ABSTRACT
This chapter examines public health conditions in Valparaiso, Chile, between 1870 and 1930, assessing the extent of government commitment to social progress. In general, urban health conditions are most shaped by two large forces: the environment, the challenges to health imposed by nature; and politics, the response by government in improving sanitary and public health conditions. The chapter emphasizes how a uniquely dysfunctional Chilean political system and the class and racial prejudices of the Chilean elite and middle class undercut progress on health care reform in Valparaiso and Chile. The growth of Valparaiso's commerce, especially after the 1888 port improvements carried out by the Kraus Commission, stimulated an expansion of other economic activities in the city. Hospital death rates at public charity facilities in Valparaiso were much higher than those in the more commodious private facilities in the city. Chile failed in health care reform because its leaders lacked the political will to do anything meaningful about it.
