Geographical Locations - Jamaica

• (Statistical) Number of Inhabitants per Doctor: 6,159
• CIA - World Factbook: Jamaica

Organisations and Networks

UN and Multinational

• WHO
  -WHO country profile - Jamaica
  - PAHO - Pan American Health organisation / Organización Panamericana de la Salud
  - Regional Office for the Americas / Pan American Health Organization (AMRO / PAHO) in Washington, D.C. (USA)
  - WHO - Tobacco control: Country Profile - Jamaica
  - WHO - Environmental Burden of Disease: Country Profile – Jamaica
• UNDP - Jamaica

Government

• Ministry of Health

Non-Government

Academic Institutions

• University of the West Indies, Faculty of Medical Science

National Policy and Related Documents

• National Health Policy 2006-2015 and MOH Strategic Plan 2006-2010
  The National Health Policy 2006-2015 and the accompanying Strategic Plan 2006-2010 is prepared within the framework of the Medium Term Socioeconomic policy and the philosophy (The Manifesto); international and regional health and development guidelines and. other related national plans… This National Health Policy and Strategic Plan is predicated on 1999 and 2002 data and trends… Based on a national development perspective, the most important challenge to the health sector over the period 2006-2010 is the need to reduce/control the spread of HIV / AIDS, reduce materna1 mortality and control the lifestyle diseases. The approach of the population to health is illness and hospital oriented. It follows that the cause and effect principles of engaging in risk behaviour related to lifestyles are pursued unabated, until signs and symptoms become acute/gross. Health Promotion must therefore continue to be an important strategy.

