With non-communicable diseases (NCDs) accounting for almost 80 per cent of deaths in Jamaica, we have witnessed the exacerbation of these lifestyle diseases due to the current coronavirus (COVID-19) pandemic throughout 2021.
Statistics from the Ministry of Health and Wellness, Jamaica, in 2018 indicate that approximately 32 per cent of Jamaicans over 15 years are living with hypertension, and 12 per cent of our population over the age of 15 have been living with diabetes. One in two Jamaicans are overweight or obese. Living in the era of COVID-19 has shown how damaging its effects can be, especially for persons already battling with these chronic diseases. Studies have shown that being overweight or obese increases the risk of severe illness from COVID-19. The year has also led to the advent of an array of COVID-19 vaccines to provide strong protection against serious illness, hospitalisation, and death.
The impact of COVID-19 throughout 2021 has also taken a toll on the mental health of many Jamaicans. Under extreme pressure or circumstances, persons have availed themselves of unhealthy lifestyle behaviours, which may include increased consumption of unhealthy foods, tobacco, and alcohol, as coping mechanisms
On the other hand, the devastating effects of COVID-19 have compelled work from home, and our students were impelled to engage in remote learning. While these repercussions of COVID-19 might have been seen as a welcome opportunity, the uncertain environment, and some protocols, have contributed to the increased consumption of and access to convenience and fast foods. It is well known that these foods are high in unhealthy fats, salt, and sugar. This, coupled with increased marketing of these foods to both adults and children and more convenient delivery service options, has led to reduced motivation and opportunity to access wholesome, healthy foods. One can assume that the rates of NCDs and obesity as a direct cause of this challenge will have increased over the last two years since the advent of COVID-19.
OPPORTUNITIES AND CHALLENGES
Tobacco Control Bill 2020
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The MOHW has risen to the challenge and introduced key tools in the fight against NCDs such as the submission to Cabinet of the Tobacco Control Bill 2020 in December 2020, which presents a raft of effective measures designed to reduce tobacco use and discourage persons from starting to smoke. The minister of health and wellness warned that for persons who smoke or otherwise use tobacco, COVID-19 poses an additional threat. We know that smokers are also at higher risk for developing severe diseases associated with COVID-19. The Joint Select Committee for Tobacco Control, which was convened by Minister Tufton, has completed the first phase of public consultations and is now charged to debate the bill. We hope that the final bill will not be watered down. The bill seeks to strengthen the Government’s ability to protect the health of Jamaicans,
FRONT-OF-PACKAGE WARNING LABEL
Another key tool in the fight against those NCDs was the proposal for ‘High-in’ front-of-package warning labels (FOPWLs), which has been proven to allow Jamaican consumers to make healthier food choices. The vote for approval of the Octagon ‘High-in’ model, (the most effective FOPWL, backed by local and international research), was changed in an irregular meeting of the National Mirror Committee of the Bureau of Standards Jamaica. Further to this, a Cabinet decision to vote against the black octagonal ‘High-in’ front-of-package warning label and food-labelling standard proposed by the Caribbean Regional Organisation for Standards and Quality (CROSQ) was submitted, a very disturbing development for public health.
FOPWLs can be simple, clearly visible labels to warn or inform consumers of what is in their food, thereby allowing them to make healthier choices. Scientific evidence from the PAHO, MOHW, and UTech study done recently in Jamaica shows that octagon-shaped front-of-package nutritional warnings is the best-performing system to allow consumers to correctly, quickly, and easily identify products with unhealthy nutritional profiles, enabling them to make healthier food choices and potentially reduce the prevalence of non-communicable diseases (NCDs) and obesity in Jamaica.
On the local scene, organisations such as the Heart Foundation of Jamaica’s Global Health Advocacy Project, and partners, have dedicated their time and energy to increase advocacy efforts around educating the public on healthy eating options and healthy food policies, such as FOPWLs, that are indispensable to the health of Jamaicans, especially now more than ever.
