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The Chronic Disease problem in the Caribbean

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Title: The Chronic Disease problem in the Caribbean


1
The Chronic Disease problem in the Caribbean
civil society perspective
  • Twelfth OECS Health Ministers Meeting, 11th
    September 2009
  • Prof. Trevor A. Hassell
  • Chairman of the Healthy Caribbean
    Coalition, Chairman of the National
    Commission for Chronic Non Communicable
    disease, Barbados

2
  • Three primary risk factors (tobacco, poor
    diet and physical inactivity) and three
    intermediate risk factors (hypertension, obesity
    and diabetes) lead to three diseases (heart
    disease, lung disease and cancer) resulting in
    50 of all deaths

3
CARICOM Member States
Year
Source CAREC, based on mortality reports from
countries
4
Leading Causes of Death in CARICOM Countries by
Sex, 2004 (excluding Jamaica)
MALES
FEMALES
  • Heart Disease
  • Cancers
  • Injuries and violence
  • Stroke
  • Diabetes
  • HIV/AIDS
  • Hypertension
  • Influenza/pneumonia
  1. Heart Disease
  2. Cancers
  3. Diabetes
  4. Stroke
  5. Hypertension
  6. HIV/AIDS
  7. Influenza/pneumonia
  8. Injuries and violence

Source CAREC, based on country mortality reports
5
Potential Years of Life Lost lt65years by Main
Causes, 2000
2004, CARICOM Countries (minus Jamaica)
Source CAREC, based on country mortality reports
Note Chronic Disease includes heart disease,
stroke, cancer, diabetes, hypertension,
chronic respiratory disease
Injuries includes traffic fatalities, homicide,
suicide, drowning, falls, poisoning
6
Disability Adjusted Life Years (000) 2002
7
Mortality Attributable to Select Risk Factors
(Latin America Caribbean)
from DCP2
0
100
200
300
400
500
Attributable Deaths (thousands)
8
(No Transcript)
9
Prevalence () of diabetes among adults in the
Americas
Source Pan Am J Public Health 10(5), 2001
unpublished (CAMDI), Haiti (Diabetic Medicine)
USA (Cowie, Diabetes Care)
10
Caribbean Trends in Diabetes Mortality
11
  • From community surveys, the
    prevalence of hypertension in adults 25-64
    years of age was
  • Barbados 27.2
  • Jamaica 24.0
  • St. Lucia 25.9
  • The Bahamas 37.5
  • Belize 37.3

CARICOM
Control of blood pressure would reduce the
death rates from Cardiovascular Disease by
about 15-20.
12
Hypertension
  • Uncontrolled hypertension contributes to 45 of
    all ill health from CVD
  • Hypertension uncontrolled in 80 of hypertensive
    Barbadians
  • 49 anti-hypertensive drugs available in Barbados
    National Formulary

13
Estimated Economic Burden (US Million, 2001)
BAH BAR JAM TRT
Diabetes 27.3 37.8 208.8 494.4
Hypertension 46.4 72.7 251.6 259.5
Total 76.7 110.5 460.4 753.9
14
Estimated Cost of Diabetes and Hypertension as
percent () of GDP
15
Caribbean Initiatives and Reports
  • Caribbean Commission on Health and Development
    Report
  • Nassau Declaration, CARICOM Heads of Government,
    2001
  • Caribbean Charter for Health Promotion
  • Caribbean Cooperation in Health initiative 1,11,
    111
  • Caribbean Regional Plan for Prevention and
    Control of NCDs and Injuries, 2008-2012, PAHO
  • Heads of Government of CARICOM Summit and
    Declaration against CNCDs, 2007

16
(No Transcript)
17
Purpose
  • To bring together a wide spectrum of partners
    from throughout the CARICOM countries civil
    society, the business community, educators and
    researchers, policy makers to plan civil
    societys response to the CNCD pandemic

18
Objectives
  • Provide a forum for cross section of
    representatives from various sectors of society
    to learn about CNCDs and consider how best to
    tackle them
  • Build capacity in important elements of civil
    society
  • Identify and promote evidence based best
    practices for addressing the CNCD epidemic in the
    Caribbean
  • Strengthen capacity of civil society to monitor
    implementation of the POS Summit Declaration
  • Consider resource mobilization

19
Recent initiatives
  • Ratification of the FCTC
  • Establishment of NCD Commissions
  • Recognition of Annual Caribbean Wellness Day
  • National Chronic Disease Registry, Barbados
  • Risk Factor Surveillance
  • Healthy Caribbean Coalition public education
    campaign
  • National Nutrition improvement and salt reduction

20
Recent initiatives
  • CNCD National Summits held in Dominica and St.
    Lucia
  • Blood Pressure Monitoring initiative in barber
    shops and hairdressing salons developed in St.
    Kitts
  • Completion of STEPS survey for CNCDs and risk
    factors in Barbados, Dominica, BVI and St. Kitts
    and Nevis
  • Grenada completed a Workplace Wellness Summit
    (Part 1)
  • Expert consultations on Cancer Registries in
    Barbados, Antigua and Barbuda and Grenada

21
Complementary approaches to chronic disease
prevention
Individual responsibility
Changes to the "toxic" environment
HEALTH CARE AND DOCTOR
POLICY ENACTMENT
COMMUNITY AND CIVIL SOCIETY
22
Areas of support and recommendations for further
action
  • Establishment of NCD Commissions in all OECS
    countries
  • Ratification and full implementation of FCTC by
    all OECS countries
  • Implementation of a population salt reduction
    programmes in OECS countries
  • Support by OECS Governments for HCC led public
    education campaign on NCDs

23
Areas of support and recommendations for further
action
  • Support for Annual Caribbean Wellness Day
  • Acceptance of Caribbean Civil Society Declaration
    and Action Plan for tackling NCDs
  • Official recognition of the Healthy Caribbean
    Coalition by OECS Ministers of Health

24
www.healthycaribbean.org
Thank You
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