In 2023, the Cayman Islands Ministry of Health & Wellness embarked on a long overdue examination of the health status of the population, to help inform health policy and steer initiatives at a public health level. The results, published in December 2024, make for sobering reading and point not only towards the massive public health challenge facing the Islands but also a looming crisis in healthcare sustainability should that picture not be addressed.
A National Health Audit
Following the WHO’s standardised methodology, the STEPS Survey assessed a wide range of health indicators among adults in the Cayman Islands. By examining behaviours such as tobacco and alcohol consumption, physical activity levels, and dietary patterns alongside biometric measures (including body mass index, blood pressure, and blood sugar levels), the survey gives us critical insight into the country’s current health challenges. The data not only quantifies personal risk factors but also points to the broader public health infrastructure that must evolve to meet these challenges.
The Data: Numbers That Demand Attention
According to the report of the 2023 STEPS Survey, published in late 2024, the survey uncovered several trends that underscore the urgency of addressing both individual behaviours and community-wide conditions:
- Overweight and Obesity:
The survey found that approximately 37% of adults in the Cayman Islands are classified as overweight, while another 33% fall into the obese category—meaning 70% of the adult population is carrying excess weight. This high prevalence is particularly alarming because excess body weight is a major risk factor for chronic conditions such as type 2 diabetes, cardiovascular disease, and certain cancers. - Physical Inactivity:
Nearly 20% of respondents did not meet the WHO’s minimum recommended levels of physical activity, and if looking at women specifically, this rises to 27.1%. In an age where sedentary lifestyles are increasingly common – exacerbated by desk-bound work habits, high environment temperatures and road safety issues for pedestrians and cyclists – this lack of exercise significantly heightens the risk of heart disease and metabolic disorders. - Hypertension
The survey indicates that roughly 30% of adults have elevated blood pressure, a key warning sign for potential cardiovascular complications, or are on medication for raised blood pressure. Alarmingly, around 35% of those with raised blood pressure are undiagnosed, a figure that rises to 44.4% when looking at men specifically. - Diabetes:
Nearly 1 in 4, or 23.6%, of the population report never having their blood sugar level measured, representing significant potential for severe health consequences associated with untreated disease. However, even in those with identified diabetes, the survey identified many who were not undergoing treatment and around 50% of identified diabetes patients had never had a foot exam. - Tobacco Use:
While the Cayman Islands has a lower rate of tobacco usage than its peers, about 12.5% of adults still reported current tobacco use. Even at this lower rate compared to global averages, continued efforts are needed to reduce smoking-related illnesses. - Alcohol Consumption:
The survey also highlighted some concerns over alcohol use, with 18% of respondents engaged in risky drinking behaviours defined as consuming 6 or more drinks on one occasion. The prevalence was significantly higher in men at 25% of respondents. Such patterns not only pose immediate health risks but may also contribute to longer-term issues such as liver disease and other alcohol-related conditions. - Dietary Habits:
A closer look at nutrition reveals a significant shortfall in the consumption of recommended daily servings of fruits and vegetables. The guidance for a healthy and well-balanced diet points to five servings of a variety of fruits and vegetables daily and is recommended by WHO. Cayman residents consume on average just 1.3 portions of fruit and 1.4 portions of vegetables, across an average of 5 days only.
Expanded data and findings can be found in the 2023 STEPS Survey Report.
The Individual Health Challenge: A Call for Personal Accountability
For many Caymanians and Cayman Islands residents, the 2023 STEPS Survey serves as a personal wake-up call. The statistics reveal that even those who feel “healthy” might be accumulating risk factors silently. Consider the following:
- Weight and Lifestyle:
With nearly 70% of adults affected by overweight or obesity, the survey highlights how modern lifestyles – characterized by convenience foods and reduced physical exertion – are taking their toll. For individuals, even modest adjustments – such as integrating daily walks or choosing whole foods over processed options – can make a significant difference. - Silent Threats:
Elevated blood pressure and blood sugar levels often do not present immediate symptoms. This silent progression means that many may not realize the danger until more serious complications, such as heart attacks or diabetic complications, occur. Regular health screenings and proactive management are vital. - Behavioural Modifications:
The data on tobacco and alcohol use underscores that while progress has been made, there is still room for improvement. Each person’s decision to quit smoking or moderate alcohol consumption contributes not only to their own health but also to the community’s overall wellness.
Public Health Perspectives: Beyond the Individual
While personal responsibility is a key part of the equation, the survey’s findings point to broader systemic challenges that require coordinated policy responses:
- Healthcare System Preparedness:
The high prevalence of overweight/obesity, hypertension, and raised blood sugar levels means that the healthcare system faces an increased burden of chronic diseases. Policymakers must prioritise measures to change this picture. These could include initiatives such as subsidised community fitness programs, accessible health screenings, and nutritional education campaigns. - Successful Campaigns as Models:
The relatively low rate of tobacco use stands as a testament to the effectiveness of sustained public health focus. Similar strategies – using mass media outreach, school-based interventions, and community programs – could be harnessed to improve dietary habits and boost physical activity levels. - Infrastructure and Urban Planning:
Encouraging physical activity requires more than personal motivation – it calls for supportive infrastructure. Urban planning that integrates safe walking paths, parks, and recreational facilities can help create an environment where healthier choices are the easier choices. Such investments not only improve health outcomes but can also enhance community cohesion and quality of life. - Data-Driven Policies:
The robust dataset provided by the STEPS Survey enables public health officials to design targeted interventions. By continually monitoring these indicators, the government can assess the impact of its policies and recalibrate strategies as needed. This feedback loop is essential to ensure that health initiatives remain responsive to emerging challenges.
Drawing Conclusions: A Roadmap for the Future
The 2023 STEPS Survey is more than a compendium of statistics – it is a clarion call for change. It lays bare the intertwined roles of individual behaviour and public policy in shaping the health of the Cayman Islands. Here are some key takeaways:
- Personal Empowerment:
Every Caymanian can benefit from a closer look at daily habits. Whether it’s incorporating regular exercise, opting for a more balanced diet, or committing to routine health checks, small changes can yield significant benefits over time. - Policy and Community Action:
The survey’s findings make it clear that systemic change is needed. Investment in preventive healthcare, community-based initiatives, and supportive urban design will be critical to reducing the burden of chronic diseases. Learning from the successes of anti-tobacco campaigns, similar robust, evidence-based approaches can be applied to other areas of public health. - A Collaborative Effort:
Addressing these challenges requires cooperation among government bodies, healthcare providers, community organizations, and citizens. By working together, the Cayman Islands can craft a future where health and wellness are not merely aspirations but lived realities. - Data as a Guide:
Finally, the STEPS Survey provides a valuable benchmark. Its data-driven insights empower policymakers to track progress, refine strategies, and ensure that interventions are effective. This ongoing evaluation is key to adapting to the evolving health landscape.
As the Cayman Islands grapples with these multifaceted challenges, the 2023 STEPS Survey stands out as both a diagnostic tool and a call to action. Its findings remind us that while the road ahead may be demanding, informed and collaborative efforts can forge a healthier, more resilient future for all.
For those interested in exploring the detailed statistics and recommendations, the full 2023 STEPS Survey report is available on the Cayman Islands Government’s Health and Wellness website. By turning data into action, the Cayman Islands is poised to not only confront its current challenges but also to set a strong foundation for a healthier tomorrow.
Disclaimer: The figures cited above are based on the latest available data from the official 2023 STEPS Survey report as summarized on the Cayman Islands Government website. For the most current and detailed information, please refer to the source directly at gov.ky/health-wellness/steps-survey.
