Christopher Tufton | Fierce urgency to tackle the NCDs problem
Martin Luther King, in his famous 1963 speech ‘I have a dream’, noted ‘the fierce urgency of now’ while cautioning against what he called ‘the luxury of cooling off or to take the tranquillising drug of gradualism’.
Jamaica is at just such an inflection point, not with respect to democracy which was the subject of reference for King, but rather to public health and in particular the scourge of non-communicable diseases (NCDs).
The NCDs problem is currently one of the principal drivers of the policies, programmes, and projects that are prioritised and pursued by the Ministry of Health & Wellness; and members of the public should understand why.
Speaking in my Sectoral presentation on May 3, I revealed the precise state of play with NCDs and the reality that Jamaicans are dying younger as a direct consequence of these diseases, including diabetes, heart disease, and cancers.
Some 22,022 deaths from all causes were recorded in our most recent mortality figures. Diabetes was the most frequent underlying cause of death at 13 per cent, followed by stroke at 11 per cent; hypertensive disease at eight per cent; schaemic heart disease (for example, heart attack), also at eight per cent; and assault (violence/intentional injury) at four per cent.
Importantly, NCDs were the cause of death for 16,918 individuals, almost eight of 10 (or 77 per cent) deaths that year, 2020.
When we analysed the deaths occurring in persons before their 75th birthday, we found that 12,747 (59 per cent) persons died early in 2020. This represents 296,578 years of potential life lost in 2020 – a 19 per cent increase in the potential years of life lost or 57,645 more years lost in one year compared to a decade ago (2011).
In 2020, NCDs-related deaths were the cause of 144,853 potential years of life lost, representing a 30 per cent increase in potential years of life lost or 33,775 more years lost per year in a decade. This rate of increase for persons dying from NCDs was greater than from all causes (30 per cent increase for NCDs compared to 19 per cent per cent for all causes).
It is, therefore, vital that we act out of a fierce urgency of now, in our individual and collective health interest. The NCDs fight cannot be one only for the Ministry of Health & Wellness. We must, all of us, do the necessary work to get and stay ahead of this problem.
It is time to make better, albeit hard, decisions about what we put int our bodies. We must read our food labels, taking note of the content of the foods we eat to ensure that we consume fewer sugars, less salt, and zero trans fats.
Manufacturers must themselves join that effort, making sure that there is adequate and legible information on their product labels for consumers to read. Manufacturers should also strive to reformulate their products to reduce the sugar and salt content and eliminate trans fats. Importantly, they are also encouraged to demonstrate corporate social responsibility in the marketing of those products.
We need also to prioritise our health checks; we must know our numbers. It is for precisely this reason that the ministry is, this year, rolling out a new initiative of the same name – #KnowYourNumbers.
Knowing our numbers is a fundamental first step to preventing and managing premature illness and mortality. This is a practical response to the biggest health crisis we face today: lifestyle diseases and early death.
Too many Jamaicans are walking sick people because they do not know their health status.
• It is estimated that 236,000 or nine per cent of Jamaicans have diabetes and only 106,000 or 45 per cent are aware of their status. Furthermore, 95,030 have one or more complications related to diabetes, including amputation, chronic kidney disease, and heart attack.
• Of note is that approximately 679,000 or a quarter of all Jamaicans have hypertension with only 377,000 or 54 per cent aware of their status. More than 300,000 do not know their status.
These statistics are alarming and make the case for getting answers to some very important questions. What are your blood pressure numbers? What are your blood sugar numbers? What is your body mass index? What is your HIV status? These are questions to which every Jamaican must have an answer.
AVOID A STROKE
Here’s another interesting statistic: an estimated 75 per cent of Jamaicans could avoid a stroke if they were aware of the warning signs through screening and took corrective action. Clinically, this is called a modifiable risk factor.
The #KnowYourNumbers initiative, therefore, focuses on getting Jamaicans to screen at least once each year in order to know their health status and what they need to do to modify their behaviour to reduce illness and avoid dying young.
Our goal is to get half a million screening tests done this year to provide Jamaicans with the opportunity to know what they are vulnerable to and the needed lifestyle changes for them to get and stay healthy.
I encourage all Jamaicans to know their numbers and invite the collaboration of all stakeholders – from the private sector to civil society – to make this latest initiative a success and to get ahead of our NCDs problem.