Reports, Guidelines, and Projects

• A public health and suicide risk in Jamaica from 2002 to 2006
  Background: Globally, suicide is the third leading cause of mortality among persons aged 15-44 years. However in Jamaica it is not among the leading cause of mortality; but its importance cannot be ignored because of this fact. Aims: This study seeks to 1) update the prevalence of suicide in Jamaica, 2) make comparisons with international data, 3) provide an understanding of age-sex composition of those who are committing suicides, and 4) provide public health practitioners with valuable information which will be used to inform policy decisions. Materials and Methods: Secondary data published by the Jamaica Constabulary Force was used for this study. Data were summarized using percentages and associations were examined by Kruskal-Wallis or Analysis of Variance. Results: The suicide rate averaged 2.26 per 100,000 over the last six years. In 2006, the suicide rate for males was 9 times higher than that of females. The group of 65-74 age, among the male population, recorded the highest suicide rate (11.3 per 100,000) and the 5-14 age group recorded the lowest (0.3 per 100,000). The highest rate for the female population (3.4 per 100,000) was recorded in the 65-74 age group. The 30-39 age group showed an overall higher rate of suicide over the study period, this was followed by the 40-49 age group. Conclusions: Jamaica’s suicide rate is among the lowest in the world and in spite of this, there is a need to formulate a suicide policy for the nation in particular males and young adults. [author abstract] [North American Journal of Medical Sciences 2009 August, Vol. 1. No. 3, pp.142-147]
• Access to contraception by minors in Jamaica: a public health concern
  Background: Access to contraceptive by minors (pre-adolescents and adolescents) has spurred policy and legislative debates, part of which is that in an effort to successfully meet government’s objective of a healthy sexual lifestyle among minors. Aims: This study examined factors affecting sexual reproductive health in minors, namely: access to contraceptive advice and treatment, pregnancy, number of sexual partners, sexually transmitted infections (STIs) and confidentiality. Materials and Methods: This research involved quantitative and qualitative data. Two hundred and thirty eight sexually active cases were investigated in Jamaica by the researchers, during the period 2006-2007. The age group population was 9-11, 12-14, and 15-17. Results: The study showed that access to contraceptive advice and treatment by minors was more favorable to males than females. The difference in access to contraceptive between male and female was statistically significant (x˛ = 20.16, p<0.05). Of the 80 male respondents, who are contraceptive users, 11 encountered challenges in legitimately accessing contraceptive methods, while 38 of the 40 female users also encountered challenges. This resulted in unintended pregnancies and impregnation (33.2%), as well as the contracting of STIs (21%). Conclusion: The findings of this study will be important in informing the development of reproductive health services and family life education programs for pre-adolescents and adolescents in Jamaica and other Caribbean countries. [author abstract] [North Am J Med Sci 2009; 1: 247-255]
• Attitude Towards Intimate Partner Violence Against Women and Risky Sexual Choices of Jamaican Males
  For young Jamaican men, it is necessary to prove their virility to their peers and prove to their parents that they are of heterosexual orientation. These demands have produced a society in which men are sexually aggressive, even to the point of using violence to control the sexual choices of women. This paper examines whether Jamaican men who support intimate partner violence (IPV) against women are more likely to have unsafe sexual practices and social attitudes that could increase women’s risk of contracting sexually transmitted infections. Men who responded ‘yes’ to violence against women are more likely themselves to have multiple sexual partners and less likely to use condoms consistently. They are also more likely to have forced a partner to have sex within the last year. Multivariate regression analysis shows that men who responded ‘yes’ to IPV are likely to be young, less educated and living in urban areas. Clearly, women in certain regions or subpopulations face an increased risk of contracting sexually transmitted infections due to the sexual choices of their partners. Intervention programmes to reduce sexually transmitted infections need to be developed with specific aspects of the cultural context of sexual relationships in mind. It seems especially important that male sexual choices and attitudes be directly addressed. Specific suggestions are made about an approach that has a proven record of success in reducing risky practices in high risk groups. [author abstract] [West Indian Med J 2007; 56 (1): 66-71]
• Confronting the Don: The Political Economy of Gang Violence in Jamaica
  "This report presents an overview of the history, prevalence, and distribution of gangs, focusing in particular on their involvement in international drug and arms trafficking and the possible influence of deportees from the United States. It finds that there is a dense social web connecting highly organized, transnational gangs to the loosely organized gangs whose activities are often indistinguishable from broader community and interpersonal violence. It finds that contemporary gangs in Jamaica have their roots in the organized political violence of the 1940s. Though the political facilitation of crime has declined since the country’s bloodiest national elections in 1980, it remains an enduring — though less overt — force. The persistent facilitation of gang activity by politicians continues to hinder targeted violence reduction efforts, despite the government’s vociferous public condemnation of crime and violence and official support of both punitive and social approaches to violence reduction." [Occasional Paper 26 of the Small Arms Survey]
