Be more responsible for health, public urged
People are being urged to take personal responsibility in the fight against obesity and poor health.
Doctors alone cannot do it all, according to Dy-Juan DeRoza, the Assessment Officer for the Department of Health’s Epidemiology and Surveillance Unit.
The STEPS to a Well Bermuda Survey conducted in 2014 showed that 75 per cent of the Island’s population is overweight or obese. And if the problem is not addressed, Ms DeRoza said it could lead to higher healthcare costs, reduced life expectancy and more chronic diseases among the younger population.
“Time with the physician can be limited and individuals may need to take more personal responsibility on getting the information that they need,” Ms DeRoza said.
“Doctors can’t do it all, the Health Department can’t do it all. It needs to be a combined approach to improving the health of our population.”
According to Ms DeRoza, the STEPS survey identified five main risk factors for non-communicable diseases: smoking, less than five servings of fruit and vegetables per day, not meeting the World Health Organisation recommendations for physical activity, being overweight and obese, and raised blood pressure.
“Ideally we address all of them,” Ms DeRoza said. “I think the one that resonates with most people is going to be the overweight and obesity. And the fact that overweight and obesity is interrelated — it’s a risk factor and a condition — is what elevates it to one of the highest priorities.”
The survey also showed that almost 40 per cent of adults reported being advised by their doctor or healthcare worker to either maintain a healthy weight or to lose weight.
“We did ask people if physicians have given them lifestyle advice regarding eating more fruits and vegetables and the physical activity and the results weren’t as high as we would have expected,” Ms DeRoza said.
She explained that the survey specifically asked if people had been told to reduce their fat or salt intake. She said the numbers could indicate that people do not remember being given advice or that doctors are imparting more general advice.
But by providing more targeted advice, doctors can help tackle the obesity problem, according to Jeanne Atherden, the Minister of Health, Seniors and Environment.
“I do think that doctors have to make sure that the conversations they have with their patients are more targeted because there is a tendency that the doctor says something to you but you don’t view it as a conversation,” the Minister said.
She added: “It isn’t just about taking the measurement but turning around and having a conversation with them. You don’t want them to get up to where they are now really overweight because then you’ve got too much of a lifestyle to change. We’ve got to start identifying it earlier, so the conversations have to be earlier.”
But she added that the extent to which patients take in the advice is also questionable.
“If the patients aren’t hearing it, even though you’re saying it, then the reality is that the message didn’t get there.
“If they don’t take the message to heart, what will end up happening is that more people will get overweight, more people will get the chronic diseases that come as a consequence of that, more people will then be on medication.”
Ms Atherden added that more people will also be off work and as a consequence the cost of healthcare will go up and the productivity of the country will decline.
“And we can’t afford that from the perspective that we want a well Bermuda,” she said.
“Our target is to make sure that when we do the survey next time that it has not gone any higher. It’s all about us turning around and saying ‘get down to your ideal body weight because it’s important to you from the perspective of being able to carry that weight, trying to be as healthy as you can.
“This is important. This is so that you can live longer, this is so that you can have a better quality of life.”
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The Department of Health is ramping up its efforts to spread the message about the importance of a healthy lifestyle to combating obesity.
Through initiatives such as the Well Bermuda strategy it hopes to educate people about the effects of being overweight and the importance of diet and physical activity.
“We’re trying to focus now on prevention,” said Jeanne Atherden, the Minister of Health, Seniors and Environment. “We’re really going to pay lots of attention now to getting the message out to people about diet and health and exercise. We’re trying to say to people as we go forward ‘all things in moderation’.”
Dy-Juan DeRoza, the Assessment Officer for the Epidemiology and Surveillance Unit, added: “Department of Health’s focus this year is the healthy weight action plan because it impacts on diabetes, because it impacts on cancer, because it impacts on all of those other issues, we’re putting an extra focus on healthy weight for height.”
She explained that the Well Bermuda strategy is a national health promotion strategy that combines three different sections.
“It’s called healthy people, healthy families and healthy communities,” Ms DeRoza explained. “Within each of those there’s a set of goals and each goal has a lead agency and each agency then has to put together an action plan.”
The 2008 strategy, which is now being revised with the STEPS to a Well Bermuda survey results, saw the Department partner with organisations such as the Bermuda Diabetes Association and the Bermuda Cancer and Health Centre to help people understand how their illnesses are related to lifestyle and how to bring about change.
“The purpose of the Well Bermuda strategy is to get community involvement and buy-in from these public health partners to make Bermuda an enabling environment for people to eat better and exercise and reduce these other risk factors such as tobacco use, alcohol use,” Ms DeRoza said.
“We would love it if we could reach the entire population with our messages but unfortunately, with public health messaging throughout the world it is difficult to reach certain segments of the population so we do have to rely on people to recognise that the resources are out there and to recognise that there is personal responsibility for these issues.”
Both Ms DeRoza and Ms Atherden said there are simple steps that can be taken to reduce excess weight, such as following the Eat Well guidelines put together by the nutrition section.
Increasing physical activity by taking flights of stairs, walking and gardening can also make a difference.
“The more things people can do naturally the better because you don’t want to end up putting a stress on them financially when we’re trying to turn around and encourage them to get healthier,” Ms Atherden said.
