Chronic diseases: the new epidemic.

Mortality statistics show that there has been a significant change in the leading causes of death in Jamaica over the last 50 years, characterized by a decrease in the infectious diseases and those due to undernutrition and an increase in the non-communicable diseases. The various patterns of this epidemiological transition worldwide are outlined and the characteristics of this 'new' epidemic are discussed. Data are presented from the findings of the recent multi-country study of hypertension and diabetes, including Jamaica, which shows that as the body mass index (BMI) increases across the African diaspora, so does the prevalence of hypertension and diabetes. Among the Jamaican population studied, the prevalence of hypertension was 19.1% among males and 28.2% among females. Reported prevalence of previously diagnosed diabetes was 5.3% in men and 10.4% in females. The gender differences are in part explained by the differences in mean BMI which were 23.8 and 27.9, respectively, for males and females. 30.6% of males and 64.7% of females were either overweight or obese, with obesity prevalent in 7.2% of the males and 31.5% of the females studied. The increasing prevalence of obesity across the Caribbean is cause for concern as it significantly impacts on the demand for health and medical care. The identification of these reversible risk factors should be used to inform public policy to tackle what will be a growing concern.