• Contraceptive use among Jamaican teenage mothers
  Objective: To compare the prevalence of contraceptive use among teenage mothers who were participating, and teenage mothers who were not participating, in a program in Jamaica that had been established to deal with the country’s serious problem of repeat pregnancies among adolescents. Methods: A historical cohort design was used to assess the impact that the Women’s Centre of Jamaica Foundation (WCJF) Programme for Adolescent Mothers had on contraceptive use among the target population of adolescents 16 years and under who had experienced a first live birth in 1994. Results: Contraceptive use at first intercourse was found to be higher among WCJF program participants (44%) than among nonparticipants (37%), but this difference was not significant (P = 0.35). Contraceptive use after first live birth was also higher among WCJF program participants (94%) than among nonparticipants (86%), and this difference was significant (P = 0.04). Contraceptive prevalence at last intercourse (in 1998) did not differ between participants and nonparticipants (both 69%). Conclusions: Contraceptive use among this population in Jamaica was highest when the respondents’ perception of vulnerability to pregnancy was most acute, that is, after the first live birth. All adolescents, both males and females, need to be educated about the importance of sustained and effective use of contraception in order to reduce the risk of unintended pregnancy and sexually transmitted diseases. [author abstract] [Rev Panam Salud Publica/Pan Am J Public Health 11(3), 150-157, 2002]
• Globalization, Liberalization and Sustainable Human Development: Progress and Challenges in Jamaica: Occasional Paper
  "This paper presents results from the Jamaica Country Assessment Study, which is part of the UNCTAD/UNDP Programme on Globalisation, Liberalisation, and Sustainable Human Development in Jamaica. It draws together work from country papers, meetings, interviews and other sources to present an overview of Jamaica’s current development position; an assessment of how Jamaica should react to globalization; and a discussion of how Jamaica can achieve the ultimate goal of the development process: sustainable human development. The paper analyses Jamaica’s position in light of an analytical framework developed for the UNCTAD/UNDP Programme by Agosin and Bloom (2000). This framework identifies three overlapping and interlinked policy spheres. Sphere One covers integration into the global economy and the liberalization of markets; Sphere Two addresses the needs for economic growth; and Sphere Three concerns sustainable human development. The framework argues that only a balanced portfolio of policy interventions in each of these spheres is likely to yield mutually reinforcing and positive results, creating a virtuous spiral as growth in one area leads to gains in another." [United Nations Conference on Trade and Development and United Nations Development Programme]
• Hated to death
  Homophobia, violence and Jamaica's HIV/AIDS epidemic [Human Rights Watch]
• Health insurance coverage in Jamaica: Multivariate Analyses using two cross-sectional survey data for 2002 and 2007
  Introduction: Health insurance is established as an indicator of health care-seeking behaviour. Despite this reality, no study existed in Jamaica that examines those factors that determine private health insurance coverage. This study bridges the gap in the literature as it seeks to determine correlates of private health insurance coverage. The aim of this study is to understand those who possess Health insurance coverage in Jamaica so as to aid public health policy formulation. Method: This study used two secondary cross-sectional data from the Jamaica Survey of Living Conditions (JSLC). The JSLC was commissioned by the PIOJ and the Statistical Institute of Jamaica (STATIN) in 1988. The surveys were taken from a national cross-sectional survey of 25 018 respondents (for 2002) and 6,782 people (for 2007) from the 14 parishes across Jamaica. The JSLC is a self-administered questionnaire where respondents are asked to recall detailed information on particular activities. The questionnaire was modelled from the World Bank’s Living Standards Measurement Study (LSMS) household survey. There are some modifications to the LSMS, as JSLC is more focused on policy impacts. The surveys used stratified random probability sampling technique to draw the original sample of respondents. Descriptive statistics were used to provide background information on the sample, and logistic regression was to determine predictors of private health insurance coverage. Results: Health insurance coverage can be predicted by socio-demographic factors (such as area of residence; education, marital status, social support, social class, gender, age), and economic (consumption and income). The findings revealed some similarities and dissimilarities between data for 2002 and 2007. Area of residence, consumption, educational level, marital status, income and social support were determinants over the two periods. Asset ownership was a factor in 2002 but not in 2007. For 2007, age, gender and social class