Non-communicable diseases (NCDs) such as cardiovascular diseases, cancer, chronic respiratory diseases and diabetes are the leading cause of illness and death globally. In Saint Lucia, the Epidemiology unit reports that 82% of deaths are attributed to these diseases. NCDs are largely caused by common risk behaviours such as tobacco use, physical inactivity, unhealthy diets and the harmful use of alcohol.
On Wednesday February 14th, 2024, officials from the Ministry of Health, Wellness and Elderly Affairs held a stakeholder consultation to officially release the results of the 2019/2020 Pan American Health Organization (PAHO)/World Health Organization (WHO) STEPwise Approach to Noncommunicable Disease Surveillance survey, otherwise known as STEPS.
The STEPS survey consists of a simple, standardized method for data collection, analysis and dissemination related to chronic diseases and their risk factors. Saint Lucia has now completed two rounds of STEPS, the first in 2012 and most recently in October 2020. The final STEPS results were received by the Ministry of Health, Wellness and Elderly Affairs from WHO/PAHO early in 2022. The official final St. Lucia STEPS report was released in October 2023.
The goal of the STEPS survey was to determine the prevalence of common risk factors for NCDs while exploring demographic and socioeconomic characteristics of the population. The 2019/2020 STEPS survey was carried out from December 2019 to October 2020, with the survey being on hold from March to June 2020 due to the COVID-19 pandemic. A total of 2964 St. Lucians, a representative sample of the Saint Lucian population, were successfully interviewed. This resulted in a 71% survey response rate.
Ministry of Health Officials have highlighted the key findings of the STEPS report which have caused concern, given the association with undesirable NCD outcomes. Overweight and obesity, a body mass index (BMI) over 25 kg/m2 and 30 kg/m2 respectively, are known to pose significant risks to health. The 2020 STEPS results revealed that from a representative sample of the Saint Lucian population aged 18-69 years old, 65% were overweight or obese, (50% of the males, and 76.8% of the females) while 46.1% of the females and 20.6% of the males were obese, BMI>30kg/m2.
The percentage of persons surveyed with raised blood pressure was 39.4% while those with raised blood pressure who had not been previously diagnosed with hypertension was 37.3% (52.8% males and 26% females). 17.1% of respondents (13.9% males, 19.5% females) reported insufficient physical activity i.e.150 minutes of moderate-intensity activity per week. Also concerning was the fact that 83.2% of the population interviewed did not meet WHO’s recommendations for fruit and vegetable consumption, 5 servings of fruits and/or vegetables a day.
The percentage of individuals surveyed with three or more risk factors for developing major NCDs (current daily smokers, eating less than 5 servings of fruits and vegetables daily, and engaging in insufficient physical activity, overweight/obese and raised blood pressure) was 35.4% of the survey population (31.3% males, 38.7% females).
Compared to the findings of the 2012 STEPS results, the prevalence of raised blood pressure has increased, from 27.3% in 2012 to 39.4%, while that of obesity in general and in men has also increased, 31.9 to 34.9 and 17.1 to 20.6 respectively.
The data from STEPS will continue to be used for the development and strengthening of current and future policies and programmes aimed at preventing and managing non communicable diseases. From 2022 the data has been used to support initiatives such as St Lucia Moves which was launched in September 2022. The trends in Alcohol and Tobacco use continue to be a cause for concern and results from STEPS will guide the planning and implementation of programmes which can successfully target these risk factors.
The official results of the Saint Lucia STEPs survey can be found on the WHO website at Saint Lucia – STEPS 2019 (who.int).
The official STEPS report can be found on the govt website at https://www.govt.lc/