Trends in Obesity Related Noncommunicable Diseases: a Caribbean Pandemic

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Trends in Obesity Related Non-communicable
Diseases a Caribbean Pandemic?

• Dr. Laura McDougall
• CAREC

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Obesity related non-communicable diseases

• Hypertension
• Diabetes
• Heart disease
• Cerebrovascular disease
• Colon cancer
• Endometrial cancer
• Musculoskeletal functional disability
• Chronic respiratory disease

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Hypertension (Now)

• Studies where blood pressure was measured
• ICSHIB gt140/90 mmHg ages 25-74
• Jamaica (1994-5) n524 24.7
• St. Lucia (1991-4) n 491 26.9
• Barbados (1991-4) n 330 27.9

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Hypertension (cont)

• Foster et al gt160/95 ages 40-79
• Barbados ( 91-2) n464
• ?47 ?43
• Okusun et al (vs. Nigeria US)
• Jamaica n 491 26

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Hypertension (cont)

• Beckles et al gt160/95 ages 35-69
• Trinidad (St. James, 1979) n2184
• African Indian Eur.
  Mixed
• ? 33 27 25 24
• ? 28 26 27 26

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Hypertension (cont)

• Self-Reports
• 
  
  Ages
• St. Kitts/Nevis (? 98) 24 15 y
• TT (1994-5) ?28 ?18 35 y
• Jamaica (1993) ?18 ?8 15-49 y
• Curacao (1993-4) 23 45-64y

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Crude death rates from hypertension in CAREC
member countries (per 100,000)
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Management of Hypertension

• ICSHIB study (St. Lucia)
• - the proportion of hypertensive individuals who
  were
• aware (gt160/95) 74
• pharmacologically treated (gt160/95) 59
• controlled 35
• Men, particularly those lt55 years, were less
  likely to be treated and controlled.

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Summary - Hypertension

• Need standardized definitions and methodology
• Prevalence rates steady
• Mortality rates declining
• Women ? prevalence mortality
• Men poor management

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Diabetes (Now)

• Studies where blood sugar was measured
• Wilks et al ages
  ??
• Jamaica (Spanish Town) ( 98) n1303
• ?15.7 ?9.8
• Ragoobirsingh et al ages 15
• Jamaica ( 93-4) n2109
• 17.9

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Prevalence of Diabetes

• Foster et al ages 40-79
• Barbados ( 91-2) n464
• ?18 ?15

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Diabetes

• Poon-King et al ages
  35
• Trinidad (1961)
  n23,900
• ?6.3 ?4.6
• Beckles et al ages
  35-69
• Trinidad (St. James, 1979) n2184
• African Indian Eur.
  Mixed
• ? 17 23 10 8
• ? 8 20 4 8

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Diabetes (cont)

• Self-Reports
  Ages
• 
  
  
• St. Kitts/Nevis ( 98) 11 15 y
• Jamaica (93) ?5 ?3 15-49 y
• Curacao (93-4) 9 45-64y
• ICSHIB (91-5)
  25-74y
• Jamaica ?10 ?5
• St. Lucia ?9 ?3
• Barbados ?8 ?8

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Crude death rates from diabetes in CAREC member
countries (per 100,000)
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Summary - Diabetes

• Need standardized definitions and methodology
• Need routine measures over time
• Prevalence rates ?
• Mortality rates ?
• Women higher prevalence mortality
• Social inequities

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? Pandemic of Diabetes

• Approximately 2,400 excess reported deaths
  directly due to diabetes in 1995 compared with
  what was expected based on 1980 mortality data.

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The way forward

• Do we know enough about the
• trends in obesity related
• non-communicable diseases in the
• Caribbean?