were factors and not for 2002. A dissimilarity in this study was with social support. It was found that in 2002, social support was negatively correlated with Health insurance coverage and this shifts to a positive correlate in 2007. In 2002, age and gender were not associated with Health insurance coverage but these became significant predictors in 2007. Interestingly, poor health status is not correlated with private health insurance coverage. More health insurance coverage is owned by urban than by other town or rural residents. Conclusion: Health insurance coverage is more structured for employed people who are in the private or public sectors more within urban and other towns than rural areas indicating that rural residents, who are faced high poverty and self-employment, will be more likely in continuing their choice in home remedy or non-traditional medicine in order to address their ill-health. Health which is strongly correlated with income means that poor individuals, families, societies, nations, will be less healthy and will need assistance in the form of health insurance to be able to reduce mortality. [author abstract] [International Journal of Collaborative Research on Internal Medicine & Public Health, Vol. 1 No. 8, pp. 195-213 (October 2009)]
• Health in the Americas 2007: Jamaica
  As a health agency, the Pan American Health Organization’s core discipline is epidemiology, which enables the measurement, definition, and comparison of health problems and conditions and their distribution from the perspectives of population, geography, and time. This publication on Jamaica addresses the issue of health as a human right, taking into account both the individual and community contexts, and examines various critical determinants of health, including those of a biological, social, cultural, economic, and political nature. That examination reveals the existence of gaps, disparities, and inequities that persist in Jamaica, especially those related to access to basic services, health, nutrition, housing, and adequate living conditions as well as to the lack of opportunities for human development—all of which contribute to the greater vulnerability to diseases and health risks of some population groups. [Adapted from the preface of Health in the Americas 2007]
• Health Policy and Eye Care Services in Jamaica
  Purpose: To test the hypothesis that access to and amount of eye care services in Jamaica are inadequate and that this is related to insufficient eye care personnel and legal limitations on optometric practice in Jamaica. Methods: An eye care provider survey, a consumer survey, and a literature search were used for data collection. The consumer sample consisted of 500 subjects (aged 16 to 84 years or older) recruited from a stratified random sample of food markets in Jamaica. The provider sample consisted of 10 ophthalmologists and 10 optometrists, randomly selected from licensing rosters. Adequacy of amount of eye care services was measured by comparing the frequency of eye examinations in Jamaica with professional practice guidelines. Access was measured by the eye provider to population ratio compared with calculated need for adequate care. Results: Only 38.6% of the study population had received an eye examination within 3 years and only 23.4% reported having eye examinations at least once every 3 years. Over 43% had never received an eye examination. The total eye care provider/population ratio was only 2.04/100,000 and only 1.32/100,000 when optometrists are excluded. Conclusion: Access to and amount of eye care services are severely inadequate in Jamaica. Outdated optometric laws governing the activities of eye care professionals compounds the problem. [author abstract] [Optometry & Vision Science: January 2000 - Volume 77 - Issue 1 - pp 51-57]
• Homosexuality and HIV/AIDS stigma in Jamaica
  This paper reports on a study of the relationship of homophobia to HIV/AIDS-related stigma in Jamaica. Ethnography, key informant interviews and focus groups were used to gather data from a sample of 33 male and female adults during the summer of 2003. The sample included health and social service providers, HIV positive men and women, and men and women with same sex partners in urban and rural Jamaica. A strong and consistent relationship between homophobia and HIV/ AIDS-related stigma was reported, but the relationship varied according to geographic location, social class, gender, and skin color (complexion) — to the extent that this coincided with class. Stigma against people living with HIV/AIDS and homosexuality was implicated in low levels of use of HIV testing, treatment and care services and the reluctance of HIV positive people to reveal their serostatus to their sexual partners. Data reveal a pressing need for anti-stigma measures for both homophobia and HIV/AIDS, and for training for health and human service professionals. [author abstract] [Culture, Health & Sexuality, 2005; 7: 1–13]
• Inflation, Public Health Care and Utilization in Jamaica
