Jaevion Nelson | Is Gov't doing enough to fight lifestyle diseases?
There has been a lot of talk and some visible, positive and commendable initiatives of late to treat with the pervasiveness of non-communicable diseases (NCDs) in Jamaica.
I wonder, though, if the Government is prepared to take the necessary actions to reduce the intake of trans and saturated fat, and excessive salt and sugar consumption, and increase the consumption of fruits and vegetables while encouraging people to exercise.
Research shows that NCDs account for 60 per cent of mortality globally. That's about 38 million people dying each year because for whatever reason, they do not eat properly. Unsurprisingly, 80 per cent of these deaths are in low- and middle-income countries like ours. I speculate that this is partly because, like Jamaica, healthier food options in many of these countries are more expensive, and government's intervention to address these challenges is woefully inadequate.
Regrettably, data for Jamaica are a little dated, but according to the Statistical Institute of Jamaica (STATIN), in 2009, "Diseases of the circulatory system, neoplasms, endocrine and metabolic diseases and disease of the respiratory system accounted for approximately 60 per cent of deaths among men and 75 per cent of deaths among women." In 2014, there were 12,773 deaths as a result of NCDs.
The major NCDs (cardiovascular disease, cancer, diabetes and chronic respiratory disease) share common behavioural risk factors (tobacco, unhealthy diet, physical inactivity and the harmful use of alcohol) and provide common pathways for prevention.
NCDs put a huge financial burden on the country as well. In 2001, it was estimated that diabetes and hypertension cost us 5.87 per cent of gross domestic product, or US$460,442,870.
By 2007, according to data from the World Bank, "the total economic burden on individuals, including indirect income loss, [was] estimated at J$47,882 million (US$641 million)."
In a recent news report in this paper, Dr Tamu Davidson-Sadler, director of non-communicable diseases and injuries prevention in the Ministry of Health, said that Jamaicans can spend up to one-third of their household income treating and managing NCDs.
Jamaica has undertaken a number of initiatives over the years to respond to the prevalence and impact of NCDs. The National Cheerleading Initiative in High Schools, Jamaica Drug for the Elderly Programme (1996), Healthy Lifestyle Policy and Strategic Plan 2004-2008, National Health Fund (2004), removal of user fees (2008), Programme for Advancement Through Health and Education (2002), Schools Nutrition Pilot 2003, 2006), Food Security & Nutrition Policy (2006) are among the things the Government has done. There is also now a Food Task Force which will "recommend a number of measures to influence choice and to possibly restrict choice in some cases".
Policies and strategies to address the unhealthy behaviours such as tobacco use, physical inactivity, unhealthy diet, and harmful use of alcohol are hugely critical for prevention and control of NCDs. Without them, it is virtually impossible to reduce their prevalence and impact on families and the country. I am eager to see what the Government will do this year to scale up existing interventions and introduce new ones.
I hope, though, that the Government is cognisant of the need to make them rights-based, since those who are most likely to be affected by NCDs are those who are poor and vulnerable. This must not be overlooked by the policymakers.
The Government should, therefore, pursue/explore the following:
- Provide farmers, who will supply schools, hospitals, infirmaries, and other places our poor and vulnerable citizens are, with subsidies so they can produce and market fruits and vegetables that are affordable to all of us.
- Review the meal plans at all schools and ensure that students, including those on PATH, are being fed nutritiously.
- Increase taxation on unhealthy foods - sodas, fast food, etc., and remove taxes from those that will have a more positive effect on people's health (i.e., fruits and vegetables).
- Ban importation of food products that are harmful such as those that are high in trans and saturated fat.
- Mandate that all food products produced locally and those that are imported are properly labelled to ensure citizens are duly informed.
This should be aggressively monitored.
- Change the food basket of protected items to remove innutritious foods.
- Enforce the smoking ban that is in place.