It is important that we continue to act and garner public and partner support for the implementation of the ‘High-in’ Octagon FOPWL in Jamaica. More countries are approving and implementing the ‘High-in’ Octagon FOPWL. They have been introduced in Chile, Peru, Uruguay, and Mexico and now recently approved by the Argentinian Senate. In Chile, a comprehensive regulatory approach, including octagon warnings, showed a decrease in household volume of high-sweetened beverages purchases by 23.7 per cent. In Mexico, it has been projected that the octagonal warnings will reduce obesity by 14.7 per cent after five years of implementation and save the country an estimated US$1.8 billion in obesity costs. Current research also shows that there was a decrease in the purchase of unhealthy food and even children are able to easily identify unhealthy products
SCHOOL NUTRiTION POLICY
Good nutrition is crucial for optimising health, development, and academic performance. As students consume a significant portion of their daily energy intake in school, school nutrition may lead to beneficial changes in health outcomes – academic performance and most importantly, dietary behaviours. Research also shows that schools are also a common setting for food marketing by ultra-processed food companies globally through tactics such as branded content and sponsorships, which have an impact on the food preferences and behaviours of children and youth.
With the rates of obesity constantly increasing in Jamaican youth, schools can play an important role in the prevention of obesity. In 2019, we were informed by the minister of health and wellness that the draft National School Nutrition Policy for schools developed in collaboration with the Education, Youth and Information Ministry had been completed and would be brought to Cabinet. The policy aims to promote healthy eating and physical activity among students. “Once finalised, it will become, essentially, the guide for schools to work with those who provide meals to be able to provide a range of options for students so they are not locked into a daily diet of excessive salts, sugars, fats, and other things that may become a problem,” he noted. The National School Nutrition Policy also includes recommendations for regulation of policies banning or restricting the marketing of High Fat, Sugar and Salt (HFSS) foods in the school environment, including sponsorships, grants, and donations by HFSS brands. Nonetheless, the pandemic has presented an ideal opportunity and priority for the speedy implementation of such a policy upon the planned reopening of schools in January 2022 to help minimise the rates and impact obesity and its related diseases have among our youth.
This year has also led to the emergence of inter-generational partnerships in advocacy for healthy food policies. Through the support of the Jamaica Youth Advocacy Network (JYAN) and the University of Technology’s Association of Nutrition and Dietetic Students (UTANDS), Jamaican youth have been given a platform to increase their self-perception as citizens of Jamaica and to lend their voices in support of resources and health policies that will help to shape their future and increase their voice.
Actions included a press release by JYAN, in partnership with the UTANDS and the Jamaica Medical Students Association (JAMSA), published on International Youth Day, calling for the urgent move to finalise and implement the National School Nutrition Policy. Underscoring the current trends in NCDs in Jamaica and disparities in accessibility to safe and nutritious food, the JYAN urges the Government to ensure that such a policy is crafted to encourage diets focused on locally grown produce and other food items that are sustainably manufactured. In addition, these youth-led movements have shown their full-blown support for the implementation of the ‘High In’ FOPWL system as part of Jamaica’s plan to combat the growing NCD epidemic.
THE WORK CONTINUES
As we close 2021, we must be grateful for the many insights gained that will help to pave the way forward to help shape and build a healthier Jamaica. We recognise that we are not alone, and we look forward to embarking upon another eventful journey throughout 2022. We look forward to continuing and strengthening partnerships with our current stakeholders as every single action matters.
We remain hopeful that 2022 brings opportunities for us to revisit areas that have been halted or delayed due to COVID-19, but we will not lose track of them. Let us continue to aspire to create a national movement strong enough to help Jamaicans stay informed, stay engaged, and stay healthy!
We need to advance the following:
• Continued importance of vaccination, pandemic protocols, and leading healthier lives, especially during this pandemic
• Increased availability of healthier food options
• Implementation of a comprehensive school-nutrition policy
• Continued advocacy for the implementation of ‘High-in’ octagonal front-of-package warning labels
• Restriction of the marketing of unhealthy foods to children
• Active participation of youth in national development
• Unintentional consequences of corporate social responsibility and conflicts of interest.
For every inspirational breakthrough, drawbacks are expected. However, we will continue to respond with renewed unity and commitment to defend and expand our scope of health policies that put the health of Jamaicans first. Most importantly, let us highlight the importance of and call for the use of evidence as the basis for all of our government’s decisions around health policies.
Remember … there is nothing sweeter than a healthy lifestyle!
Barbara McGaw is the project manager of the Global Health Advocacy Project at the Heart Foundation of Jamaica. Send feedback to [email protected].