1. Back From the Future: Chapter 5 The Irony of Success: Social Accomplishments and their Unintended Consequences

2. Health Welfare: The Medical Delivery System G Castro’s government invested in expanding and democratizing access to the medical delivery system G Cuba came to rank among the Latin American countries with the largest number of doctors, nurses, and hospital beds G Medical training was designed to produce a new professional man G Medical students accounted for one-third of all university enrollments G Family Doctor Program G Medical facilities ran the risk of becoming museums of Castro’s once showpiece social project, just as shut-down industries became mausoleums of bygone oil-guzzling Soviet- financed development G Castro’s government invested in expanding and democratizing access to the medical delivery system G Cuba came to rank among the Latin American countries with the largest number of doctors, nurses, and hospital beds G Medical training was designed to produce a new professional man G Medical students accounted for one-third of all university enrollments G Family Doctor Program G Medical facilities ran the risk of becoming museums of Castro’s once showpiece social project, just as shut-down industries became mausoleums of bygone oil-guzzling Soviet- financed development

3. Nutrition G Government regulation on the production and distribution of food directly influence dietary patterns G ~ 20 years for average caloric consumption to surpass pre-revolutionary levels G There was a deterioration in nutritional standards in the 1960s G Improvements of the 1980s, by national and regional standards, were short-lived G Reintroduction of near-total food rationing equalized dietary consumption among socioeconomic strata once again G Government regulation on the production and distribution of food directly influence dietary patterns G ~ 20 years for average caloric consumption to surpass pre-revolutionary levels G There was a deterioration in nutritional standards in the 1960s G Improvements of the 1980s, by national and regional standards, were short-lived G Reintroduction of near-total food rationing equalized dietary consumption among socioeconomic strata once again

4. Life Expectancy and Infant Mortality G Expansion and reorganization of the medical delivery system changed the mortality in Cuba G Average life expectancy rose from fifty-nine years before the revolution to seventy-six years in 1992 G Though government social policy contributed to a marked decline in the infant mortality rate G Castro ordered prenatal intensive-care units in all maternal-infant hospitals G The rate dropped from 20 to 6 per thousand after the Family Doctor Program was initiated G Infant mortality rates continued in the pre- revolutionary tradition to vary with socioeconomic status, and class variations, diminished over the years G Expansion and reorganization of the medical delivery system changed the mortality in Cuba G Average life expectancy rose from fifty-nine years before the revolution to seventy-six years in 1992 G Though government social policy contributed to a marked decline in the infant mortality rate G Castro ordered prenatal intensive-care units in all maternal-infant hospitals G The rate dropped from 20 to 6 per thousand after the Family Doctor Program was initiated G Infant mortality rates continued in the pre- revolutionary tradition to vary with socioeconomic status, and class variations, diminished over the years

5. Fertility Decline G Cuba’s birth and fertility rates had come to resemble that of the First world in Castro’s first five years of rule. G Later dropped to the lowest regional standards. G Women under Castro appeared to have fewer children by choice. G With infant mortality rate low, women wanted fewer kids. G Changes in the health care delivery system made it possible for women’s ideal family size to become reality. G Cuba (like other third world countries) came to apsire to a drop in the population growth rate. G Cuba’s birth and fertility rates had come to resemble that of the First world in Castro’s first five years of rule. G Later dropped to the lowest regional standards. G Women under Castro appeared to have fewer children by choice. G With infant mortality rate low, women wanted fewer kids. G Changes in the health care delivery system made it possible for women’s ideal family size to become reality. G Cuba (like other third world countries) came to apsire to a drop in the population growth rate.

6. Social and Fiscal Ramifications of the Demographic Revolution G Cost to the state rose, because Castro’s government financed almost all of the Social Security system. G Castro thought employment tax would cover the cost for Social Security. G Image of Castro ‘trying to help the elderly population’ adding to his ‘Cult of Personality’. G Many Cubans dying from cancer and heart disease. G Health Care Expenditures came to be a burden on the economy. G Cost to the state rose, because Castro’s government financed almost all of the Social Security system. G Castro thought employment tax would cover the cost for Social Security. G Image of Castro ‘trying to help the elderly population’ adding to his ‘Cult of Personality’. G Many Cubans dying from cancer and heart disease. G Health Care Expenditures came to be a burden on the economy.

7. The Impact of the “Revolution within the Revolution: Women’s Participation in the Labor Force G Working age: 15-64 G Cuba saw women as a ‘source of productive labor’. G Women suffered from unemployment the most. G Employment of women seen as responsible for adding to the drop in fertility rates. G The state’s concern with reproducing the population make the employment of women a problematic economic strategy. G Rise in divorce rate due to ‘double duty’. G Working age: 15-64 G Cuba saw women as a ‘source of productive labor’. G Women suffered from unemployment the most. G Employment of women seen as responsible for adding to the drop in fertility rates. G The state’s concern with reproducing the population make the employment of women a problematic economic strategy. G Rise in divorce rate due to ‘double duty’.