Chronic illnesses up demand on health care
By CANDIA DAMES
Guardia News Editor
In The Bahamas, an estimated 500 people die annually from either heart disease or diabetes, which are both driven by obesity, according to health officials.
Diabetes, heart disease and strokes account for an estimated 1,700 admissions annually, notes Dr. Patrick Whitfield, a consultant in family medicine at the Princess Margaret Hospital (PMH), who recently completed a paper on the growing risks posed by obesity in The Bahamas. worsen as time goes by in the absence of any significant change in lifestyles and our increasing prevalence of obesity which is largely driven by poor diets and lack of exercise.
“But it is far more complicated than that,” Dr. Whitfield said in an interview with The Nassau Guardian yesterday.
“I think universally people have been focusing on advising people to lose weight, exercise regularly, eat healthier meals but it is far more complex than that because that does not equate to behavioral change. What we need is behavioral change. “And there seems to be no correlation
between passing information on to members of the public — not just here but universally — and that actually leading to change in behavior.”
Dr. Whitfield notes in his paper — “Breaking the culture of obesity requires an intersectoral approach” — that in 2005, the Ministry of Health conducted a Chronic Non-Communicable Disease Prevalence and Risk Factor Survey which revealed that obesity is a significant risk factor in the population.
That study found that approximately 70 percent of the population is overweight. “What we see is the back end of the problem,” Dr. Whitfield told The Guardian. “We’re seeing more and more people getting heart attacks, more and more people are going into renal failure requiring dialysis, that comes from increasing incidence of high blood pressure, increasing incidence of diabetes which is driven by obesity, which is in turn driven by lifestyle.
“And so what we’re seeing is a number of issues that are now arising. We’re seeing people getting sicker, staying in hospital for longer periods of time. “We’re seeing people sustaining far more complications of these diseases, which has proven to be very, very costly to us.”
Officials at the Princess Margaret Hospital said recently that violence and other trauma cases are placing increasing pressure on their resources. The high crime rate is helping fuel the problem, they reported.
Dr. Whitfield said, “In spite of the fact that we have such a high degree of trauma in our society — motor vehicles, homicides and assaults — you will probably find the leading costing item in our Intensive Care Unit is as a result of strokes and heart attacks and so we’re seeing a lot of that.
“We’re also seeing families who are being decimated in terms of financial security where the leading breadwinner will become disabled or heaven forbid have a premature death which leaves the family vulnerable of course to all these financial issues.
“We’re seeing increasing costs in the private sector of insurance premiums. We’re seeing employers having to look at their bottom line and trying to devise schemes whereby they can continue their employee benefits, that is insurance premiums, with the risk of affecting their profit margins.”
Dr. Whitfield estimated that about 80 percent of the 1,700 admissions at PMH is as a result of chronic non-communicable diseases.
He said about $200 to $250 is spent per day, per patient. “We’re having more and more patients who are undergoing dialysis which ballpark costs anywhere between $70,000 and $80,000 per year, per patient and we have in excess of 100 patients now on dialysis,” Dr. Whitfield added.
Dr. Duane Sands, consultant surgeon at PMH, pointed out that the Pan American Health Organization (PAHO) predicts that the impact of these diseases on this economy and all the economies in the Caribbean region will be phenomenal.
“More so than any single other concern, chronic non-communicable diseases will impact our economy negatively by not only a 300 percent increase in deaths (over the next 20 years) but loss of productivity, illness, disability etc.,” Dr. Sands said.
“We’re looking for innovative ways to reduce the bottom line charge to the taxpayers. But if you say you want to have good health and you also want to have education, national security, immigration controls etc. then the money has to come from somewhere.”