Causes of ill health
Despite the high standard of health care available here, there is still very little known about ill-health, the overall health profile of the Barbados.
And in fact, Director of the Chronic Disease Research Centre, Professor Anselm Hennis says the outcomes of heart attacks and strokes seen here now, were what was seen in major overseas countries about three decades ago.
Addressing an audience at the Barbados National Registry’s public lecture and discussion entitled Who’s Getting Heart Attacks and Strokes in Barbados? Finding from the BNR, Hennis said: “It is a bit unfortunate to say but I think the outcomes that we are seeing in heart attacks and so on right now, given no other constraints, are what were seen in places like Europe and the United States 30 years ago. We have to improve this. We only know this because of the BNR.”
Following the lecture delivered by Director of the BNR, Angela Rose, Hennis commented that the work of the BNR and studies it was engaging in would help reveal the kind of profile and information to help shape policy and make health decisions for the island.
“[T]he idea is that we don’t have any good information on the main cause of ill-health and death in Barbados, which really are heart attacks, strokes and cancers… and we set out for the very first time to get real information that’s relevant… So it allows us to use the information to improve the wellbeing of Barbadians…
“When we started the Registry, we discovered that documentation of heart attacks in the hospital was not optimal, documentation of strokes in the hospital by my colleagues was not optimal and right away we started a programme of medical education, so that doctors who write down that someone is having a heart attack based on the changes in ECGs and the blood levels. We realised that documentation of the cause of death was not optimal either, which then led to efforts to improve death registration.
“So much of what we’ve done is based on the information that we’re getting and certainly the stroke unit about to come into being to my mind is one of the outcomes of what we’ve been doing in the Registry. And the idea is now, you can see that roughly there is one new stroke a day and three strokes every two days. The idea now is that we can now, by virtue of this intervention, decrease the severity and prevent death due to stroke in Barbados and the Registry would be able to tell us how well we are doing. We have documented that there is a very high mortality after heart attacks in Barbados and some people don’t make it to hospital alive,” Hennis noted.
While he underscored the work the BNR has done, Director Rose revealed some of the findings on heart attacks and strokes dating back about seven or eight years, though noting the first record of heart attacks at the Queen Elizabeth Hospital was 1971, when there were 24 patients admitted.
Some of the results seen, she suggested, were expected given an increasingly ageing population that would be subject to such. A study from 2007 she said revealed that 25 per cent of the population, age 25 and over had diabetes – about 20,000 people, a ratio of 1:8, compared to 1:25 in the UK. Those in the age range 55 to 64, showed that one out of every five had diabetes, while those 65 and over had a ratio of 1:3.
The study found as well that 34,000 people, one out of every five person had high blood pressure, a figure that rose to one of every two among the elderly over 65.
While there was not a lot of data on non-communicable diseases in the island, Rose said they were slowly gathering the data to form a basic health profile.
Where heart attacks were concerned, 2008 to 2009 figures based on discharged data over a period of 10 years from the QEH suggested that 130 to 150 attacks were being recorded per year.
“Over 30 or 40 years the population has grown and ageing, so what you would expect to see is an increase of heart attacks over time and that is what we are seeing…,” she said.
The study that began in 2009, she said recorded 352 heart attacks per year, which represented an attack per day, while for strokes there were two per day.
It also revealed that one in two persons who suffered heart attacks died before reaching hospital, which she said suggested that people were not aware of the symptoms.
The purpose of the Registry she noted was to help improve and inform on care as well as create national guidelines for healthcare in the island. She said the various studies helped to keep track of what was happening, where problems were occurring and to find solutions. (LB)