Poverty levels causing poor health outcomes

People living on low wages are too poor to pay for the medical treatments that could help save their lives, according to the findings of the Ministry of Health and Wellness’s STEPS 2023 National Health Survey findings. They also found that people were still not taking responsibility for their own health – they were overweight, had poor diets and did not exercise sufficiently. The findings were presented by Cayman Islands’ National Epidemiologist, Rachel Corbett, at the Cayman Islands Health Care Conference, held at the Ritz-Carlton last month. They revealed a damning state of health among the local population in the Cayman Islands.

According to the findings, many people are living with undiagnosed conditions, including raised blood pressure and diabetes, with more than 1 in 3 people with raised blood pressure being undiagnosed. Despite the high contact with healthcare services among the population, the data revealed a clear opportunity for healthcare professionals to empower people with healthcare advice and education to improve their health outcomes.

The survey data also highlighted missed opportunities for care, as only 27% of Cayman’s population with raised blood pressure had been diagnosed and were on medication that was 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%. Additionally, concerning diabetes monitoring, the data revealed that large proportions of the diabetic population were not receiving regular foot and eye exams, which are standard in determining diabetic retinopathy and diabetic foot ulcers.

In a press release, the Ministry said that it could not be ignored that finances and good health insurance played a crucial role in people being able to access the care that they needed. 20% of Cayman households survived on less than $15,000 per year. And though 50% of the population were reported to be on a comprehensive insurance plan from a local provider, Chief Medical Officer Dr Nick Gent said:

“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. The cost, or fear of the cost, of health care 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.”

These findings are particularly important when viewed in light of the fact that non-communicable diseases are the leading cause of death and disability in the world. According to the 2022 Compendium of Statistics, in the Cayman Islands, cardiovascular disease was the leading cause of death that year, followed by cancer, unintentional injuries, and then diabetes.

Ms Corbett also highlighted that nearly 50% of older adults were found to have 3 to 5 NCD risk factors, which significantly increased their chance of developing serious health problems and suggested a growing demand on healthcare services, as the prevalence of NCDs rises with age.

In addition, Ms. Corbett highlighted that, despite numerous public health efforts since the previous STEPS National Health Survey in 2012, 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 underscored the need for a review of current public health approaches to promoting healthier lifestyles and preventing NCDs.

Minister for Health and Wellness, Sabrina Turner, said the journey to better health for the Cayman population was 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 stated.

A full report of the STEPS 2023 National Health Survey data and findings will be available from 1 December 2024, on www.gov.ky/steps