1. Saving the Hearts of Jamaicans:Evaluaation, Management and Prevention of Hypertension and Cardiovascular Disease Department of Humanities, Health & Society Division of Family Medicine Herbert Wertheim College of Medicine Florida International University

2. Objectives To learn the risk factors for cardiovascular disease To recognize importance of social determinants in preventing cardiovascular disease. To learn role of Diaspora Mission in diagnosing and managing hypertension.

3. The Problem Cardiovascular Disease is number one cause of death for women in Jamaica and US. Stroke number three cause of death in Jamaica and US Hypertension – Eighth leading cause of death in Jamaica Diabetes- Seventh leading cause of death in Jamaica Life expectancy at birth: 73.48 years male: 71.87 years female: 75.17 years (2014 est.)

4. Population-2,930,050 (July 2014 est.) Age structure: 0-14 years: 28.4% (male 423,855/female 409,651) 15-24 years: 21.7% (male 319,291/female 316,773) 25-54 years: 36.4% (male 525,288/female 542,015) 55-64 years: 5.6% (male 79,875/female 84,562) 65 years and over: 7.7% (male 102,377/female 126,363) (2014 est.)

5. CVD Risk Factors Diabetes Obesity Hypertension Genetics (family history) Hypercholesterolemia

6. 30% Hypertension Rate in 15yo and older The Jamaican hypertension prevalence study. Dalip Ragoobirsingh, Donovan McGrowder, Errol Y Morrison, Pauline Johnson, Eva Lewis-Fuller, John Fray Faculty of Medical Sciences, UWI, Mona, Kingston, Jamaica. Journal of the National Medical Association (Impact Factor: 0.91). 08/2002; 94(7):561-5.

7. Diabetes More than 220,000 Jamaicans between 15 and 74 years old have diabetes-13.6% of the population (2009) The ministry data shows that, up to 2009, there were 92,860 men and 132,469 women, aged 25 years and over, who had diabetes. In 2011, the National Health Fund had 106,017 persons with diabetes on its card programme. The agency paid $616,461,903 to beneficiaries for diabetes alone

8. Obesity Durazo-Arvizu et al. BMC Public Health 2008 8:133 doi:10.1186/1471-2458-8-133

9. Obesity Obesity - adult prevalence rate: 24.1% (2008) Pan American Health Organization 2014 found 30% of Caribbean children 11-14, overweight or obese. Rate doubled over 10 years.

10. Prevention is KEY

11. Social Determinants The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries. World Health Organization

12. Place Matters Urbanization: urban population: 52% of total population (2011) rate of urbanization: 0.51% annual rate of change (2010- 15 est.) Major urban areas - population: KINGSTON (capital) 571,000 (2011)

13. Wealth Matters Unemployment, youth ages 15-24: total: 34% male: 27.1% female: 42.6% (2012) 2014- Overall 13.4% ( www.statinja.gov/jm) CIA World Fact Book,2014

14. Improve daily living conditions Address policies that continue inequitable distribution of power, money and resources. Increase nutrition education in schools and through media. Monitor impact of measures. World Health Organization Address Social Determinants

15. Missions from Diaspora Attempt to align activities to addressing the major health needs. Collaborate with local health agencies to ensure more continuity of care after leaving mission. Provide low cost health monitoring devices- sphygmomanometers, scales, glucometers and strips to local health clinics. Provide culturally appropriate nutrition education materials( alert to sugar content in sodas).

16. Other Ideas THANK YOU.