HEALTH-WISE
Yasmin WilliamsTHE NATIONAL Policy on The Promotion of Healthy Lifestyles in Jamaica has been described as an intersectoral approach, dealing with critical health issues which have their genesis in unhealthy lifestyle practices.
The goal of the policy is to decrease the incidence of common chronic non-communicable diseases, violence and injury and high-risk sexual behaviour.
Currently, the non-communicable diseases cardiovascular disease (including stroke, heart attack and other heart and blood vessel diseases), diabetes, cancer and obesity are reported by the Ministry of Health as accounting for 56 per cent of death annually.
The cost of providing care to persons with non-communicable diseases is enormous. It is reported that in 1999, for cardiovascular disease, the projected cost for hospital care and public and private sector ambulatory care (visits to public clinics and private doctors' offices) was $1.8 billion. It would cost much less to implement effective programmes to address relevant risk factors such as poor diet, lack of physical activity and smoking.
ADOLESCENTS TARGETTED
The reproductive health component of the policy will specially target pre-adolescents/adolescents/youth as the Ministry's data indicate that boys start sexual activity at about 13.4 years and girls start at about 15.9 years. The early onset of activity results in serial monogamous sexual relationships or sexual relationship with multiple partners with an increased risk of teenage pregnancy, sexually transmitted infections like HIV and cancer of the cervix (neck of the womb).
The Ministry reports that 40 per cent of 20-year-old females have already had one child. Biologically, these girls were ready for pregnancy but in many instances the required psychosocial preparation for pregnancy was absent.
In previous articles, the high rate of HIV cases in the 10-19 age group was highlighted. A CAREC/UWI study showed that the HIV/AIDS epidemic could cost Jamaica as much as 6.4 per cent of gross domestic product (GDP) by 2005. This is equivalent to $70 billion in 1997 terms. This kind of data again highlights the enormous amount of money that may be needed to deal with a health condition which could be prevented by the implementation of less expensive prevention programmes.
DEATH FROM VIOLENCE
The death from violence rate of 44/100,000 population (2002) is said to be among the highest in the world. Access to emergency medical care must impact the rate of death from violence and therefore it would be instructive to see how Jamaica compares to other parts of the world with respect to adequate emergency medical care.
The Ministry of Health reports that adolescents (10-19 years) account for 26 per cent of persons with injuries from violent acts treated at the Accident and Emergency Units of all hospitals and that based on the study done by Taylor and McCartney on the impact of violence on Health Care at Kingston Public Hospital (KPH), the cost to the Intensive Care Unit was $8 million in 2002.
The National Policy for the Promotion of Healthy Lifestyles in Jamaica takes us to a focus on the much less expensive primary prevention strategies which promote health and wellness. These strategies result in savings in the expenditure for treatment of patients at public clinics and private doctors' offices as well as hospitals and rehabilitation facilities a very important consideration for a resource-poor country like Jamaica.
Dr. Yasmin Williams is a Family Doctor and Public Health Specialist;
e-mail yourhealth@gleanerjm.com.
