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Third round of STEPS survey underway: Assessing health habits and risk factors for NCDs

As chronic non-communicable diseases are the leading cause of death in The Bahamas, accounting for more than 74 percent of deaths, according to Minister of Health Dr. Duane Sands, his ministry is collaborating with the Pan American Health Organization (PAHO) in conducting a STEPS 2019 survey on seven islands to assess health habits and risk factors for the diseases.

STEP, is a simple, standardized method for collecting, analyzing and disseminating data in World Health Organization (WHO) member countries.

The household survey, similar to the national census, collects information on the health habits of Bahamians and their risk factors for chronic non-communicable diseases (NCDs) like diabetes, hypertension, cancer and chronic respiratory diseases; tobacco use, physical inactivity, unhealthy diet, excessive alcohol consumption, obesity and high blood pressure are some of the risk factors associated with NCDs.

“NCDs are caused largely by our lifestyle choices or habits rather than infections,” said Sands. “They include diabetes, cardiovascular diseases, cancer, and chronic respiratory diseases. These diseases account for 74 percent of the deaths in our country, and they also significantly contribute to the increased expenditure in the health sector. They also demand a lion’s share of the national health budget to provide medications, health and rehabilitative services. Knowing the prevalence of risk factors helps to tailor policies, systems and interventions. Additionally, they help Bahamians understand their risks, and empower Bahamians to make healthier choices,” said Sands.

The voluntary survey which began this month will be conducted through March. Approximately 4,000 Bahamians are expected to participate in the home-based one-hour survey. Participants will be screened on New Providence, Grand Bahama, Abaco, Eleuthera, Exuma, Cat Island and Inagua – to assess health habits and risk factors for NCDs.

“Participating in STEPS is very important. It will help us collect the correct information that tell us about the health of our nation, forecast and plan for the future demands for health services related to NCDs – [for] example, how many nurses, doctors and health centers we will need in the future; evaluate how effective their programs are and to plan programs and health services to prevent, reduce and control these diseases in our country. At the end of the day, all services, plans and programs are geared toward keeping all Bahamians well and healthy,” said the health minister.

“When you participate, you will have some of the important health screenings/checks done free of charge in the comfort of your home – your blood pressure, blood sugar and cholesterol checked. Your height, weight, waist circumference will be measured and urine tested.”

Persons 18 to 69 years of age will be identified to participate in the survey.

Interviewers from the Ministry of Health, Department of Statistics and the University of the Bahamas (UB) will visit selected homes to complete the three-step survey.

“The STEPS Survey is a tool to determine risk factors for developing a non-communicable disease at the population level.”

The risk factors for NCDs are grouped into modifiable risk factors and biological risk factors. NCDs share four common modifiable risk factors – physical inactivity, unhealthy diet, tobacco smoke and the harmful use of alcohol. The biological risk factors he said are high blood pressure, overweight/obesity, high blood glucose and high cholesterol.

The health minister said by participating in STEPS people will aid the Ministry of Health in forecasting, planning programs and health services to prevent, reduce and control the diseases in the country.

According to Sands, the survey is important because it helps the Ministry of Health understand how much of the population has the risk factors.

This will be the third round of this study in The Bahamas. Earlier rounds were conducted in 2005 and 2012. During the 2012 survey, conducted on 1,654 adults aged 25 to 64, socio demographic and behavioral information was collected in step one; physical measurements such as height, weight and blood pressure were collected in step two; and biochemical measurements collected to assess blood glucose and cholesterol levels were collected in step three.

With the 2019 round, which was to have taken place in 2018 with the findings scheduled for a March release, The Bahamas became the only country in the region of the Americas to have participated in more than one round of STEPS, a reflection of the political and attending financial commitment to advance evidence-based policies for wellness and health system improvement. The third round STEPS survey was initially to have been conducted October through November 2018.

In an earlier interview Sands said that the WHO estimates that by 2020, chronic non-communicable diseases will be responsible for more than 60 percent of deaths worldwide.

At the time, he said The Bahamas in 2018 already exceeded that target with 74 percent of deaths resulting from an NCD.

“In simple terms, Bahamians have a 17 percent chance of dying prematurely from NCDs like heart disease, diabetes, cancer, or chronic respiratory illnesses; almost two percentage points higher than the rest of the region,” he said in October 2018.

Last year, Dr. Esther Mary De Gourville, a PAHO representative said the survey would allow the country to collect its own data, but it would also allow the WHO to compare the data from The Bahamas to other countries in the world and to look at the trend in disease prevalence.

Gourville said the WHO recommends that the STEPS survey be repeated every five years, and that the importance of repetition of the survey is to allow for monitoring of the trends in the occurrence of the non-communicable diseases and risk factors and also to allow the Ministry of Health to evaluate the impact of its own public health interventions in improving the health of the Bahamian population.

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