Half Cayman’s older people at high risk for NCDs

| 28/10/2024 | 59 Comments
CMO Dr Nick Gent

(CNS): Nearly 50% of older adults in Cayman have multiple high-risk factors for non-communicable diseases (NCDs), significantly increasing their chance of developing serious health problems, according to a new report based on a national health survey. This will place more strain on the healthcare system and the public purse as the population ages. Even more worrying is the very high number of people already suffering from NCDs that were undiagnosed.

More than one in three people who have high blood pressure were undiagnosed, with poverty playing a part in their failure to seek help.

A release from the Ministry of Health and Wellness noted the lack of progress in people adopting healthier lifestyles, which means there needs to be a review of how healthier lifestyles are promoted. On coming to office, the current health minister, Sabrina Turner, made wellness and prevention a central policy platform.

The data comes from the first glimpse of the ministry’s STEPS 2023 National Health Survey findings, which were unveiled at the annual Cayman Islands Health Care Conference last week. The survey was conducted across all three islands last year to identify the national prevalence of NCD risk factors.

Non-communicable diseases are the leading cause of death and disability worldwide. In 2022, cardiovascular disease was the leading cause of death here, followed by cancer, unintentional injuries, and diabetes.

For the first time at the national level, the STEPS 2023 survey has provided valuable data on cholesterol levels, raised blood sugar and vaping prevalence, which provides a clearer picture of the islands’ health challenges and allows for more targeted and effective interventions. Finances and good health insurance play a crucial role in people’s ability to access the care that they need, the survey has found.

But 20% of Cayman households survive on less than $15,000 per year. While half the population is reportedly on a comprehensive insurance plan from a local provider, Chief Medical Officer Dr Nick Gent said financial issues were playing a part in people not accessing the care they need.

“The undiagnosed numbers of diabetics and hypertensives show us that poverty is causing people not just to be selective about what care they can afford to receive, but often that they are choosing not to seek any care at all,” he said.

“The cost, or fear of the cost, of healthcare is now a major barrier to many people. It is especially apparent in the scale of the diagnosed, but untreated, numbers of hypertensives and diabetics. These are people who are knowingly taking a risk with their own health and fitness but having to make that choice faced by other more pressing needs.”

The newly available STEPS survey data exposes important insights on undiagnosed disease in Cayman, treatment gaps, disparities in health outcomes, and missed opportunities for care, and it also marks the collection of new data that has never been available at the national level.

In her presentation of the findings, Cayman Islands National Epidemiologist Rachel Corbett said a large proportion of the population is living with undiagnosed conditions, including raised blood pressure and diabetes. More than one in three people with raised blood pressure are undiagnosed. Despite the high contact with healthcare services among the population, the data reveal a clear opportunity for healthcare professionals to empower people with healthcare advice and education to improve their health outcomes.

The survey data highlighted missed opportunities for care, as only 27% of Cayman’s population with raised blood pressure have been diagnosed and are on medication that is successfully managing their blood pressure.

Alarmingly, undiagnosed high blood pressure was found to be significantly higher among younger adults aged 18 to 44 at 57% than among those aged 45 to 69 years at 25.5%. The data also revealed that large proportions of the diabetic population are not receiving regular foot and eye exams, which are standard in determining diabetic retinopathy and diabetic foot ulcers.

Nearly 50% of older adults were found to have three to five NCD risk factors, which significantly increases their chance of developing serious health problems and, since the prevalence of NCDs rises with age, suggests a growing demand for healthcare services.

Despite numerous public health efforts since the previous STEPS National Health Survey in 2012, Corbett said there had been no significant change in the prevalence of behavioural risk factors, such as diet and exercise, or in BMI. This lack of progress underscores the need for a review of current public health approaches to promoting healthier lifestyles and preventing NCDs.

Turner said officials would soon apply the most comprehensive data ever captured at a national level on the prevalence of NCD risk factors. “Our journey is just beginning; with this wealth of data in our hands, we are now all armed at an individual, family, community and government level to act on the information we have received and reclaim the health of our nation,” she added.

The ministry will share the results of the STEPS Survey in the coming weeks, but the full report and findings will be published on 1 December, when they will be posted here.


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Category: Health, Medical Health

Comments (59)

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  1. Anonymous says:

    Maybe our grossly overweight politicians will set the example for better choices and healthier living. And make a plan for affordable health care for all Cayman residents…

    Trouble is, all of that would fall at the first hurdle, once they consider “what’s in it for me, my bank account, and my cronies”.

