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Health Promotion International Advance Access published online on December 14, 2007
Health Promotion International, doi:10.1093/heapro/dam040
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© 2007 The Author(s)
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article

Promoting health in response to global tourism expansion in Cuba

J. M. Spiegel1,2,3,*, M. Gonzalez4, G. J. Cabrera5, S. Catasus5, C. Vidal3 and A. Yassi2,3

1 Liu Institute for Global Issues, University of British Columbia (UBC), 308-6476 N.W. Marine Drive, Vancouver, BC, Canada V6T 1Z2 2Department of Health Care and Epidemiology, UBC, Canada 3 Institute of Health Promotion Research, UBC, Canada 4Centro de Estudios Turísticos, Universidad Central de las Villas, Santa Clara, Cuba 5 Centro de Estudios Demográficos de la Universidad de la Habana (CEDEM), Havana, Cuba

* Corresponding author. E-mail: jerry.spiegel{at}ubc.ca


  Abstract

The ability of communities to respond to the pressures of globalization is an important determinant of community health. Tourism is a rapidly growing industry and there is an increasing concern about its health impact on local communities. Nonetheless, little research has been conducted to identify potential mitigating measures. We therefore took advantage of the ‘natural experiment’ provided by the expansion of tourism in Cuba, and conducted four focus groups and key informants interviews in each of two coastal communities. Participants expressed concerns about psycho-social impacts as well as occupational and environmental concerns, and both infectious and chronic diseases. A wide array of programs that had been developed to mitigate potential negative were described. Some of the programs were national in scope and others were locally developed. The programs particularly targeted youth as the most vulnerable population at risk of addictions and sexually transmitted infections. Occupational health concerns for workers in the tourism sector were also addressed, with many of the measures implemented protecting tourists as well. The health promotion and various other participatory action initiatives implemented showed a strong commitment to address the impacts of tourism and also contributed to building capacity in the two communities. Although longitudinal studies are needed to assess the sustainability of these programs and to evaluate their long-term impact in protecting health, other communities can learn from the initiatives taken.

Key words: tourism; globalization; community capacity; Cuba


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