Understanding the Situation

Nearly every family and community have people suffering from preventable health problems caused by noncommunicable diseases (NCDs), holding them back from a quality social and productive life. This is because NCDs accounts for most of the premature deaths in the Caribbean. In adults, the four main NCDs (cardiovascular disease, diabetes, cancer and chronic respiratory disease) now account for eight of 10 deaths and most of the avoidable health care costs. In fact, the Caribbean has the highest premature mortality in the Americas, when compared to other sub- regions in the Americas.

The transformation of food environments to calorie dense, nutrient poor diets high in fat, salt and sugar, combined with increasingly sedentary lives and occupations are major drivers of the huge and costly epidemic of chronic NCDs, like diabetes, cancer, and heart disease in which families, governments and businesses bear large costs. Rates of obesity are spiraling and driving up diabetes, hypertension and renal failure. Diabetes and hypertension alone in Jamaica, Trinidad and Barbados have an estimated $1.3 Billion annual cost and a 5-8% negative impact on GDP. These problems contribute to poverty and are also caused by poverty.

Lost productivity is another key issue. NCDs often strike people in the Caribbean during their prime; younger than in high-income countries. The indirect costs of NCDs typically exceed the direct health costs by a factor of two to three. This is understandable when one thinks of the time off work of the person with NCDs, and that family members often have to take time off work or leave work entirely to care for family members with complications of NCDs like heart disease, stroke, amputation, renal failure. Household poverty is often worsened or triggered by out-of-pocket payments for NCD treatment and care and can trap poor households in cycles of catastrophic expenditure and impoverishment, particularly in countries that lack universal health coverage.

The demographic shift underway means that many more persons are entering retirement age than are coming into the workforce in many countries. The dependency ratio is increasing and makes healthy ageing an economic imperative. The demographic shift is a huge driver of the increased incidence of NCDs, but it also underlines the imperative of healthy ageing to avoid a sickly population of retirement age, where health costs outstrip pension costs, as no economy was set up for this.