    Vote out these Teletubbies.

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  2. Anonymous says:

    I hate to say it, and I don’t think it’s intended this way; but our current system of health insurance and pensions is basically centered around people dying young.

    Think about it: our pension schemes are absolute crap and the fees eat up most or all of the gains. If, after a lifetime of work you’re able to retire, you can only take out just over $1000 per month.

    If you don’t own your home outright that will not be enough for a mortgage or rent. It’s enough for food and CUC and NOT health insurance.

    So basically, you either work your whole life until you drop dead.

    Or you work most of your life until you “retire” but can’t afford medical care and drop dead.

    Or you’re financially stable enough to sort it out and retire “normally” which is maybe 10-15% of the population.

    In the meantime we eat a terrible diet high in sugar and fat. Lead a sedentary lifestyle. It feels as though it’s by design because this country and its people cannot afford to live long after they stop working.

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    • Anonymous says:

      Well, it’s time the Caymanian electorate make some changes instead of just talking about ‘how bad it is here’. I agree with everything you said, but didn’t see where any thought was offered for recruiting and electing better ministers. 30 years of ‘pointing out problems’ has not made a da.n bit of difference to the electorate.

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      • Anonymous says:

        We need a social security plan. Not a plan that just makes money for the Insurance companies

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  3. Anonymous says:

    How did we get this washed up CMO?

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  4. Anonymous says:

    what do you expect?…. caymanians have a garbage diet and have an aversion to any physical activity….
    and the cycle continues…cayman kids are amongst the most inactive on the world

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  5. Anonymous says:

    free money saving solution:
    eat less and do more.
    unfortunately caymanians have been doing the exact opposite for decades

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  6. Anonymous says:

    Waiting in line for drive thru donuts is stressing me out!

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  7. Anonymous says:

    100% of Cayman’s older people will ultimately die.

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  8. Anonymous says:

    and a very expensive school, builders housing and park too.

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  9. Anonymous says:

    … high blood pressure were undiagnosed…
    …the undiagnosed numbers of diabetics and hypertensives…
    … numbers of hypertensives and diabetics.
    … including raised blood pressure and diabetes.
    … More than one in three people with raised blood pressure…

    So BP and diabetics is their focus. Do they really know what are the causes of elevated BP and diabetes? Lower you BP then die from cancer?

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  10. Remove Duty on healthy foods says:

    Government should consider removing Import Duty on Fruits and Vegetables. It would encourage more persons to make healthier choices improving overall health and reducing CINICO burden on the CI Gov budget

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  11. Remove Duty kn says:

    Government should consider removing Import Duty on Fruits and Vegetables. It would encourage more persons to make healthier choices improving overall health and reducing CINICO burden on the CI Gov budget

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  12. Anonymous says:

    So blood pressure is to blame? Hmmm….

    One of the Cayman specific factors affecting health (and BP) of its residents:
    There are more and more people per unit area, population density is ever increasing.

    The inevitable by-product of this population growth is physical poisoning and aesthetic degradation of land, water, air environment, leading to a general deterioration of the living conditions of a person, the vulgarization of values, the erosion of the meaning of life.

    Due to the emotional immaturity of a man compared to his technological achievements, the possibility of self-destruction becomes statistically guaranteed.

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    • Veritas says:

      “The inevitable by-product of this population growth is physical poisoning and aesthetic degradation of land, water, air environment, leading to a general deterioration of the living conditions of a person, the vulgarization of values, the erosion of the meaning of life.”

      But self-responsibility to live a more healthy lifestyle is a choice that many are choosing to ignore. There are MANY things each individual can do, but won’t make the effort. Why does government have to spoon-feed a population to use common sense?

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    • Anonymous says:

      soundbites and buzzwords….

    • Anonymous says:

      Assertion:

      “There are more and more people per unit area, population density is ever increasing. The inevitable by-product of this population growth is physical poisoning and aesthetic degradation of land, water, air environment, leading to a general deterioration of the living conditions of a person, the vulgarization of values, the erosion of the meaning of life.”

      Reality:

      Singapore does very well with a far higher population density. Assuming the total population of Grand Cayman is 100,000, with a land area of 240 square kilometers, the population density is approximately 416 people per square kilometre. Singapore’s population, on the other hand, is over 6 million people, covering a land area of 718 square kilometres. This places Singapore’s population density at around 8,357 people per square kilometre.