  Objective: The current study examines whether public and private health care utilization switching occurs in periods of inflation, and secondly to investigate the role of inflation on illness/injury, prevalence of health insurance coverage, cost of health care in both public as well as private health care. Method: The research design used secondary data from the Planning Institute of Jamaica and the Statistical Institute of Jamaica. The current study used 2 decades of statistics on inflation, expenditure on health care (public-private utilization), self-reported illness/injury, and annual prevalence of health insurance coverage. Results: Over the past 2 decades [1988-2007] there has been a narrowing of public and private health care utilization in Jamaica. On examination of aforementioned issues, we found that inflation accounted for some of this lowered gap. Another interesting finding is the direct association between inflation and injury/illness, and inflation is inversely correlated with prevalence of health insurance coverage. Conclusion: Jamaicans have a preference for the utilization for private health care than public health care services. Despite this preference, persistent increases in the inflation rate, economic recession in America, lowered remittances, increasing costing on ‘food and beverage’ and ‘meats and poultry’, increased fuel bills are causing a substitution to public health care utilization. [author abstract] [Australian Journal of Basic and Applied Sciences, 3(3): 3008-3024, 2009]
• Jamaican and Barbadian Health Care Providers’ Knowledge, Attitudes and Practices Regarding Emergency Contraceptive Pills
  Context: Little is known about health care providers’ knowledge of, attitudes toward and provision of emergency contraceptive pills in the English-speaking Caribbean, where sexual violence and unplanned pregnancies are persistent public health problems. Methods: We conducted interviewer-administered surveys of 200 Barbadian and 228 Jamaican pharmacists, general practitioners, obstetrician-gynecologists and nurses in 2005–2006. For each country, Pearson’s chi-square tests were used to assess differences in responses among the four provider groups. Results: Nearly all respondents had heard of emergency contraceptive pills, and large majorities of Barbadian and Jamaican providers had dispensed the method. However, about half had ever refused to dispense it; frequently cited reasons were medical contraindications to use, recent use, method unavailability, safety concerns and being uncomfortable prescribing it. Only one in five providers knew that the method could be safely used as often as needed, and few knew that it was effective if taken within 120 hours of unprotected sexual intercourse. About a quarter of Barbadian and half of Jamaican providers thought the method should be available without a prescription, and half of all providers believed that its use encourages sexual risk-taking and leads to increased STI transmission. Nonetheless, most respondents believed the method was necessary to reduce rates of unintended pregnancy and were willing to dispense it to rape victims, women who had experienced condom failure and women who had not used a contraceptive. Conclusions: Future educational efforts among Jamaican and Barbadian health care providers should emphasize the safety and proper use of emergency contraceptive pills, as well as the need to increase the availability of the method. [author abstract] [International Family Planning Perspectives, 2007, 33(4):160–167]
• National Report of Jamaica on Millennium Development Goals for the UN Economic and Social Council: Annual Ministerial Review, Geneva, July 2009
  "The country has made good progress in eight out of the 14 MDG targets for 2015. Jamaica has already achieved the targeted reduction in absolute poverty, malnutrition, hunger and universal primary enrolment and is on track for combating HIV/AIDS, halting and reversing the incidence of malaria and tuberculosis, access to reproductive health, and provision of safe drinking water and basic sanitation. Lagging in gender equality and environmental sustainability, it is far behind in child and maternal mortality targets. Of great concern is the significant slippage in the proportion of the urban population living in unacceptable living conditions or slums." [Planning Institute of Jamaica in collaboration with the Ministry of Foreign Affairs and Foreign Trade for UNDP]
• Nutritional status of 11–12-year-old Jamaican children: coexistence of under- and overnutrition in early adolescence
  Objective: To determine the nutritional status of a cohort of 11–12 year olds and ascertain social and demographic factors associated with under- and overweight in early adolescence. Design: Cross-sectional. Subjects: Subgroup (n = 1698) of the birth cohort (September–October 1986) of the Jamaican Perinatal Survey enrolled in schools in the Kingston Metropolitan area. One thousand and sixty-three parents or caregivers provided social and demographic information. Results: Undernutrition and overnutrition are of public health significance among adolescent Jamaican children. Ten per cent of 11–12 year olds had body mass index (BMI) values below the 5th percentile (boys, 10.6%; girls, 7.1%) but this prevalence is relatively low compared with other developing countries. The prevalence of stunting was low (3%). The prevalence of overweight (BMI$85th percentile) (19.3%) was approaching prevalence rates found in the USA. Similar social and demographic variables were associated with thinness and fatness in males. Birth weight predicted overweight in girls. Conclusions: Under- and overnutrition in early adolescence are important problems in Jamaica. There is a need to address both under- and overnutrition in adolescence in preventive and rehabilitative intervention programmes. [author abstract] [Public Health Nutrition: 5(2), 281–288, 2002]
• Physical and psychological violence in Jamaica’s health sector
