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COMBATING OBESITY

COMBATING OBESITY. Current Situation in St. Kitts & Nevis: Trends, Drivers, Barriers, Solutions, Recommendations. Patrick Martin Chief Medical Officer @ PACO III, Aruba June 2013. THE CARIBBEAN. ABOUT ST. KITTS & NEVIS. 52, 300 pop; LE: 75 years

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COMBATING OBESITY

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  1. COMBATING OBESITY Current Situation in St. Kitts & Nevis: Trends, Drivers, Barriers, Solutions, Recommendations Patrick Martin Chief Medical Officer @ PACO III, Aruba June 2013

  2. THE CARIBBEAN

  3. ABOUT ST. KITTS & NEVIS • 52, 300 pop; LE: 75 years • Total Health Expenditure ~ US$ 600 per capita • Epidemiology Profile • 2/3 deaths = CHD; Stroke; Cancer; Diabetes • NCDs costs ~ 2% of GDP • Diversion from growth and development activities

  4. OVERWEIGHT PREVALENCE Percent From 1/5 to 1/3 in 6 years

  5. OBESITY PREVALENCE Percent

  6. 10 year boy 71Kg BMI » 30

  7. WHY COME TO PACO III Health is • “Intrinsic to human dignity” • A pre-condition of • Sustainable Economic Growth and Development • Social Stability and National Security • Epidemic Childhood Obesity: A threat to All

  8. Children learn by imitation (they behave like the people around them) • Obesity Continuum Health Sector $$$,$$$,$$$

  9. FOCUS # 1: THE ENERGY EQUATION Obesity = Energy Equation manipulation/distortion

  10. Obesity = Energy Equation manipulation/distortion

  11. Obesity = Energy Equation manipulation/distortion

  12. Obesity = Energy Equation manipulation/distortion

  13. Obesity = Energy Equation manipulation/distortion

  14. Influenced by Price & Mindset

  15. How to Reduce Price of Unhealthy Foods • Subsidies • Low Wages • Mass production • No/Low Border Tariffs

  16. How to Shape Mindset of A People • Marketing/Advertising • Perception Body Image • Perception of Social Status

  17. OBESITY VECTORS ARE IMPORTED • Vectors • Energy-Dense Food • Energy-Sparing Gadgets & Games • Importation driven by supply and demand. • In SKN, demand stimulates supply. • Therefore, Focus # 2 is DEMAND REDUCTION

  18. BARRIERSSOLUTIONSRECOMMENDATIONPROGRESS DEMAND REDUCTION

  19. BARRIER: FOOD IS A STATUS SYMBOL • Shopping in air-conditioned comfort means I have arrived! • Root Vegetables are “Poor people food” I now eat Pizza ...

  20. BARRIER: FATNESS IS AN ASSET • A healthy child is “nice and fat” • Slimness attributed to HIV/AIDS and other illnesses • Fatness (females) is sexy

  21. BARRIERSSOLUTIONSRECOMMENDATIONSPROGRESS DEMAND REDUCTION

  22. COMPETITIVE PRICING • Make Healthy Food More Affordable • Increase Food Security • Subsidize local production • Limited by tight fiscal space • Make Unhealthy Food More Expensive • Higher VAT: Proposed by MoH • Not enacted: Unhealthy foods are popular

  23. RE-SHAPE MINDSET • Prohibit advertising • Need policy & legislation (regional template) • Social Marketing Strategy • PSAs promoting Healthy Diet & Physical Activity (regional action) • Junk-Food Free schools • Alliance Building with Education Sector

  24. RE-SHAPE MINDSET & HABITS • “Eat Local Day” and “Caribbean Wellness Day” • High Level Political Support • Food Service Menus • Reduce salt, refined sugar and fat content • Alliance Building with Private Sector and School Meals Program • Off-Road exercise trails • Alliance Building with Physical Planning

  25. SOLIDARITY IS KEY • Global • “Champion of Change” (e.g. WHO’s FCTC) • Regional • CARPHA/PAHO : Support for • National research • Translation of Research to Policy • Regional SMS + Production of PSAs • Performance Monitoring & Evaluation • PACO  • Best Practices; Lessons Learned; Progress Assessment

  26. CONCURRENCE • Obesity is fundamentally a Social Determinants of Health issue • Genetics plays a minor role • Multi-factorial/sectorial Interventions • Trade, Education, Agriculture, Tax, Health

  27. OBESITY DRIVING FACTORS • CHOICES PEOPLE MAKE (price & mindset) • CHOICES MADE FOR PEOPLE (manipulation) “Although obesity has profound health outcomes and impacts, combating Childhood Obesity requires healthy public policy action on several fronts including the sectors responsible for international trade rules, national taxation, education, and food security.”

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