      Singapore therefore has over 20 times Grand Cayman’s population density and exponentially better public transport, wider infrastructure, etc.

      😇 Singapore: Asian diet, Asian attitude to physical exercise, Asian levels of governance, Asian levels of marriage and single parenting, Asian levels of atheism, Asian levels of corruption, Asian levels of educational achievement, Asian work ethic, Asian approach to criminal justice (corporal & capital punishment) Asian levels of crime, Asian levels of success.

      🤡 Cayman: Caribbean versions of ⬆️…

      In this context, and as previous commentors have noted, an obvious policy decision would be for CIG to remove import duty on vegetables. Why don’t they do this? One infers that they aren’t interested in anything which doesn’t offer tangible prospects for kickbacks and bribes, and they are also haemorrhaging cash on boondongles such as the new Brac school, and studiously ignoring unsustainable long term liabilities such as civil service pensions and healthcare. They therefore can’t afford to make cuts.

      None of these points are necessarily a major problem for expats, because we’re not allowed to stand for election here, or even vote, so we will leave upon retirement. Terrible for Caymanians, but since they elect such utter dross, one can only infer that they have a collective death wish for their children.

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  13. Anonymous says:

    Give all Caymanians free healthcare and require permit holders to carry the insurance burden.
    Once retired, we can barely afford to live on our pensions and the costs of decent health insurance coverage are prohibitive.

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    • Anonymous says:

      That’s how you end up with no expats working in the Cayman Islands and no health insurance for Caymanians

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    • Anonymous says:

      Healthcare is already free for all Caymanians. The HSA can’t refuse them care so why would they bother to pay?

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    • Anonymous says:

      that will solve nothing. prevention before cure.

    • Anonymous says:

      Work permit holders already fund Cayman. Nonetheless, it is getting increasingly difficult for financial services firms to attract candidates from overseas, because the cost of living is so high here because CIG is so incompetent (e.g. import taxes on vegetables).

      We regularly see people move back home once they have kids, because it becomes too expensive for them to remain. Try shifting even more the burden on to expats and you will kill the golden goose.

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      • Anonymous says:

        Cayman HAS to shift the burden (and as always the blame) on expats. Otherwise they would have no other to blame than themselves… can’t have that. Kind of like: “Who elected these incompetent Ministers? OH SH.T – WE did.”

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  14. Anonymous says:

    This is a classic example of the Ministry of Health and Wellness living in la-la- land. They HAVE NO CLUE.
    Forget about blood pressure and cholesterol numbers. it is an extremely high pollution in the environment, food chain, overmedication and other assaults on a human body.
    No money in the world will fix that.

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    • Anonymous says:

      “Forget about blood pressure and cholesterol numbers…” Yea, that is a good strategy. You can’t fix stupid and there is a lot of that going around here.

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    • Anonymous says:

      What pollution? I heard this oft-repeated trope, and so:

      Environment/air. I bought a variety of air quality monitors from Amazon. They all report extremely low-to-non-existent levels of air pollution.

      Food chain. As the expression goes, “Eat less, mainly vegetables, and exercise daily”. Eating cr*p is a choice.

      Overmedication. Why would you be on medication, if you’re not fat because of eating cr*p?

      “Other assaults on a human body”. Objection: embarrassing for lack of particulars. Please provide further and better particulars of your claim.

      If I were a cynic – which, fortunately I am not – I would suggest that the reason for people’s poor health is overwhelmingly their own poor life choices, most notably their penchant for fast food over vegetables. However, the sort of people who make such poor life choices tend to have what’s called an external locus of control; that is to say that they want to blame other people for their problems. The unpalatable truth may be, to quote an excellent book which I recommend:

      “Realise That It’s YOUR FAULT This one is often a bitter pill to swallow. Not happy with your body shape? Your fault. Not happy with your bank balance? Your fault. Not happy with your job? Your fault. Everything you do in life is a choice. It is YOUR choice. You choose what you get out of this life”

      Self Discipline, Gemma Ray, https://www.amazon.com/Self-Discipline-How-Procrastination-self-discipline-ebook/dp/B07L2G94H7

      But, as I say, fortunately I’m not a cynic. I’m sure that it is indeed all someone else’s fault. Specifically, probably an expat’s fault (particularly during election season).

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      • Veritas says:

        I have not heard the term ‘Locus of control’ for many years (used to dabble in social psychology). Your comments are spot on! The Cayman culture is so engrained to blame others for what is entirely in their control to influence. Scapegoats are easier to stomach than self responsibility.

