Saving the Hearts of Jamaicans:Evaluaation,

Management and Prevention of Hypertension and

Cardiovascular DiseaseDepartment of Humanities, Health &

SocietyDivision of Family Medicine

Herbert Wertheim College of Medicine

Florida International University

ObjectivesTo learn the risk factors for cardiovascular disease

To recognize importance of social determinants in preventing cardiovascular disease .

To learn role of Diaspora Mission in diagnosing and managing hypertension.

The Problem

Cardiovascular Disease is number one cause of death for women in Jamaica and US.

Stroke number three cause of death in Jamaica and US

Hypertension – Eighth leading cause of death in Jamaica

Diabetes- Seventh leading cause of death in Jamaica

Life expectancy at birth: 73.48 years

male: 71.87 years

female: 75.17 years (2014 est.)

Population-2,930,050 (July 2014 est.)

Age structure:

0-14 years: 28.4% (male 423,855/female 409,651)

15-24 years: 21.7% (male 319,291/female 316,773)

25-54 years: 36.4% (male 525,288/female 542,015)

55-64 years: 5.6% (male 79,875/female 84,562)

65 years and over: 7.7% (male 102,377/female 126,363) (2014 est.)

CVD Risk Factors

Diabetes

Obesity

Hypertension

Genetics (family history)

Hypercholesterolemia

30% Hypertension Rate in 15yo and older

The Jamaican hypertension prevalence study.

Dalip Ragoobirsingh, Donovan McGrowder, Errol Y Morrison, Pauline Johnson, Eva Lewis-Fuller, John Fray

Faculty of Medical Sciences, UWI, Mona, Kingston, Jamaica.

Journal of the National Medical Association (Impact Factor: 0.91). 08/2002; 94(7):561-5.

Diabetes

More than 220,000 Jamaicans between 15 and 74 years old have diabetes-13.6% of the population (2009)

The ministry data shows that, up to 2009, there were 92,860 men and 132,469 women, aged 25 years and over, who had diabetes.

In 2011, the National Health Fund had 106,017 persons with diabetes on its card programme. The agency paid $616,461,903 to beneficiaries for diabetes alone

Obesity Durazo-Arvizu et al. BMC Public Health 2008 8:133 doi:10.1186/1471-2458-8-133

Obesity

Obesity - adult prevalence rate: 24.1% (2008)

Pan American Health Organization 2014 found 30% of Caribbean children 11-14 , overweight or obese. Rate doubled over 10 years.

Prevention is KEY

Social DeterminantsThe social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.

World Health Organization

Place Matters

Urbanization:

urban population: 52% of total population (2011)

rate of urbanization: 0.51% annual rate of change (2010-15 est.)

Major urban areas - population:

KINGSTON (capital) 571,000 (2011)

Wealth Matters

Unemployment, youth ages 15-24:

total: 34%

male: 27.1%

female: 42.6% (2012)

2014- Overall 13.4% ( www.statinja.gov/jm)

CIA World Fact Book,2014

Improve daily living conditions

Address policies that continue inequitable distribution of power, money and resources.

Increase nutrition education in schools and through media.

Monitor impact of measures.

World Health Organization

Address Social Determinants

Missions from Diaspora

Attempt to align activities to addressing the major health needs.

Collaborate with local health agencies to ensure more continuity of care after leaving mission.

Provide low cost health monitoring devices- sphygmomanometers, scales, glucometers and strips to local health clinics.

Provide culturally appropriate nutrition education materials( alert to sugar content in sodas).

Other Ideas

THANK YOU.