Links between Population, Health, and Environment in Haiti: Contributions to Vulnerability Rochelle Rainey, Heather D’Agnes, and Scott Tobias August 2, 2006

Haiti’s Population Issues Population Size: 8.4 Million (2006 Census) Fast Growing and Young ~2% annual population growth rate Total fertility rate of 4.9 children per woman 50% of population is under the age of 20 Urbanizing Urban population growth rate of 3.63 vs. 0.92% for rural Port-au-Prince metro area annual growth rate of 5% from Low income, 2/3 are subsistence farmers 80% of population below poverty line High Unmet Need for Family Planning 40% of women expressed an unmet need Contraceptive prevalence rate 23% (modern methods)

Haiti’s Health Statistics Health StatisticHaitiDominican Republic USA Life expectancy at birth (women) Life expectancy at birth (men) Child mortality Maternal mortality

Haiti’s Health Issues Poor nutrition Access to improved water source –Urban 91%, Rural 59% Access to improved sanitation facility –Urban 52%, Rural 23% Indoor air quality and use of traditional fuels HIV prevalence ages 15-29: 5.6% (range 2.5%-11.9%)

Haiti’s Environment Issues Deforestation Soil Erosion –Reduced agricultural productivity –Landslides Availability and quality of water –Last (of 147 ranked) on 2003 water poverty index (resource, access, capacity, use, environmental impact) –Heavy rainfall on exposed soils, flooding –Coastal and marine resources degraded Biodiversity –High endemism –Highly threatened biodiversity hotspot

PHE Links in Haiti Population Need more … Health Poor… Environment Fewer…

PHE Contribution to Vulnerabilities during Natural Disasters Slides and floods Unplanned settlements on unstable hillsides and floodplains Lack of access to water and sanitation Contaminated floodwaters Rural areas isolated No excess capacity (no stored food or supplies)

1.Strengthen policy and donor attention on the linked population, health and environment dimensions of natural hazards in Haiti 2.Promote improvements in health and access to family planning as part of a national strategy that will also help reduce medium- and long-range vulnerability to natural disasters. Target youth and urban poor populations Strengthen supply chain Recommendations

3Where appropriate, integrate the provision of health and family planning information and services with interventions to conserve natural resources, both forest and coastal 4.Introduce programs for improved cookstoves along with intensive behavior change communications for adoption 5.Promote adoption of nutritious foods and sustainable agricultural techniques 6.Strengthen the capacity for emergency environmental health response to a disaster 7.Use existing community organizations to integrate activities through cross training, build local government capacity Recommendations