1. Figure 1. Central America and the Caribbean Source: World Health Organisation, Pan American Health Organisation, Library of the University of Texas. Student No: 0828266 GROUP 7: DIABETES IS A KEY PUBLIC HEALTH CONCERN THE ECONOMIC BURDEN OF DIABETES IN THE ENGLISH SPEAKING CARIBBEAN Introduction The global increase in the recorded cases of diabetes constitutes a major public health problem, especially for countries undergoing rapid economic development where most of the new cases will occur (Hennis and Fraser, 2004, p.90). A region which exemplifies this global increase is the English speaking Caribbean, where steadily increasing high rates of diabetes are being recorded (Hennis and Fraser, 2004). The English speaking Caribbean, which is normally referred to as the Caribbean or West Indies, consists of 18 different countries and territories (Hennis and Fraser, 2004) with an approximate population of 6.5 million people (Caricom Statistics, 2007). It is a region that is in the process of a demographic and epidemiological transition, which has resulted in economic growth, urbanization, modernisation and an epidemic of diabetes caused by the adoption of developed countries risky lifestyles behaviours, such as eating large amounts of processed foods and increasing inactivity (Gavin, 2004). These trends have had the impact of making the Caribbean, one of the fastest growing regions of the world for Type 2 diabetes and its myriad complications (Gavin, 2004). Inflicting a high socio-economic burden on the population of the Caribbean, as some countries in the region, are coping with the prevalence of diabetes, in conjunction with high incidences of communicable diseases (Barcel ó et al., 2003). Method This objective of this poster is to present an estimate of the indirect and direct socio-economic costs of diabetes in the Caribbean. The protocol used included statistical data and demographic information obtained from 14 of the 18 Caribbean countries; the World Health Organisation; the Pan American Health Organisation and published journal articles. Statistical data was also extrapolated and formulated into tables relevant to this poster. Results on the indirect costs of diabetes in the Caribbean in 2000 Data extrapolated from a Caribbean population of 5.15 million estimated the number of people with diabetes at 317,200, with type1 accounting for 5,500 people (1.7%) and type 2 accounting for 311,700 people (98.3%) [Table 1]. The total number of deaths caused by diabetes was 5,500 (4.9%) out of an overall mortality rate of 110.200 [Table 1]. The corresponding years of productive life lost was 17,366, representing an estimated of cost $50.9 million for lost working days. In addition, 15,064 individuals were permanently disabled and 50,800 temporary disabled. This accounted for 266,126 years of productive life lost, representing at an estimated of cost of $812.4 million from lost working days [Table 1]. Results on the prevalence of diabetes in the Caribbean Countries with an estimated prevalence of diabetes ≥ 4% than their population were: Antigua and Barbuda, Bahamas, Dominica, Grenada, Saint Kitts and Nevis, Saint Vincent and the Grenadines, and Trinidad and Tobago [Figure 1]. Countries with an estimated prevalence statistics ≤ 3.9% than their population are: Barbados, Belize, Guyana, Jamaica, Suriname [Figure 1]. Results on the estimated direct costs of diabetes in the Caribbean in 2000 The total combined cost of different medications was $152.9 million, whilst the cost of hospitalization was estimated at $2.8 million [Table 2]. I In addition the estimated cost related to consultations was $3.9 million, whilst the estimated cost of complications arising from diabetes was $45.8 million [Table 2]. In total the direct cost of treating diabetes was estimated at $205.4 million [Table 2]. Discussion The findings presented in this poster are all referred to as estimates, because of the lack of comprehensive collated data on the socio-economic costs of diabetes in the English speaking Caribbean. As well as the true extent of indirect and direct costs being difficult to ascertain due to some patients in the Caribbean usage of indigenous remedies instead of prescribed medication,(Hennis and Fraser, 2004), due to the cost of obtaining the recommended medications and treatments. In spite of the limitations of obtaining pertinent data, the information that was revealed does illustrate the economic burden of diabetes for a developing region, and why diabetes is such a key public health concern. For whilst mortality, permanent and temporary disability are quantified in financial terms, these estimates costs do not account for the effects on the members of the Caribbean who are having to provide long term care for individuals disabled by diabetes. Thereby, impinging on their ability to engage in productive employment, which is detrimental to the growth of the more impoverished countries of the Caribbean. In order that diabetes should not become an overwhelming public health problem and socio-economic burden, the Caribbean needs improve the education of both care providers and patients regarding diabetes (Hennis and Fraser, 2004). As well as doing more research into the prevalence of diabetes and its co-morbidities. Item English Caribbean Population No. of people with type 1 diabetes No. of people with type 2 diabetes Total no. of people with diabetes 5,150,000 5,500 311,700 317,200 Mortality Deaths related to diabetes Years of productive lives lost Cost 110,200 5,555 17,366 $50,900,000 Disability No. of permanently disabled patients Years of productive lives lost Cost No. of temporarily disabled patients Years of productive lives lost Cost 15,064 263,281 $750,200,000 50,800 2,845 $11,300,000 Total indirect cost$812.400.000 Item English Caribbean Medication $152,900,000 Hospitalization $2,800,000 Consultations $3,900,000 Complications $45,800,000 Total direct cost $205,400,000 Source: Bulletin of the World Health Organization 2003, 81 (1) Source: Bulletin of the World Health Organization 2003, 81 (1) Table 2. Estimated direct cost of diabetes in the Caribbean 2000 Table 1. Data on people with diabetes and estimated indirect costs of diabetes in the Caribbean 2000 an