  Objective: To determine the prevalence of experiences with physical violence and psychological violence that health staff have had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. Design and Methods: A total of 832 health staff answered the standardized questionnaire that was used in this cross-sectional study. Sampling was done at public facilities, including specialist, tertiary, and secondary hospitals in the Kingston Metropolitan Area; general hospitals in the rural parishes; and primary care centers in urban and rural areas. Sampling was also done in private hospitals and private medical centers. Results: Psychological violence was more prevalent than was physical violence. Verbal abuse had been experienced in the preceding year by 38.6% of the questionnaire respondents, bullying was reported by 12.4%, and physical violence was reported by 7.7%. In multivariate analyses there was a lower risk of physical violence for health staff who were 55 years or older, worked during the night, or worked mostly with mentally disabled patients, geriatric patients, or HIV/AIDS patients. Staff members working mostly with psychiatric patients faced a higher risk of physical assaults than did other health staff. Of the various health occupations, nurses were the ones most likely to be verbally abused. In terms of age ranges, bullying was more commonly experienced by health staff 40–54 years old. Conclusions: Violence in the health sector workplace in Jamaica is an occupational hazard that is of public health concern. Evaluation of the environment that creates risks for violence is necessary to guide the formulation of meaningful interventions for the country. [author abstract] [Rev Panam Salud Publica, 2005; 18(2): 114–21]
• Preventing Dental Caries in Jamaica
  Health condition: In the early 1980s, dental caries in Jamaica was widespread. On average, children had 6.7 decayed, missing, or filled teeth, and fewer than 3 in every 100 children were free of caries. Global importance of health condition today: Dental caries, or tooth decay, is one of the most common chronic health problems of children. Untreated caries is painful and may affect diet, school attendance, and sleep. Tooth decay can have significant negative health and social consequences in later life. Intervention or program: In 1987, at the encouragement of a dentist from the country’s Ministry of Health, Jamaica’s only salt producer began producing and selling fluoridated salt. The Ministry of Health and the Jamaican Parliament completed the necessary legal and regulatory framework, and the government provided biological and chemical monitoring of the salt. Cost and cost-effectiveness: Salt fluoridation costs only 6 cents per person annually. Cost savings from the program are extraordinary: For each $1 spent on salt fluoridation, $250 will be saved in reducing the need for future dental treatment. Impact: By 1995, the health of children's teeth in Jamaica had improved dramatically. In both 6-year-olds and 12-year-olds, the index of the severity of caries had fallen by more than 80 percent. [publication overview] [Case Studies in Global Health: Millions Saved (Center for Global Development, 2007)]
• Public Health Behaviour-Change Intervention Model for Jamaicans: Charting the Way Forward in Public Health
  Health education and health promotion are driven based on understanding lifestyle practices of a population. The aims of the study are to construct health care demand and health promotion models, which are appropriate to the Jamaican population, and to determine the predictors of health care demand. The current research extracted a sub-sample of 16,619 respondents from the survey, the Jamaica Survey of Living Conditions (JSLC), based on those who indicated having sought medical care in Jamaica. The sub-sample was taken from a nationally cross-sectional survey of 25,018 respondents from the 14 parishes in Jamaica. It was administered by the Planning Institute of Jamaica and the Statistical Institute of Jamaica between July and October 2002. A self-administered questionnaire was used to collect the data. Majority of the respondents did not have private health insurance coverage (88.2%); 53.6% had a partner; and 35.2% were poor; 50.4% had at most primary level education. The predictors of health care demand are: health care demand in previous period (t-1) (OR = 0.049); illness (OR = 10.338); injury (OR = 2.370); social class (middle class: OR = 1.135; wealthy: OR = 1.394); per capita consumption (OR = 1.099); union status (OR = 0.845); gender (OR = 2.221); private health insurance coverage (OR = 1.942); age (OR = 1.022) and educational attainment of respondents (OR = 1.315). This study can be used to model critical health promotion emphasis in Jamaica, and any other country with similar socio-demographic and political characteristics. [author abstract] [Asian Journal of Medical Sciences, 2(2): 56-61, 2010]
• Public Hospital Health Care Utilization in Jamaica
  Objective: Health is a crucible component in any discussion on development, and public-private hospital health care utilization accommodates this mandate of governments. The aim of the current study is to examine factors that account for people’s public hospital health care facilities utilization in Jamaica, and to as certain whether is a difference between public hospital care utilization and income quintile and area of residence. Method: The current study has extracted a sub-sample of 1,936 respondents from a national survey of 25,018 respondents. The sub-sample constitutes those respondents who had indicated visits to public hospital facilities for health care or private hospital health care facilities owing to self-reported ill-health. It is taken from a larger cross-sectional survey which was conducted between June and October 2002. It was a nationally representative stratified probability survey of 25,018 respondents. The data were collected by a comprehensive self-administered