The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean.

Diabetes, hypertension and heart disease inflict a heavy health burden on the Caribbean Republic of Trinidad and Tobago. This study assessed the prevalence of self- reported diabetes, hypertension and heart disease in lower socioeconomically placed individuals accessing welfare grants. Data collected between July 2008 and June 2009 were analyzed from 14,793 responses. The survey sought information on education, average monthly income, health, housing, and household facilities. Self-reported disease prevalence was 19.5% (95% CI: 18.9-20.2) for diabetes mellitus; 30.2% (95% CI: 29.5-30.9) for hypertension; and 8.2% (95% CI: 7.7-8.6) for cardiac disease. Diabetes and cardiac disease had equivalent gender frequency; hypertension was more prevalent in women (p<.001). Disease prevalence was highest in Indo-Trinidadians, married and divorced subjects, non-Christians and increased with age. Those with primary education alone were at greatest risk. Trinidad and Tobago have a high prevalence of hypertension, diabetes and heart disease. Hypertension showed gender specificity in women. Prevalence was highest in Indo-Trinidadians, increased with age, and primary education alone was a risk factor. Interventions to arrest the high prevalence of chronic non-communicable diseases to promote wellness are needed in Trinidad and Tobago.

To describe the prevalence of missing teeth, use of bridges and dentures and unmet dental needs among those aged 60 years and above. The associations of these conditions with socio-demographics, type 2 diabetes mellitus and depression were also studied. The work was carried out in 7 Latin American and Caribbean (LAC) cities in 1999-2000. A secondary analysis was conducted on the Survey of Health and Well-Being of Elders (SABE) dataset. The 7 cities were Buenos Aires, Bridgetown, São Paulo, Santiago, Havana, Mexico City and Montevideo. This survey did not employ any oral examinations. Descriptive statistics, chi-square and regression analysis were used to test for associations. Data for 10 902 persons were analyzed. Females made up 62% of the population. Across the SABE population, between 93.7% (Mexico City) to 99.9% (Santiago) reported missing teeth, with an average of 97.5%. Of those with missing teeth, between 55.1% (Mexico City) and 82.4% (São Paulo) reported having bridges or dentures, with an average of 70.1% across all SABE cities. The proportion of the SABE population with ‘unmet dental needs’ ranged from 85.8% (Santiago) to 98.4% (Havana), with an average of 94.5%. Bridgetown, São Paulo and Mexico City demonstrated a statistically significant association between aging and tooth loss. Generally a greater proportion of females (97.6%) reported tooth loss compared with males (96.8%), but in only São Paulo and Montevideo was there a statistically significant association between sex and tooth loss. Generally those with higher education reported less tooth loss, primary education (97.6% had tooth loss), secondary (96.8%) and tertiary (94.7%). All the SABE cities except Buenos Aires demonstrated a statistically significant association between tooth loss and education. The prevalence of missing teeth, use of bridges and dentures and unmet dental needs were high in the SABE cities in 1999-2000. In general across the SABE cities, the elderly with the most missing teeth were less educated or less likely to be a professional. They tended to be not working and were receiving a pension. Additionally they were less likely to report their health as ‘excellent’, were diabetic and were more likely to give responses suggestive of depression.

Background: Accurately defining obesity using anthropometric measures that best capture obesity-related risk is important for identifying high risk groups for intervention. The purpose of this study is to compare the association of different anthropometric measures of obesity with 10-year cardiovascular disease (CVD) risk in adults in the Eastern Caribbean. Methods: Data from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study (ECS) were analyzed. The ECS is comprised of adults aged 40 and older residing in the US Virgin Islands, Puerto Rico, Barbados, and Trinidad. 10-year CVD risk was calculated using the American Heart Association (ACC/AHA) ASCVD Risk Algorithm and categorized in the following high-risk groups: > 7.5, > 10, and > 20%. Logistic regression was used to examine associations between four anthropometric measures of obesity (BMI, waist circumference, waist-to-hip ratio, waist-to height ratio) and 10-year CVD risk. Results: Mean age (SD) of participants (n = 1617) was 56.6 years (±10.2), 64% were women, 74% were overweight/obese, and 24% had an ASCVD risk score above 10%. Elevated body mass index (BMI, > 30 kg/m²) and waist circumference were not associated with CVD risk. Elevated waist-to-hip ratio (WHR, > 0.9 men, > 0.85 women) and elevated waist-to-height ratio (> 0.5) were associated with all three categories of CVD risk. Area under the receiver curve was highest for WHR for each category of CVD risk. Elevated WHR demonstrated odds of 2.39, 2.58, and 3.32 (p < 0.0001) for CVD risk of > 7.5, > 10 and > 20% respectively. Conclusion: Findings suggest that WHR is a better indicator than BMI of obesity-related CVD risk and should be used to target adults in the Caribbean, and of Caribbean-descent, for interventions.

Background: Palliative care is in its infancy in most of the developing world. We set out to explore the lived experiences of families and caregivers of recently deceased cancer patients in Trinidad and Tobago and to determine the unmet needs of the patients and what recommendations could be derived to improve the current services.Methods: A phenomenological approach with purposeful sampling was used. Participants were referred by key health professionals. Face-to-face interviews were conducted. Interviews were transcribed verbatim, with analysis and data collection occurring concurrently. Thematic content analysis was used to determine common domains, themes and sub-themes.Results: Interviews were completed with 15 caregivers. All were spouses or children of the deceased. Ages of the deceased ranged from 43 to 93, the average being 65.5 years. The deceased experienced a variety of cancers including lung, colorectal and oesophageal.Unmet needs were identified under 4 domains of institutions, community, the family unit and the wider society. Institutional unmet needs were delayed diagnosis and treatment and poor inter-institution coordination. Medical and nursing care failed in the areas of health care providers’ attitudes, pain management and communication. The family unit lacked physical and psychosocial support for the caregiver and financial aid for the family unit. Societal needs were for public education to address myths and cultural beliefs around cancer.Conclusion: There is need for systemic interventions to improve the care of those dying from cancer in Trinidad and Tobago. Stakeholders need to commit to palliative care as a public health priority, implementing education, planning services and mobilizing community resources.