Dr Christopher Tufton | Our kids are sweet enough
The 2016-2017 Jamaica Health and Lifestyle Survey paints for us a picture of a Jamaican society in desperate need of bold action to successfully overcome the scourge of non-communicable diseases (NCDs), especially as we consider the health of our children and youth.
The survey reveals that one in every two Jamaicans 15 years and older is overweight or obese; one in every eight has diabetes, and that one in every three has hypertension. These are not numbers that we can shy away from. They should, in fact, provide inspiration to act swiftly and without reservation to preserve public health – and particularly for our children and youth.
It is against this background that the Ministry of Health is pressing ahead with the imposition of restrictions on sugar-sweetened beverages in schools. Those restrictions are to be reflected in a set of interim guidelines that are to be introduced in schools in January 2019.
The guidelines – developed in collaboration with the Ministry of Education, Youth and Information – aim to reduce exposure to, and consumption of, sugar-sweetened beverages, as well as increase consumption of water. They are to cover all public schools and all beverages sold and served at school.
The consumption of sugar-sweetened beverages is currently above the recommended amounts for maintaining good health in Jamaican children, some 70 per cent of whom consume one or more sweetened beverages per day, thereby increasing their risk of obesity, Type Two diabetes, hypertension, and tooth decay.
Overweight and obesity have also reached epidemic levels among youth aged 13 to 15 years old. The Global School-based Student Health Surveys 2010 and 2017 show that obesity has increased by 68 per cent over the past seven years.
However, in addition to weight gain, consumption of sugar in liquid form alters metabolism and promotes insulin resistance, oxidative stress, fat deposition and displacement of more nutritious foods, which can eventually lead to Type Two diabetes, hypertension and heart disease.
In Jamaica in 2015, STATIN reports that an estimated 70 per cent of deaths in the population five years and older died from the four main NCDs (cardiovascular disease, diabetes, chronic lower respiratory disease and cancer). Other research reveals that Jamaica is projected to lose about $77 billion because of cardiovascular disease and diabetes over the next 15 years.
The ministry is, therefore, working to finalise the guidelines, in a bid to help create the enabling environment for the behaviour change that has long been emphasised through our public education efforts and which is so critical to successfully relieving the country’s NCD burden.
We have heard and understand the concerns of some stakeholders over the timeline to implementation. We have also heard and are sympathetic to the concerns of those stakeholders who have said that the more healthy options are also the more expensive.
However, the truth is we cannot afford to delay. Delay, as is said in local parlance, is danger’. It is imperative that we guard against that.
So yes, we may save a few dollars today by sticking to business as usual instead of pursuing what, to some, may seem an aggressive approach to protecting the health of our children and youth. However, is it worth the cost we will have to pay in the future?
If we take overweight or obesity among the young, for example, not only are there financial implications, there can also be psychological implications. Counted among them are depression, anxiety and poor self-esteem. Obese youngsters can, too, face social problems, including bullying, stigma, poor socialisation, as well as reduced educational attainment. What is more, research has shown that childhood obesity will leave a permanent imprint on adult health.
Jamaica, meanwhile, is not alone in its efforts to restrict the consumption of sugar-sweetened beverages in schools. Bermuda, the Cayman Islands and Trinidad have also prohibited the sale or serving of sugary beverages in schools. Other countries, such as Australia, Bahrain, the United States, and Uruguay, have implemented similar restrictions in schools.
Still, restrictions on sugar-sweetened beverages is but one of the actions being taken by the Ministry of Health since the scale of the NCD epidemic is such that it requires a variety of interventions.
Included in those actions is the Jamaica Moves in Schools programme that is to strengthen the capacity of the school community to become a healthy setting for learning and working.
To make that happen, in addition to restrictions on sugary beverages, the programme is, among other things, to see the finalisation of the School Nutrition Policy and the development of School Nutrition Standards; mandatory physical activity from early childhood to grade 13; and a minimum of one hour of physical activity per week through physical activity breaks in all public schools.
It is also to see the integration of NCD risk factor assessment into routine school medicals and the child health and development passport.
We need the people of Jamaica to become health advocates and make the connection between how they live their daily lives and their personal state of health. Many of us do not exercise, eat and drink badly and only visit the doctor or hospital when we feel ill, which is often too late.
This is an unfortunate feature of our culture with the consequences being sickness, compromised productivity, and ballooning healthcare costs. However, I believe in our Jamaican people and their capacity to adapt and thrive.
- Christopher Tufton is minister of health and member of parliament for St Catherine West Central. Email feedback to firstname.lastname@example.org