questionnaire, which was primarily completed by heads of households on all household members. The questionnaire is adopted from the World Bank’s Living Standards Measurement Study (LSMS) household surveys and was modified by the Statistical Institute of Jamaica with a narrower focus and reflects policy impacts. Chi-square, t-test and analysis of variance (ANOVA) were used for bivariate relationships, and logistic regression was used to explain factors that determine who attended public hospital health care facilities. Findings: The current findings revealed that 6 factors determine 35.6% of the variability in visits to public hospital health care facilities utilization in Jamaica. Two major findings from this study are 1) health seeking behaviour and health insurance coverage are the two most significant factors that determine public hospital health care facilities utilization, and that 2) the two aforementioned factors and positive affective conditions inversely correlate with public hospital health care facility utilization. In addition to the above, there is no statistical difference between the utilization of public hospital health care facilities and area of residence while lower income quintile becomes the greater public hospital health care facilities utilization has been. Conclusion: The demands for public hospital health care facility utilization in Jamaica are primarily based on inaffordability [sic] and low perceived quality of patient care. The issue of low quality of patient care speaks not to medical care, but to the customer service care offered to clients. The greater percentage of Jamaicans who access private health care is not owing to plethora of services, higher specialized doctors, more advanced medical equipment, or low, but this is due to social environment – customer service and social interaction between staffers and clients- and physical milieu – more than one person per bed sometimes , uncleansiless [sic] of the facilities. [author abstract] [Australian Journal of Basic and Applied Sciences, 3(4): 3067-3080, 2009]
• Rapid increases in obesity in Jamaica, compared to Nigeria and the United States
  Background: Weight gain in adulthood is now common in many populations, ranging from modest gains in developing countries to a substantial percentage of body weight in some Western societies. To examine the rate of change across the spectrum of low to high-income countries we compared rates of weight change in samples drawn from three countries, Nigeria, Jamaica and the United States. Methods: Population samples from Nigeria (n = 1,242), Jamaica (n = 1,409), and the US (n = 809) were selected during the period 1995–1999 in adults over the age of 19; participation rates in the original survey were 96%, 60%, and 60%, respectively. Weight in (kg) was measured on 3 different occasions, ending in 2005. Multi-level regression models were used to estimate weight change over time and pattern-mixture models were applied to assess the potential effect of missing data on estimates of the model parameters. Results: The unadjusted weight gain rate (standard error) was 0.34(0.06), 1.26(0.12), 0.34(0.19) kg/year among men and 0.43(0.06), 1.28(0.10), 0.40(0.15) kg/year among women in Nigeria, Jamaica, US, respectively. Regression-adjusted weight change rates were significantly different across country, sex, and baseline BMI. Adjusted weight gain in Nigeria, Jamaica and US was 0.31(0.05), 1.37(.04), and 0.52(0.05) kg/year respectively. Women in Nigeria and the US had higher weight gains than men, with the converse observed among Jamaicans. The obese experienced weight loss across all three samples, whereas the normal weight (BMI < 25) had significant weight gains. Missing data patterns had an effect on the rates of weight change. Conclusion: Weight change in sample cohorts from a middle-income country was greater than in cohorts from either of the low- or high-income countries. The steep trajectory of weight gain in Jamaica, relative to Nigeria and the US, is most likely attributable to the accelerating effects of the cultural and behavioral shifts which have come to bear on transitional societies. [author abstract]
• Rural health in Jamaica: examining and refining the predictive factors of good health status of rural residents
  Introduction: Poverty is mainly concentrated in rural areas. Rural populations also generally experience excessive deficiencies in healthcare access, social services, and other goods and services needed for healthy living. This study investigated the health status and determining factors of Jamaican rural residents in order to provide healthcare practitioners and policy makers with research findings to assist in effectively addressing health in rural Jamaica. Methods: The current research used a sub-sample of 15 260 respondents. The sub-sample was taken from a national cross-sectional study of 25 018 respondents from the 14 parishes of the island. The survey from which the present study is drawn used a stratified random probability sampling technique to draw the 25 018 respondents. Descriptive statistics were used to provide background information on the demographic characteristics of the sub-sample population. The model will be established using logistic regression using statistically significant (p <0.05) variables. Results: The sub-sample population of this study constituted 15 260 respondents of which 99.1% responded to the gender question. Of the 99.1%, 50.7% were males and 49.3% females. It was found that 17.2% of the population reported poor health (n = 2554), 82.8% (n = 12 285) reported good health and 5.9% (n = 873) reported private health