a civil society alliance for combatting chronic disease in the caribbean

Caribbean Wellness Day: mobilizing a region for chronic non-communicable disease prevention and control

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Samuels TA, Fraser H. Caribbean Wellness Day: mobilizing a region for chronic non-communicable disease prevention and control. Rev Panam Salud Publica. 2010; 28(6):472–9.


The member states of the Caribbean Community (CARICOM) have the highest prevalence of chronic noncommunicable diseases (CNCDs) in the Americas. The CARICOM heads of government issued the Port-of-Spain Declaration “Uniting to Stop the Epidemic of Chronic Non- Communicable Diseases in the Caribbean,” mandating intersectoral, population-based approaches and commemoration of the summit on the second Saturday in September as “Caribbean Wellness Day (CWD).” CWD, inaugurated in September 2008, is designed to strengthen public, private, and civil society partnerships and to promote multicountry, multisectoral activities in support of wellness. By 2009, the second year of the celebrations, 18 of the 20 CARICOM countries embraced and celebrated with multifaceted, multifocal activities, using this as a catalyst for sustained physical activities, healthy food choices, and health screening in a smokefree environment. Organizational support and Caribbean branding of products came from the Pan American Health Organization/World Health Organization and CARICOM. Outcomes will be measured by input and process indicators and CNCD risk factor surveillance.

The Caribbean Community (CARICOM) includes mainland countries Guyana, Suriname, and Belize and the islands of Antigua and Barbuda, Bahamas, Barbados, Dominica, Grenada, Haiti, Jamaica, Montserrat, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, and Trinidad and Tobago. The five United Kingdom Overseas Territories-Anguilla, Bermuda, British Virgin Islands, Cayman Islands, and Turks and Caicos Islands-are associate members (1).

With the exception of Haiti, they are middle income developing countries with a population of 7 million, mean per capita income of US$7 005, and mean life expectancy of 72 years (Table 1) (2, 3). The Caribbean has the highest prevalence of chronic non-communicable diseases (CNCDs) in the region of the Americas (2). Diabetes mortality in Trinidad and Tobago and in Saint Vincent and the Grenadines is 600% higher than in North America (United States and Canada), and cardiovascular disease mortality rates in Trinidad and Tobago, Guyana, and Suriname are 84%, 62%, and 56% higher, respectively, than in North America (Figure 1). In Barbados, the prevalence rate and mortality rate of diabetes related lower extremity amputations are among the highest in the world (4, 5).

Globally, CNCD mortality in middle-income developing countries is projected to increase to 61% by 2015 and 75% by 2030 (6, 7). Currently, almost half of CNCD deaths occur in people < 70 years old, with a quarter < 60 years old, adversely affecting the economy at the individual, household, and national levels (8). CNCDs are more prevalent among the poor, and the decline in cardiovascular diseases in higher income countries occurs later among the poor (9). Addressing chronic diseases is thus a challenge for the core principles of social justice, equity, and access.

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