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      • Anonymous says:

        Pro level troll.

  15. Beaumont Zodecloun says:

    I believe we need to truly nationalise CINICO. Yes, yes, I realise there is a “policy for everybody”, but really CINICO is excellent insurance for government employees, and excellent emergency care for everyone else. Those who aren’t government employees have to pay for their day-to-day meds, doctor visits, ongoing health care, screenings, treatments, etc. As noted in this article, too many people have to choose how to spend the little that they have. Those with families are particularly vulnerable, as parents will spend money on their children’s health care, to the detriment of their own.

    At the top of the pyramid are the government employees. Nothing against them, they work hard for their due. At the bottom are those many NAU recipients, and they are FAR more than most people realise. NAU recipients have a difficult time, however for the most part, their medical needs are covered.

    Those in between these two groups are struggling much more than seems to be taken into account — the Non-CIG middle class, whose insurance premiums could otherwise be used to finance a house, and the lives of a family.

    I don’t want my government to spend money on a cruise port that won’t affect anyone I know. I don’t want my government to spend our money on lofty tourism projects. I want our government to fix the dump in a sustainable way, and I want them to fund –even if it is subsidised — national health care for everyone that truly provides a benefit. We have retired Seamen and Veterans who are struggling to put food on the table, who have no health care. We have elderly that can’t afford the luxury of health care. This is a national disgrace. If we care at all about the people, the fabric of these beautiful islands, we will fund those policies which improve our quality of life.

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    • Anonymous says:

      It’s great to have you back, Beaumont! I have missed your caring, fair and well written comments. You always seem to be able to find a balance when commenting on divisive issues.

      How I wish you would present yourself in politics. We would all benefit from your inclusive views on important topics!

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    • Anonymous says:

      What veterans? Who are these phantom veterans?!

      An 18 year-old in 1945 would now be 97 years old. There aren’t many Caymanians in their late 90’s with WWII service. In fact, I suggest that there are none at all.

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      • Anonymous says:

        Simple math will boggle the simple minds.

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      • Beaumont Zodecloun says:

        Is that really the divisive point you want to make? Do you think there aren’t Veterans and Seamen who have paid their dues and are suffering because of poor health care coverage? Do you really think they should just be flushed because they are too old?

        Have a heart. Someday it will be YOU.

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        • Anonymous says:

          “Do you think there aren’t Veterans […]”

          Yes. This is exactly what I think. I shall be more blunt, because apparently you misunderstood the first time:

          – Caymanian politicians are lying.
          – There are no veterans.
          – They died off many, many years ago.
          – Caymanian politicians are almost exclusively bottom of the barrel idiots who are unemployable off island, and even unemployable on island except in politics.
          – They talk about non-existent “veterans” because simple-minded idiots engaging in high-emotion, low/no-intellect reasoning will deactivate what pitifully few critical faculties you have, and happily vote for the same widow-lickers that have poisoned Caymanian politics since time immemorial.
          – Once again for the slow readers at the back of the room: THERE ARE NO VETERANS.

          Please let me know if this is clear enough to you, or if I need to rewrite it in even shorter words with fewer syllables (I’ve seen the local school results: I understand that reading is likely not your forte).

  16. Anonymous says:

    ✅ toxins from the Dump
    ✅ toxic chemicals from the Dump fires that never go away but accumulate in the environment (forever chemicals)
    ✅ toxins from mosquitoes control
    ✅ toxins from lawn care
    ✅ accumulated radiation from multiple imaging scans
    ✅ mild toxins from a/c ducts (nobody ever replaces ducts)
    ✅ GMO food
    ✅ irradiated food
    ✅ pesticides, herbicide, fungicides in food
    ✅ artificial additives in processed, manufactured food
    ✅ nut milk of all sorts that is loaded with carcinogens
    ✅ all soy products are GMO
    ✅ fake food
    ✅ noise pollution
    ✅ light pollution
    ✅ microplastic in food, water and air
    ✅ lack of sun exposure
    ✅ overuse of antibiotics
    ✅ antibiotics, hormones in meat
    ✅ toxins loaded wild and or farm raised fish

    It makes me wonder how long people born after 1990 will live. At least older people were conceived, born and grew up in a somewhat healthy environment- their DNA and their parents DNA were not assaulted from all directions.

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  17. Anonymous says:

    $575,000 for Pirate’s Week fireworks will fix this.

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