objectives for 2020–2030, the Ministry of Health has reaffirmed the four previously established health objectives, namely:

Improving the health situation of the population.
Reducing health inequalities.
Improving the quality of health care processes.
Creating the conditions for people to have a positive health care experience.