Salutations:
I am most grateful for this opportunity to address your association. Insurers and the health ministry share many interests in common, including a vested interest in preserving the well-being of our clients. We share many similar goals in this regard.
I am pleased with your continued support to the health sector over the years through your outreach projects including the donation of two specialised stretchers to the Port Maria hospital’s operating theatre, such investments bear good fruit.
The impact of avoidable illnesses due to violence, other injuries and non-communicable diseases which are lifestyle related is a major public health problem in Jamaica.
The toll is both national and personal in scope in terms of financial cost and the displacement of limited human, financial and other resources that could be better deployed otherwise.
Among the responses of the ministry of health is the establishment of a national injuries surveillance system that includes the Jamaica injuries surveillance system (JISS), hospital monthly statistical report (HMSR), monthly clinical summary report (MCSR), sentinel surveillance system, hotel sentinel surveillance system and occupational health component.
The findings have been positive in many respects. There has been a decline in the number of road traffic-related injuries treated at the eight (8) government hospitals over the past five years, except in 2009 when the number of cases reported doubled. The majority of persons treated for road traffic-related injuries were 20-29 years old.
In 2011, 4,749 persons were seen in accident and emergency at eight government hospitals due to motor vehicle crashes.
There was a 6.5% decrease in persons treated for motor vehicle crashes from 2010 to 2011. The majority of the persons were between the ages of 20-29 years old (28.7%) with a mean age of 30 years and twice as many men than women were injured (64.6% men versus 35.2%).This trend was the same for both years.
The main mode of travel for victims of motor vehicle crashes was by car (41.5%) followed by motorbike (13.6%) and pedestrians (13.4%).
More men than women were travelling by all modes except for travel by bus. There was no change in the main modes of travel for 2010 and 2011.
The majority of victims were passengers (36.7%) followed by drivers (34.2%) and bystanders (15.6%). When the victim is the driver, then they were 8 times more likely to be male than female.
The inverse is true when the victim is a passenger. This was the trend for both years.
A car (39.3%) was the counterpart vehicle in the majority of motor vehicle crashes.
The majority of persons were not using safety gear (52.8%) when they met in the motor vehicle crash. More men than women used safety gear.
The majority of persons that were treated for a road traffic – related injury did not use alcohol (60.6%). Alcohol use accounted for 3.9% of persons sustaining a road traffic injury. More men than women reported no alcohol use.
However, thirty-five percent (35.3%) of the victims, alcohol use was unknown.
With regard to violence-related injuries (VRI) for 2010 the MOH/PAHO survey shows that:
§ Males were more likely than females to encounter vri and thus represented 57% (7613) of the cases while females accounted for the remaining 43% (5761).
§ Young adults (20-29 yrs) accounted for the majority (31%) of victims of VRI.
§ In total, persons between the ages of 10 and 39 years accounted for 74.5% of the individuals who sought treatment for injuries caused by violent incidents.
§ Overall, the most prevalent method of injury was the use of a blunt object which accounted for 34% (4462) of all injuries.
§ The use of sharp objects and bodily force accounted for a total of 50% (6597), while gunshot wounds accounted for 5% (644).
§ The majority of VRI (73%) were sustained during fights or arguments (9653). Robberies/burglaries, drug and gang related injuries and sexual assaults accounted for a total of 11% of all injuries.
§ An acquaintance was the main perpetrator of VRI, accounting for 42.3% (5679) of such injuries.
§ An intimate partner and a relative perpetrated 16.8% (2252) and 12.3% (1645) respectively, while 12.9% (1724) of injuries were committed by strangers.
The direct cost of violence to the Jamaican health sector is some us $2.2 billion annually, or 40 per cent of the recurrent hospital budget of the ministry of health. Productivity losses were estimated at us$ 62.7 million. The cost of VRI’s care represented 13 per cent of the overall recurrent budget and 44 per cent of the non-salaried recurrent budget of all hospitals.
There are also severe opportunity costs, such as the cancellation of one in every three surgeries at the Kingston public hospital due to violence related injuries.
The insurance industry at this time can assist the cause of promoting increased national well-being by developing innovative products which contain incentives for behaviour change.
Among these could be instituting routine screens (annually) for a range of common illnesses among your clients, and sponsoring education campaigns to reduce injury and illness due to behavioural problems such as violence that can be avoided.
Much positive space can be opened up via this route, and resources freed for more productive activity. We have much common ground to cover.
Meanwhile, it is indisputable that chronic non-communicable diseases such as heart and other circulatory diseases, strokes, cancers, diabetes, and respiratory diseases are the leading causes of death in Jamaica.
Over fifty percent (50%) of all local deaths are linked to these conditions, chronic non-communicable diseases alone cost the ministry of health over us$170 million to treat annually and while the ministry is committed to providing the level of care required,
There is a serious disparity in terms of the opportunity cost of treating these avoidable illnesses and their complications.
Recent lifestyle surveys indicate that the majority of Jamaicans are engaged in little or no physical activity and eating habits show a growing tendency to unhealthy alternatives featuring excess fat, sugar, sodium and carbohydrates.
One in four persons has high blood pressure while one in 12 is diabetic and the rate of cancers is also increasing.
The survey reports a total of 96% of women being sedentary or involved in light physical activity compared to 82% men. Avoiding excess alcohol and reducing smoking, as well as promoting safe sexuality are also vital elements of this strategy.
The focus on prevention also fits seamlessly into my administration’s focus on implementing a transformative, patient-centered health delivery system with an emphasis on restoring and refining primary health care and maximising the use of both modern and relevant technology.
At the regulatory level this administration is committed to introducing progressive steps that will improve the health prospects of Jamaicans in the short, medium and long term.
The ministry of health is currently in the process of seeking cabinet approval to draft a tobacco control act that will provide sweeping protection against unwanted tobacco exposure.
Tobacco use remains a leading cause of cancers, heart disease and a range of other avoidable illnesses and we intend to curtail tobacco use in the public space as one method in reducing these conditions.
At the regional level Jamaica is also committed to a range of measures to reduce non-communicable diseases (NCDS).
Through CARICOM, Jamaica is signatory to the adoption of resolution 64/265which authorized the convening of the UNHLM on NCDS. The UN summit was the second time that the UN has held a global meeting at head of governments’ level on a health related issue; the first was on HIV/AIDS in 2001 which proved to be a turning point for that disease.
The forum also took cognisance of the fact that the conditions in which people live and their lifestyles influence their health and quality of life and that poverty, uneven distribution of wealth, lack of education, rapid urbanization, population ageing and the economic social, gender, political, behavioural and environmental determinants of health are among the contributing factors to the rising incidence and prevalence of non- communicable diseases and other health challenges.
We must respond to the challenge through a whole-of government and whole-of-society effort as we will not be able to treat our way out of this problem. Reducing risk factors and creating health-promoting environments, strengthening national policies and health systems, international cooperation, research and development, and monitoring and evaluation are the only way forward.
I am confident that together, the insurance and financial advisory community can play a major role in consolidating this thrust.
God bless you and thanks again for the invitation to share.