Friday, August 22, 2014

Jamaica’s growing crisis

Jamaica Cancer Society (JCS) radiographer Donnett Hyman (left) demonstrates the functions of the organisation's newly acquired mammography machine to JCS Executive Director Yulit Gordon (second left), Health Minister Dr Fenton Ferguson (second right) and JCS Chairman Earl Jarrett. Gordon estimates that being stricken by cancer can cost someone over $4.5 million

WHILE we debate the economic challenges facing Jamaica, there is an emerging crisis that many are not speaking of, but which we must address as a country. This is the health of our population, and as a result the cost it currently has and its continued impact as it worsens. If, of course, we do nothing about it.

Anyone who knows me understands how important health management is to me. In fact, my passion for lifestyle management led me to write a book (Achieving Life's Equilibrium) and one aspect of that is health management, which I also have done a few presentations on.

The data on Jamaica shows that non-communicable diseases (NCDs) account for 56 per cent of all deaths, 20 per cent of which are caused by cancer, and cost approximately US$170 million ($19.2 billion) annually. Much of this cost is avoidable just by changing some aspects of our lifestyle, such as healthier food choices and exercise. What this means is that our failure to make the right lifestyle choices is causing us to spend up to $19 billion per annum on health costs, much of which could be going towards welfare, education, or some other growth inducement spending.

The Lancet Medical Journal recently reported that high body-mass index increases the risk of developing the 10 most common cancers, according to a study conducted on over five million people. Researchers estimate that over 12,000 cases of these 10 cancers each year is attributable to being overweight, or obesity, and estimates that if average BMI continues to increase there could be an extra 3,500 cancer cases annually.

Yulit Gordon, the Executive Director of the Jamaica Cancer Society (JCS), estimates that being stricken by cancer can cost someone over $4.5 million (assuming four chemotherapy treatments) in addition to the costs to visit the doctor and hospital stay and tests. So an individual could easily spend over $6 million in the initial fight against cancer. And I say initial because many times it recurs. The JCS is doing a very good job in the fight against cancer but is in need of greater support to be able to be even more effective.

There are, of course, other significant costs for an individual to deal with NCDs, such as high blood pressure and diabetes. These NCDs are the main reasons for many of us starting to show our age, and all because we make incorrect lifestyle choices; if the proper decisions are made many of these NCDs and associated costs are totally avoidable.

In addition to the cost on the health care system, and ultimately the fiscal accounts and taxes, the fact is that many of the drugs and products used in the treatment of NCDs are imported. So if we assume that 70 per cent of the US$170 million annually is imported, then it means that NCDs are adding US$119 million ($13.4 billion) to our trade deficit annually, which is just under 10 per cent of the current account deficit.

This cost to our fiscal and balance of payments accounts does not include the cost to GDP from productive hours lost due to sick leave or death. If we assume that 40 per cent of our workforce takes their entitled seven days' sick leave per year, then on average this could negatively impact GDP by over $10 billion annually.

Even at the lower estimates, the computations show that the cost of NCDs to Jamaica is an ever growing threat, is totally avoidable, and is a cost that I don't think we emphasise enough. Certainly if you are trying to improve the cost structure (profitability) of a company, one of the first things that you do is to look at the "low-hanging fruit". In other words it is easiest to minimise avoidable costs as a means of improving the financial situation. So while we focus on new taxes, earnings, or wages and salaries, the fact is that if we look carefully at the fiscal accounts there are significant costs that can be avoided by just doing things differently. This is something I remember Ronnie Thwaites stressing when he was on Power 106 for a very long time.

But are we ready to take responsibility and make the necessary lifestyle changes? The truth is that even many of us who promote the idea of lifestyle changes are guilty of poor choices ourselves, and the most effective way to influence people is to ensure that you are a good example. I am always amazed at the way adults, for example, tell children about certain ways they should behave but at the same time do the same things they tell them not to do. So they tell them, "Do not drink and drive, do not text while driving, make sure you eat properly," etc. However, I see many adults setting a bad example for children to follow even in front of the same children that they instruct.

I also notice that many children today are living a lifestyle that will ensure they have health issues earlier, rather than later. Certainly in my teenage days when there was one television station that signed on at 5:00 pm, and there were no video games, we had no option but to go outside and engage in some physical activity like football, cricket, and so on. I also have noticed that when one speaks about the quality of a school we refer to academics and not emphasise the importance of physical education, the result being that many of the children leave school today academically brilliant but without the physical foundation that will ensure that they are healthy enough to enjoy the money they earn from the academic achievements. So many of our children are just ticking time bombs for NCDs.

There is no doubt that if we continue to ignore the necessary lifestyle choices that will improve our health, then we can safely say that Jamaica will face a health crisis in NCDs, similar to developed countries like the US, and this will impact even more on our fiscal accounts and balance of payments.

So while we try to solve our economic circumstances, we should recognise the role that behavioural choices play in our economic challenges, and the significant cost it has, both nationally and individually. In fact, I have heard many people say they cannot afford to eat properly, as proper nutrition costs more. While this may be true in relation to the direct cost of nutrition, they haven't considered the current and future medical expenses from poor nutrition choices, which ends up being significantly more and the negative impact on quality of life.

Apart from the cost, though, we should be encouraging our children to make healthier choices for their own benefit, and my own view is that this has more to do with lack of exercise and consumption of many of the imported processed foods, as our own local brands and produce are a lot healthier. Yet another reason to support Jamaican products.

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