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.

Key statistics on NCDs in the Caribbean are:

  • the estimated lifetime cancer risk is 18%; 20% for men and 16% for women. Prostate, breast, colorectal and cervical cancer are the commonest types of cancers where mortality can be reduced with early detection.

  • More than 60% of the population in some Member States are overweight including 20%-40% who are obese. A person who is overweight will experience on average 150% higher lifetime health costs, so that prevention and measures to avoid costly complications are priorities.

  • Between a half and two thirds of men and 14%-48% of women are current drinkers. Alcohol misuse and depression are the two major mental health issues in the Region.

  • Tobacco use among adults is also a significant problem, ranging from 7%-27% in surveys, Tobacco use is the cause of a range of health problems, including cardiovascular disease, cancer, diabetes, chronic respiratory disease, as well as lower respiratory infections.

  • NCDs are responsible for 73% of all premature deaths among persons 30-69 years of age.

  • The associated major risk factors for these conditions were abuse of tobacco and alcohol, physical inactivity and poor nutritional choices, with overweight/obesity affecting more than 50% of adult males and 60% of adult females.

Where will your money go:

Learn more about CARPHA and the work they do by visiting their website.

The Caribbean is not on track to meet the ambitious goals in Caribbean Cooperation in Health IV or Sustainable Development Goals (SDGs) Agenda 2030 in NCDs without increased investment in cost effective public health and prevention policies. There are a range of cost-effective solutions, public policies and health services measures, which have high return on investment (ROI), which are feasible and viable such as the NCD "Best Buys".

Funds donated to the CARPHA Foundation, will assist in:

  • Surveillance of chronic disease and its determinants. This includes behavioural surveillance of risk activities and surveys of such factors as alcohol, drug and tobacco consumption and diet;

  • Conducting research on the causation of chronic diseases and preventive strategies;

  • Health promotion and developing options for preventive action based on scientific evidence, including cost-benefit analyses.