"The largest epidemic we are currently facing is the one of chronic disease - the leading cause of premature death in our region. The top three diagnosed illnesses in our Islands are all chronic diseases: high blood pressure, diabetes and asthma. How do we prevent these numbers from rising? How do we get our nations’ health back on track? This month and the next my ministry is leading the country’s first-ever health risk factor survey to learn what is causing these illnesses. We are counting on YOUR numbers to strengthen our health response. So please support this national exercise because we need better numbers for better health."
Minister of Health, Mark Scotland
What is a health risk factor survey?
A health risk factor survey is similar to a census, but instead of gathering population data, enumerators are looking for information on health risks. Although we did get some health information through the 2010 Census, this will be the Cayman Islands’ first dedicated health survey. A health risk survey will help identify the risk factors associated with chronic diseases affecting our population. The risk factors increase your chances of getting a disease. This survey will provide a snapshot of the specific risk factors associated with our population giving us an opportunity to plan the appropriate programmes for intervention.
“This epidemic is not an individual problem; it’s not a family problem, it’s not a medical problem. It’s a societal problem with grave implications for us in terms of healthcare and healthcare costs.”
Option or necessity?
If we know that obesity and related diseases such as hypertension, diabetes and heart disease is a problem in the Cayman Islands, you might ask why we want to do a health risk factor survey. While statistics from the Health Services Authority do point to a heavy burden of non-communicable disease, at present we have no hard data on what the major causes of this is. By doing a health risk factor survey, we will find out what the specific risk factors of our population are so we can plan and manage intervention programmes.
“By 2020 – a mere decade from now – non-communicable diseases will account for 60 percent of the global burden of disease. If we fail to do something now to reverse the trend, national health systems will be severely stressed and there will be significant negative economic and social consequences.” CARICOM
“This might be the first generation where kids are dying at a younger age than their parents and it is related primarily to the obesity problem.” Judy Davis
The cost of inaction
During the financial year 2009/2010 the Cayman Islands Government spent $93.4 million on health care costs. This represents 17.5 per cent of the national budget. No local studies have been done on personal economic cost or lost productivity and life years. But looking at statistics from other countries, this is potentially a huge cost. For instance in the US, the cost of care in the first 30 days following a stroke is US$13,019 in mild cases and US$20,346 in severe cases. The lifetime cost of a stroke is approximately US$140,048. The bulk of those costs come in the form of chronic care and rehabilitation. For diabetes, the Centers for Disease Control has estimated that the annual health care costs for an individual are approximately $13,000, compared to approximately $2,600 for an individual without diabetes.
How will it be done?
A health risk factor survey is similar to a census, but instead of gathering population data, surveyors are looking for information on health risks. Although we did get some health information through the 2010 Census, this will be the Cayman Islands’ first dedicated health survey. It will be done in three steps:
Enumerators will visit a selected sample of households and gather information on demographics, alcohol use, fruits and vegetables consumption, physical inactivity and tobacco smoking.
At the same time, enumerators will take measurements on weight, height, waist circumference and blood pressure.
A smaller sample will be selected for biochemical measurements of blood glucose and total cholesterol. These will be done at the Cayman IslandsHospital.
Who will participate?
Not everyone will be visited by the enumerators. For step 1 and 2, only 2,100 households have been randomely selected. Only one person between the age of 25 and 64 will then be selected from each of these households. Only half of the households visited in step 1 and step 2 will then again be randomly selected for step 3.
Participation is voluntary which means those selected have a choice whether they want to participate or not. All participants have to give their consent to be part of the su
rvey. All information will be strictly confidential. Should the tests and/or measurements reveal potential health problems, the participant will get a free referral to a physician or healthcare professional.
What's in it for me?
Everyone should know their health numbers - your BMI, blood glucose, cholesterol and blood pressure. Participating in the health risk factor survey, is like receiving a free medical check up. If you have been selected for step 1 and 2, you will know your body mass index and your blood pressure. If you have been selected for step 3, you will know all your numbers - including blood glucose and cholesterol levels. You will also receive a free referral should any of your numbers are abnormal. Should your numbers point to a potential health problem, you will also receive a free referral to a healthcare professional.
Questions or concerns? Please contact any of the following:
Elizabeth Talbert – 244-1621/516-8398
Crispin Boney – 244-3502/517-3089
Theodore Thompson – 244-1612/939-6151
Nicole Emmanuel Jones – 244-1613/916-6012
Bodden Town/North Side/East End:
Adolphus Laidlow – 244-1618/322-3944
What we know so far
The Cayman Islands Health Services Authority (HSA) released these findings based on an annual health screening on children in transition from lower to middle school. The survey revealed that 22 percent of school children are overweight and that an additional 15 percent were deemed at risk of becoming overweight. Although there is no population based risk factor data for adults in the Cayman Islands, data from the school population indicate that there are high levels of obesity. Such risk factors in the school population is a predictor for the future development of chronic non-communicable diseases in the Cayman Islands. Reliable information on other risk factors are unavailable.
People living with chronic disease:
Incidence of diagnosed illness was 199.6 per 1000 persons, with the male population showing a lower rate (162.9 per1000) compared to the female population (229.3 per 1000). The incidence of illness among Caymanians (275.8 per 1000) is more than twice that of non-Caymanians (102.2 per 1000). This holds across illnesses such as Diabetes, High blood pressure, heart condition, cancer and asthma.
Most common chronic diseases:
The top 3 types of illnesses identified in the 2010 Census were high blood pressure (89.1 per 1000), diabetes (43.0 per 1000) and asthma (28.3 per 1000).This ranking is for both male and female population groups, and for Caymanians and non-Caymanians.
This reflects the earlier findings of the 2008 National Assessment of Living Conditions were high blood pressure was also the most common reported chronic illness (61.4% of all cases) followed by and diabetes (30.2% of cases); not an uncommon finding in the Caribbean. Almost 27 percent of respondents in the NALC survey reported more than one chronic disease.
Leading causes of death:
Mortality data for 2005 in the Cayman Islands show that the leading causes of death are cancers (72.5 per 100,000 population), ischemic heart disease (51.9 per 100,000 population), cerebrovascular diseases (21.4 per 100,000 population) and diabetes (22.2 per 100,000).