Barbadians have an unhealthy love affair with salt that is no laughing matter.
Our cultural practices that have seen our majority Black population using preserved foods with high salt content goes back hundreds of years.
It was part of our survival process. The available sources of cheap food often came in the form of meats preserved in brine, such as pigtails, salted fish and in later years, corned beef.
The population’s desire for high-salt foods has also been fuelled by our modern fast food lifestyle as food producers globally continue to push highly processed items that invariably contain high levels of salt and sugar.
High salt and sugar intake are major contributing factors in lifestyle diseases such as hypertension and diabetes, which lead to major health challenges like heart disease and strokes.
A 2015 paper titled The Investment Case for Non‐communicable Disease (NCD) Prevention and Control in Barbados, coordinated by the Ministry of Health, United Nations Development Programme (UNDP) and the World Health Organisation (WHO), laid out a most unflattering picture of the impact of NCDs in our population.
The opening paragraph of the executive summary was compelling reading.
“Over the 15-year period of the Sustainable Development Goals (SDGs), the incidence of non-communicable disease (NCD) in Barbados is expected to steadily rise. Out of an island population of 270 000 people, 49 000 people (18 per cent) are currently on treatment for hypertension, with 1 000 new cases of ischemic heart disease (IHD) and stroke hospitalised each year.
“IHD, diabetes and stroke are the top three causes of death. Scaled-up investment in NCD prevention and treatment is needed to stop the significant health and economic losses associated with NCDs in Barbados.”
It would be excellent news if we were in a position to report that the situation has improved almost a decade on; unfortunately, the NCD crisis has worsened.
In 2015, Barbados was expending approximately $64 million annually to treat cardiovascular disease and diabetes.
In other words, in the last eight years, the island spent at least $512 million on the treatment of just two NCDs in the population. This is uniquely unsustainable in a situation where other conditions such as cancers, as well as preventative healthcare, have to be factored into the total health budget.
In another display of tragic facts about NCDs in Barbados, the report outlined that NCDs represent the leading cause of death in Barbados. In 2012, it disclosed that cardiovascular diseases (including ischemic heart disease, stroke and other circulatory causes) were responsible for 17.3 per cent of all deaths in Barbados.
There are 1 000 new cases of stroke and myocardial infarction every year, and 49 000 Bajans or 18 per cent of the population are on treatment for hypertension. Moreover, four in five Barbadian women and two in three men are overweight, while over half of all women on the island are obese.
Over the years, various administrations have tried to address the NCD problem at its roots – diet and exercise.
The “sugar tax” was introduced, the impact of which is yet to be fully outlined and interrogated. The call for a “salt tax” has followed.
Interestingly, one of the country’s lead health educators and advocates is not so sure that the introduction of a salt tax elsewhere is having the desired effect.
Dr Kenneth Connell, vice-president of the Healthy Caribbean Coalition, is backing a recommendation by the Ministry of Health not to introduce a salt tax as there is little evidence to suggest that it would work.
He remarked: “I was not a supporter of the salt tax from the very beginning because unlike the sugar-sweetened beverage tax, I felt that it lacked the scientific evidence to support it. I base that on the WTO, which has a menu of public health interventions that are evidence-based in reducing the NCD risk factors.”
On the other hand, the University of the West Indies Cave Hill Campus senior academic expressed confidence in the effectiveness of the sugar tax.
What citizens and our government need to determine is what steps need to be taken as a matter of urgency to turn around what is clearly an NCD catastrophe we are facing.