insurance coverage. The model used had statistically significant predictive power (model χ² = 15939.9, p <0.001; Hosmer and Lemeshow goodness of fit, χ² = 14.46, p = 0.71). It was found that 85.1% (n = 4738) of the data were correctly classified. Of those with good health, 97.2% (n = 4387) were correctly classified, while of those with poor health, 38.6% (n = 451) were correctly classified. Some 12 factors can be used to predict the health status of rural residents in Jamaica with χ² (28) = 1595.03, p <0.001; -2 Log likelihood = 4181.232, which accounted for 38.4% of the variability in health status. An examination of the predictors revealed that the six most influential in descending order were: health insurance coverage (Wald statistic = 492.556; OR = 0.044, 95% CI: 0.033-0.058, p <0.001); age of respondents (Wald statistic = 222.211; OR = 0.957, 95% CI: 0.951-0.962, p < 0.001); secondary level education (Wald statistic = 28.403; OR = 0.580, 95% CI: 0.475-0.709, p <0.001); gender (Wald statistic = 27.804; OR = 1.602, 95% CI: 1.345-1.909, p <0.001); negative affective conditions (Wald statistic = 14.608; OR = 0.949, 95% CI: 0.924-0.975, p <0.001) and positive affective conditions (Wald statistic = 12.208; OR = 1.063, 95% CI: 1.027-1.100, p <0.0010), and number of children in the household (Wald statistic = 11.850; OR = 1.141, 95% CI: 1.058-1.230, p <0.01). Conclusions: The study showed that approximately 83% of rural residents reported good health, and the 12 factors accounted for 38% of the variability in good health. Of the 12 factors, ownership of health insurance was the most significant and this is negatively associated with good health status. The other factors that are predictors of health status of rural residents included age, secondary level education, gender of respondents, and negative and positive affective psychological conditions. Within the context of high poverty and the role of health seeking behaviour of rural residents on health status, there is a need to use an inter-sectoral approach to accomplish better quality of life through improved health status. [author abstract] [Rural and Remote Health 9: 1116. (Online), 2009]
• Rural male health workers in Western Jamaica: Knowledge, attitudes and practices toward prostate cancer screening
  Background: Statistics have shown that since 1988, a significant percentage of males are unwilling to seek medical care. The question is if they had the knowledge, worked in the health system and were educated, would this be any different? Aim: The current study aims to fill this void in the literature by examining the perception of rural male health workers (from the Western Region) about prostate examination, and why they are reluctant to inquire about the probability of having, or the likelihood of not having prostate cancer. Materials and Methods: The study utilized primary cross-sectional data that was collected during February and March 2008 from 170 males (ages 29 years and older), health-care workers who were employed in particular rural health institutions in Jamaica (i.e. Western Regional Health Authority). SPSS was used to analyze the data. Results: When the respondents were asked “Have you ever heard about the screening procedure for prostate?” 71.2% indicated yes, but only 27.1% had got their prostate checked by a health practitioner. When respondents were asked to state what influenced their choice of not doing a digital rectal examination, 20.6% indicated comfort level; 9.4% stated the gender of the health practitioner, 5.3% mentioned fear and others did not respond. Of those who had the examination 2 years ago, 96.5% did not state the choice of method. Conclusion: The current study is limited in terms of its generalizability to rural males or rural males in Western Jamaica, but it does provide an insight into the difficulty of men in breaking away from culture. [author abstract] [North American Journal of Medical Sciences, vol. 2, no. 1, 11-17, January 2010]
• Violence among youth in Jamaica: a growing public health risk and challenge
  "The purpose of this article is to review the relevant literature, describe the existing knowledge regarding aggression and violence among children and youth in the Jamaican context, and evaluate the plausibility of popular assumptions regarding the correlates of aggressive and violent outcomes in Jamaican children and youth. This article assesses the relationship between ecological processes and youth outcomes in Jamaica and is organized in the following manner: the first section addresses the incidence of violence and its impact on society; the next section focuses on the overall conceptual framework and its usefulness in assessing child outcomes in the Jamaican context. Pursuant to that, the individual attributes of violent outcomes are addressed, as well as two levels of the ecological environment: the proximal (near) environment and the distal (far) environment. In the proximal context, the issue of parental involvement is addressed as two separate issues: father absence and mother absence. This is because a substantial number of Jamaican children, historically, have not had ‘involved’ fathers, and recently, the issue of mother absence has featured prominently in the discussions surrounding youth problem behaviors in Jamaica. The final section summarizes the article and discusses implications for policy decision making." [Rev Panam Salud Publica/Pan Am J Public Health 22(6), 417-424, 2007]

Educational Resources

• Association of Caribbean States, Port of Spain, Trinidad and Tobago
• CDC - Travel Information : Caribbean
• Library of Congress, Country Study: Caribbean Islands