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Health Barriers Faced by the Elderly in JamaicaIn line with the global aging population trend, Jamaica has seen a rapid increase in its elderly population. This increase is now calling for continued action to address the health barriers faced by the elderly in Jamaica.

An Aging Population

In 1995, Jamaica reported having 110,430 males and 130,020 females in the 60 years and older group. This represented 9.42% of the total population in the country. By 2001, Jamaica’s elderly population consisted of 122,844 males and 141,869 females. A decade later in 2011, the census reported that the number of individuals who were 60 years or older had risen to 145,204 males and 159,979 females. These numbers indicated a 15.2% increase in the total number of people who were 60 years or older from 2001 to 2011.

Additionally, by 2011, those in this age group accounted for a greater share of the dependency ratio, a ratio measuring the number of young (0-15 years) and old (60 years or older) people in a population compared with that of the working population.

The World Health Organization has stated that this older population is mostly affected by chronic non-communicable diseases, such as cardiovascular diseases, diabetes, arthritis, hypertension and cancers. In 2018, Jamaica reported that 72% of elderly people had at least one chronic illness, with hypertension and diabetes being the most common. This contributes to the high percentage of people taking medication as well. Furthermore, persons over 60 years of age were much more likely to experience protracted illnesses in comparison to the rest of the population.

Healthcare Barriers

With recent progress in Jamaica’s life expectancy, the elderly are living longer. According to the World Health Organization, in 2018, the life expectancy for Jamaicans was 76.2 years. It is expected that these individuals will require more long-term care and rehabilitation services as they become increasingly vulnerable to diseases and lose physical or mental capacities.

However, there is limited access to local long-term care services in Jamaica and the number of caregivers has decreased throughout the country. Traditionally, younger Jamaicans would stay home and help care for older family members, but with the recent fall in family size resulting from a drastic drop in the fertility rate, the number of family members available to care for these individuals has significantly declined. The issue is worsened by the increasing number of young Jamaicans migrating abroad, typically to the United States, and leaving their older family members behind who frequently encounter difficulties in accessing rehabilitation services independently.

Financial Barriers to Healthcare

Many older Jamaicans also face financial barriers in accessing much needed medical treatment and services. While Jamaica has established a wide and extensive network of public primary care centers and hospitals offering free or low-cost services, the cost of medications and other health care resources has risen as most of these products are imported and the nation’s currency has undergone severe devaluation.

These financial burdens are especially felt by the country’s older population who rely on pensions to cover their living and health expenses. The Old Age Pension provided to qualifying retired Jamaicans is usually insufficient to cover the additional health costs associated with old age as the pensions do not adjust to meet the yearly changes in the cost of living.

Lack of Access to Healthcare in Rural Areas

Additionally, older Jamaicans living in rural areas experience significantly higher barriers to health as there is a lack of overall access to medical care, health and treatment services and transportation. A study conducted in 2012 found that people living in rural areas tend to have more “uncontrolled and undiagnosed disease,” evidenced by the fact that 27.5% of those surveyed who were diagnosed with high blood pressure had not previously received a diagnosis from a doctor. Furthermore, among those who had received a prior diagnosis, 72.2% had signs of the disease as being poorly controlled.

Also, health barriers are intensified by the fact that only 30% of the elderly population living in rural areas are pension recipients as compared to 44.4% in the Kingston Metropolitan Area. The elderly in rural areas also report having greater issues with food availability and adequacy as 53% stated not having easy access to the food they need.

Researchers Eldemire-Shearer, K Mitchell-Fearon and DL Holder-Nevins stated in 2014 that these difficulties in accessing treatment and food emphasize the health challenges that older Jamaicans face as the current health system is primarily engaged in reducing chronic disease and maintaining functional ability. They say a different approach is needed to better meet the new demands of older Jamaicans who suffer from prolonged mental or physical conditions.

Addressing Barriers

In 2018, the Jamaican government revised the National Policy for Senior Citizens, created in 1997, to introduce new measures for supporting and improving the quality of life for the elderly. The plan outlines a multi-stakeholder approach designed to address social, economic and health barriers faced by this fast-growing population.

The document promotes universal access to quality health care for all senior citizens and acknowledges the varying medical needs within this age group. It also calls for a greater expansion of health insurance coverage since only 23% of elderly people are insured.

