Editorial | The logic of putting wellness into health
Chris Tufton’s announcement of the formal addition of ‘wellness’ to the name of Jamaica’s health ministry may not have been the big takeaway from his review speech in Parliament last week. Yet, it implies a shifting philosophy to health and healthcare, which, if sensibly and seriously pursued, will, in time, pay big dividends in people’s well-being and in enhanced economic output.
As Dr Tufton noted, the World Health Organization (WHO) defines health as not only an absence of disease, but a state of complete physical and social wellbeing. In other words, being healthy presumes the ability of the individual to actively participate in, and enjoy, the environment within which she/he lives as a productive member of society.
“The ministry will, therefore, pursue a wellness approach to health,” Dr Tufton told legislators. “The dimensions of this approach include not only the physical, but also the mental and social, as well as the emotional, environmental, financial, intellectual, vocational and spiritual.” This is a conception of good health that insists on individuals taking responsibility for their state of well-being and actively partnering with policymakers in its delivery.
Indeed, statistics provided by Dr Tufton underline the logic of people being asked to take greater ownership of their health. A 2016-17 health and lifestyle survey revealed that up to a third of Jamaicans suffer from a non-communicable disease (NCD), generally associated with lifestyle.
Nearly 700,000 of us, that is around one in three of the population, are hypertensive. Over 236,000 are diabetic and more than one in five, upwards of 577,000 persons, are overweight or obese. Hypertension and obesity tend to be precursors to other types of illnesses, including several forms of cancers.
PREVENTION IS THE KEY
Complicating the situation is that Jamaicans are becoming greyer. Approximately 12 per cent of the population is now over 60 years. That number, in six years, will be edging close to 17 per cent. Old age usually comes with health problems, which are often exacerbated when individuals already suffer from NCDs, on which the Government spends a hefty chunk of its health budget.
One study, in the early 2000s, determined that hypertension and diabetes cost Jamaica – directly and indirectly – nearly six per cent of gross domestic product. Not only is there the cost of delivering healthcare, but there is the loss of production when people become sick and can’t work, or die during what should be productive periods of their lives.
The bad, and good, thing is that NCDs are entirely preventable, requiring no vaccines for avoidance. Prevention is in the gift of individuals, determined by lifestyles – how we eat, how we exercise and how we recreate, or play. So the Government’s expenditure on NCDs can be lessened, and the loss on production and productivity clawed back if we lived more healthily. The gain would not only enhance well-being, but economic output.
Dr Tufton’s Jamaica Moves initiative, which emphasises exercise, is a significant development on the minister’s wellness agenda, which has to be sustained and expended, and supported by policies on nutrition, labour-market relationships, community development and social intercourse. Wellness embraces the entire Government as well as myriad stakeholders. It can’t be pursued only by Dr Tufton’s ministry.