Developments in the Caribbean - The Impact of Chronic Diseases. Dr. Glennis Andall-Brereton Caribbean Epidemiology Centre

Transcription

1 Developments in the Caribbean - The Impact of Chronic Diseases Dr. Glennis Andall-Brereton Caribbean Epidemiology Centre

2 Overview of Presentation Epidemiology Mortality Morbidity and Risk Factors The Way Forward Uniting to stop the Epidemic of Chronic Disease The Port of Spain Declaration

3 Mortality

4 Major Causes of Death in the Caribbean, 1980 and 2000 (PAHO / Alleyne) Heart Disease Cancer Diabetes Stroke Injuries HIV/AIDS Hypertension ARI 0% 5% 10% 15% 20% 25%

5 Crude Mortality Rates (per 100,000 population ) for Select Diseases: ( ) CARICOM Member States Heart Disease Rates per 100,000 population Cancers Diabetes Cerebrovascular Diseases Injuries Hyperte nsive Diseases HIV Disease Year

6 Crude Mortality Rates (per 100,000 population ) for Select Diseases in Females: ( ) CARICOM Member States Heart Disease Rates per 100,000 population Diabetes Cancers Cerebrovascular Diseases Hype rte nsive Diseases 20 HIV Disease Injuries The Caribbean Epidemiology Year Centre

7 Crude Mortality Rates (per 100,000 population ) for Select Diseases in Males: ( ) CARICOM Member States Heart Disease Cancers Injuries Cerebrovascular Diseases Diabetes HIV Disease Hyperte nsive Diseases Year

8 Leading Causes of Death in CARICOM Countries by Sex, 2004 MALES 1. Heart Disease 2. Cancers 3. Injuries and violence 4. Stroke 5. Diabetes 6. HIV/AIDS 7. Hypertension Influenza/pneumonia FEMALES 1. Heart Disease 2. Cancers 3. Diabetes 4. Stroke 5. Hypertension 6. HIV/AIDS 7. Influenza/pneumonia 8. Influenza/pneumonia 8. Injuries and violence Source: CAREC, based on country mortality reports

9 Potential Years of Life Lost <65years by main causes, 2000 & 2004, CARICOM countries (minus Jamaica) Injuries HIV/AIDS Y2004 Y2000 Chronic Disease Source: CAREC, based on country mortality reports Note: Chronic Disease includes heart disease, stroke, cancer, diabetes, hypertension, chronic respiratory disease Injuries includes traffic fatalities, homicide, suicide, drowning, falls, poisoning

10 Age adjusted death rates/100,000 population (PAHO / Alleyne) Death Rate/100, Bahamas Barbados Guyana Jamaica TRT Canada USA Hypertension Isch. Heart Disease Diabetes

11 Caribbean trends in Diabetes Mortality Rate/100, Male Female

12 Morbidity and Risk Factors

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14 60 Trends in Adult Overweight/Obesity in the Caribbean Prevalence (%) Male Female s 1980s 1990s The Caribbean YEARS Epidemiology Centre

15 Physical Activity Study Household surveys done in summer: Jam, TRT and GUY Questionnaire included 24 hr activity recall and used to : Describe activity levels by age, gender, SES and location Determine the relationship of SES, BMI, location and age with PA

16 Sedentary lifestyle Male Female Trinidad Jamaica

17 Sedentary Lifestyle by Area among Countries Urban Rural KMA Trinidad Jamaica

18 Tobacco Prevalence Global Youth Tobacco Survey % currently using tobacco 30% 25% 20% 15% 10% 5% 0% Bahamas Suriname Guyana Male Trinidad & Tobago Female Haiti Belize Jamaica

19 Tobacco Smoking in Adults in the Caribbean Male Female 40% 35% 30% 25% 20% 15% 10% 5% 0% St. Vincent Jamaica Trinidad & Tobago St. Lucia

20 Smoking deaths in CARCIOM (in thousands, indirect estimates) Causes Men Women Cancers Vascular/diabetes Respiratory Other NCD Tuberculosis TOTAL Total Due to smoking Total Due to smoking % of male deaths due to smoking? and 15% of females? Source: Jha and Alleyne, 2007

21 Biological Risk Factors Blood pressure

22 Prevalence of Hypertension in Adults years Barbados 27.2 % Jamaica 24.0 % St. Lucia 25.9 % The Bahamas 37.5% Belize 37.3% Prevalence > age 40 yrs approximately doubles Optimal control of blood pressure would reduce the death rates from Cardiovascular Disease by about 15-20%.

23 BP Prevalence and Control Barbados: (Hennis et al, 2002) >40 yrs, HBP prevalence = 55% Awareness = 63% Treatment = 54% Control = 19%

24 Economic Impact

25 Economic Burden of Diabetes and Hypertension in Selected Caribbean Countries (2001) Percentage of GDP (%) The Bahamas Barbados Jamaica TRT DIABETES HYPERTENSION BOTH Source: TMRI, UWI, Jamaica

26 Uniting to Stop the Chronic Disease Epidemic

27 Regional Strategy and Plan of Action on an Integrated Approach to Prevention and Control of Chronic Diseases Caribbean history of cooperation in health The Caribbean Cooperation in Health Initiative (CCH) for health development through increasing collaboration and technical cooperation among countries CCH2 for ; CCH3 for

28 History of Caribbean leadership in health First First region to eliminate polio, measles First First region to hold a Heads of Government meeting (15th Sept 07) on NCDs, which issued the Port of Spain Summit Declaration Uniting to Stop The Epidemic of Non Communicable Diseases

29 CARICOM Heads of Government Summit 15 September 2007 Declaration of Port of Spain - Uniting to Stop the Epidemic of Chronic Non-communicable Diseases

30 DECLARATION OF PORT-OF OF -SPAIN: UNITING TO STOP THE EPIDEMIC OF CHRONIC NCDs: Burden of NCDs can be reduced by comprehensive and integrated preventive and control strategies which are evidence driven `at the individual, family, community, national and regional levels through collaborative programmes,, partnerships and policies supported by an inter-sectoral approach governments, private sectors, NGOs and our other social, regional and international partners; Based on evidence Surveillance of risk factors and NCDs

31 Declaration of Port of Spain DECLARATION OF PORT OF SPAIN.doc

32 THANK YOU