Furthermore, the plan outlines steps for improving income security for all senior citizens and tasks the government with providing food assistance when necessary. It also provides detailed initiatives for expanding access to health resources, including mental health services, home and respite care, physiotherapy and other rehabilitation services. All these health resources for the elderly are to be carried out under the supervision of the National Council for Senior Citizens, which monitors and evaluates the progress of senior citizen programs at both the national and regional levels.

While the existing health care system will require the full implementation of all these measures in the coming years to combat the health barriers faced by the elderly in Jamaica, this policy plan offers a comprehensive guide to start addressing some of these challenges.

– Emely Recinos
Photo: Flickr

Healthcare in Jamaica
In the tourist’s eye, Jamaica is an enticing island with constant summer sun and alluring beaches. However, behind this guise, Jamaicans face a complicated reality. Healthcare in Jamaica is in desperate need of improvement. There is an increasing obligation to balance public access to health services with the practitioners’ ability to keep up with the enlarged workload.

Health Problems in Jamaica

Jamaica has many health issues that require an effective healthcare system. The top health issues that lead to premature death in Jamaica include stroke, diabetes, neonatal disorders, Ischemic heart disease and HIV/AIDS. Along with these issues, mental illness and STDs disproportionately affect Jamaica’s youth, and these often correlate with social and economic factors. The 2017 Global School Health Survey found that 24.8% of students seriously considered suicide and 18.5% of students attempted suicide over a 12 month period. In terms of STDs, only 31% of Jamaicans over the age of 15 and 51% of Jamaicans under 15 living with HIV were receiving treatment in 2018.

In order to try to make healthcare accessible to all Jamaica introduced free public health services to its citizens in 2008 by removing user fees. On the surface, this appears to be a positive step in removing the economic barrier that prevents the poor from receiving adequate healthcare. However, this has revealed deeper issues for healthcare in Jamaica.

Issues with Free Public Health Services

With the increase in patients, health practitioners have found themselves experiencing overwork and extreme stress. This shift has negatively affected the performance of these practitioners as patient demand has increased, but facilities remain understaffed. In 2016, researchers evaluated how the removal of charges has directly affected the workload. The study found that before the instigation of the free services, 50% of health practitioners had satisfaction with their workload. By 2016, eight years after the introduction of free healthcare, only 14% had satisfaction with their workload.

Some doctors interviewed for the study indicated that both the clinics and hospitals were seeing more patients daily after the elimination of charges. The quality of care worsened as medical professionals did not account for waiting times and availability of resources. The size of health clinics and the number of staff pale in comparison to the number of Jamaicans seeking care.

Along with the insufficient number of health practitioners, Jamaica’s medical infrastructures often do not match the demand of patients. Those in rural areas especially must travel long distances to access health care. The expansion of health facilities is extremely expensive. With Jamaica’s financial debt, this is not a project that it can take on lightly.

Also revealed in this situation is the scarcity of resources available to health clinics. The flood of patients has caused issues such as a delay of bloodwork and a shortage of medication. There have even been situations where patients had to purchase the medical supplies necessary for their surgery, costing an extreme amount that counteracts the efforts of free healthcare.

Upgrading Health Facilities

However, the failings of healthcare in Jamaica does not mean that the country is beyond help. In fact, the Minister of Health and Wellness announced in 2019 that over the next five years, Jamaica will be upgrading public health facilities with the funds of $200 million. The Minister plans to upgrade nine public health centers and six hospitals, one of which is the Cornwall Regional Hospital, which will benefit more than 400,000 residents. The Minister also plans to build a new Western Child and Adolescent Hospital, in addition to developing more sophisticated healthcare technology.

NGOs such as UNICEF are also doing work. The agency has established a Health Promotion program that works to provide quality health services to babies, adolescents and young mothers. The two goals of this program are to enhance institutional capacity to deliver effective health services and to boost the access of adolescents to these health services. By partnering with groups such as the Word Health Organization and Jamaica’s Ministry of Health and Wellness, UNICEF is carrying out its Baby-Friendly Hospitals Initiative, Adolescent-Friendly Services and Empowerment of Girls and Young Mothers.

Healthcare in Jamaica is lacking in many areas, but the country is doing continuous work to enhance health facilities and services. This progress shows that the country should see improvement in the future.

– Natascha Holenstein
Photo: Pixabay