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Millennium Development Goals: update from North America
  1. Elizabeth Peacock-Chambers,
  2. Michael Silverstein
  1. Department of Pediatrics, Boston Medical Center, Boston, Massachusetts, USA
  1. Correspondence to Dr Michael Silverstein, Department of Pediatrics, Boston Medical Center, Vose 3, 88 E Newton St, Boston, MA 02118, USA; michael.silverstein{at}

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In the past 15 years, North America made significant advances towards the Millennium Development Goal (MDG) targets despite a crippling and global financial crisis beginning in 2008. The three countries making up North America—Canada, the USA and Mexico—aspired to reach MDGs under strikingly different political and cultural contexts; yet within their own countries, they all face the common challenge of reducing the disparities that exist in education, employment and health across socioeconomic, racial and gender spectrums.

MDG1: poverty and hunger

Progress towards reduction of disparities in poverty and hunger is evident in North America. Mexico met its goal to cut in half the percentage of people living off <$1.25 per day 3 years before the anticipated date. This reduction is consistent with the change in percentage of people living in poverty across Latin America, decreasing from 12% in 1990 to 6% in 2010. Middle-income countries, however, including Mexico, Argentina, Brazil, Chile and Peru, are largely responsible for this change.

The USA achieved a historic change in the lives of people living in poverty with the adoption in 2010 of the Affordable Care Act (ACA) providing access to healthcare for all citizens. ACA will improve healthcare access; however, it will not impact non-medical factors, such as poverty, driving poor health outcomes in the USA. Income inequality in the USA and Mexico is currently at an all-time high and remains significantly higher than in European countries …

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