Health of the Nation. National NCD risk factor survey, Barbados (2012-13)

Executive Summary

The Caribbean is experiencing increasing levels of illness and death from non-communicable disease (NCD) causes. Regional leaders pledged to combat this epidemic through increased surveillance and intervention, implementing healthcare policies and programmes across our countries. In Barbados, one of the Ministry of Health (MoH)’s initiatives has been the Health of the Nation (HotN) Survey, to provide information on the prevalence and social determinants of risk factors for lifestyle-related NCD. This will allow identification of potential targets for future interventions to improve prevention and control of these diseases in the Barbadian population. In this comprehensive, cross-sectional survey, data were collected for 1234 participants aged at least 25 years (response rate: 55%) on demographics, behavioural risk factors, medical history, place of treatment and costs incurred, blood pressure and anthropometry, and biochemical measures. The survey sample under-represented young adults (particularly men) and over-represented the elderly (particularly women), so a weighting scheme was utilised to balance the sample distribution for age and sex with that of the Barbados 2010 Census. Prevalence of each risk factor was estimated overall, for each sex separately, and stratified by three broad age-groups.

Main findings show that Barbadian adults are at high risk from NCDs due to high prevalence of biological and behavioural risk factors. Most alarming is that two in every three adults in our population (and three-quarters of women) are overweight and/or obese. In addition, more than one in three adults in Barbados (more than one in two of those aged at least 45 years) are hypertensive, and one in five have diabetes (almost one in two of those aged 65 years or older). At least one in three of those with known hypertension or diabetes who were receiving treatment had sub-optimal control. 

Daily tobacco use was reported by one in 10 men, vs one in 50 women. Harmful alcohol use followed a similar pattern, i.e. was mainly reported by young men, with excessive weekly alcohol consumption over the past 30 days reported by roughly the same proportions of men and women reporting daily tobacco use. One in three men aged 25–44 years reported binge drinking in the past 30 days. Core survey results show that Barbadian residents have low fruit and vegetable consumption, while half of the sample reported low levels of physical activity. About one in four adults had healthcare insurance (one in three of those who were employed). More in-depth information on diet, physical activity and cost/insurance will be provided from the relevant survey sub-studies at a later date. Urgent action is required to address the low levels of healthy behavioural risk and high levels of biological risk present in the Barbadian adult population. Community and civil society involvement could help support healthier behaviours. A multi-sectoral approach is required to combat NCD risk on all levels, with creation of national guidelines to supplement an appropriate regulatory framework within an enabling environment.