Notes From a Native Son: Is the Obesity Epidemic Reflective of our National Overdosing?

Hal Austin

Hal Austin

Introduction:
As Kofi Annan once memorably said, Barbados punches above its weight. It is one of those exaggerated statements that would come back to haunt the objects of such flattery and the author of such inflated praise.

According to the United Nations Food and Agricultural Organisation, this tiny island of between 270000 and 300000 people is now one of the fattest nations on earth. Of course, one only has to see the school children running – or rolling – for the bus in the mornings to realise this is a nation on its last legs. This observation, however, coincides with another development hardly mentioned by our politicians, policymakers, neighbours and workmates: Barbados is facing a ticking demographic time bomb. When the two collide, an obese younger generation and growing longevity, the fiscal explosion waiting to happen will make DLP incompetence over the recession and structural chaos look like child’s play.

For the firs time, we as nation are faced with the children and grand children of the babyboomers facing an earlier grave than their elders, through a reckless lifestyle, including a poor fast food diet, physical laziness and a reluctance to exercise.

An Ageing World:
The world is ageing, and with that emerges the twin social policy issues of a declining dependency ratio and serious ill heath in older retirement – both major issues for the economy. Despite a popular belief that the state provides an adequate social safety net for those reaching retirement age and those who have actually retired, this in reality is far from the case. The current crude and almost criminal abuse of the national insurance scheme and the too often pensioners’ voices raised about not receiving their pensions on time should raise alarm bells. Even those people who get their pensions from overseas often complain that the banks, on advice from the central bank, hold on to their money for far too long. This is made worse by the dubious practices by insurance companies and the proper lack of regulation and supervision, which allow them to operate like cowboys; Clico and its ever-running chaotic problems is just one example of incompetence at the very top level of the private and regulatory sectors. But it is the dependency ratio: the number of people of working age to those above the state retirement age, which will created problems for public finances.

Demographics of Ageing:
It is often said, usually by those in positions of authority, how sophisticated Barbados is as a society; equally, to be critical of this often brings out the hostility in those who raise questions about being constructive in criticism. The reality remains, however, that there are huge gaps in our knowledge of our society, gaps which must be filled in if our policymaking is going to have any relations to the facts on the ground.

In terms of longevity, it is still not clear what impact this demographic change will be on the rest of society, what it will mean in terms of real numbers, and in terms of health and social service costs. The problems thrown up by an ageing society, however, are not just economic, measured in terms of the labour force, productivity and GDP growth. It is also cultural and socio-economic, reflected in their consumptions patterns, social and cultural interests, but most important of all about fertility and the cost and provision of long-term care.

Like most western societies, there has been a falloff in fertility by young Barbadian women, from the four and five children of their parents’ and grand parents’ generation, to a rate now under 2.0 per cent, just below replacement levels. At the same time, due to improvements in diet, lower infant mortality, public sanitation, and medical science, people (the babyboom generation) are now living much longer than at anytime in history. The other elephant in the room in terms of longevity is the increasing divorce rate and the search for love in old age. This has given rise to growing promiscuity among the retired and, with it, an alarming rise in sexually transmitted diseases.

Economics of Ageing:
What does all this mean in economic terms? In simple macro-economic terms, the economics of ageing follows a basic equation: expected life = expected healthy working life + expected unhealthy working life + expected healthy retirement + plus unhealthy retirement. After this there is death. The underlying assumptions, which actuaries are much better at than I can ever be, are that people of working age will in the main be economically productive and contributing to the exchequer through taxation and national insurance contributions. There is also evidence that a healthy working older cohort could contribute nearly three per cent to GDP, Apart from the cost of ageing, one thing that is often overlooked is that older people are more likely to be self-employed, have greater assets, start new businesses and have investment equities past the state retirement age. They also save the state money by baby-sitting for their children, volunteer for civic  activities and, in their early retirement, play an active role in their local church and wider community. These longevity projections will inevitably call for sophisticated lifetime financial planning, from the cradle to the grave, including care home and funeral fees. This will necessitate an improved form of financial regulation, supervision and most of all training and qualifications. If government jumps at this opportunity, we will take one step back, but will be miles ahead of similar small economies. They also present challenges to the government and the insurance sector in terms of protection product design and suitability, which will become central to the relationship between client and regulated financial adviser.

Long term care planning must be separated from pensions policy. The two are different: one assumes the provision of a retirement income for the third or so of one’s life when one is not economically active, while the other assumes funding for the serious degenerative diseases and inability to help oneself in the advanced years of retirement. For pensions, ever since Bismarck, the world has become accustomed to the fact that it is prudent to save for one’s retirement. The challenge for government and policymakers is how to nudge current working population in to saving for the likelihood of serious illness in older retirement. One option that government must seriously consider is compulsory saving for long term care.

In itself compulsion is nothing new or to be afraid of. We already have a legal obligation to get motor insurance, and mortgage lenders insist on home insurance; Chile, the nation that gave us the modern form of pensions, has made it compulsory for all working people to contribute seven per cent of their pay in to the National Health Fund or to a private equivalent. So, it is a bullet we have got to bite at some point. The insurance sector in Barbados is comfortable picking low-hanging fruit – motor insurance, which is legally compulsory, dodgy annuity contract, whole-of-life insurance policies which the policyholder closes after a couple years, resulting in the providers holding on to the money and, most of all, embarrassing public ignorance.

Health, Nutrition and the Elderly:
Another major challenge facing the elderly, especially the older elderly (those aged in their 80s and 90s), is getting nutritional meals every day.
Quite often, if they live with younger relatives, they are forced to eat what the others get, like it or not. It is an issue that is largely overlooked, and apart from the Park Kitchen ran by the late Ernest Deighton Mottley, when he was Mayor of Bridgetown, such generosity of spirit and advanced thinking in social policy terms, has not been tried again. Apart from one or two politicians, who feed their constituents in exchange for their votes, few people at a governmental or civic level care very much about how the elderly eat.

It is a responsibility the management of which can easily be devolved to constituency council, working in close cooperation with relatives, neighbours and volunteers, but is rightly that of the chief medical officer. One example of community intervention on this level in Britain, which I find appealing, is in pairing home cooks with the elderly. Such an example of civic society at work, however, cannot be aw replacement for a comprehensive health and social care programme as part of the government’s overall public policy. But it is a radical change in lifestyle and nutrition that will improve the quality of Barbadian lives.

I remember as a little boy my grandmother, a lovely woman and cook, putting sugar in dumplings, sugar in condense milk; we drank sweet tea, fizzy drinks, we sprinkled sugar on fruit, ate lots of sweet cake, turnovers, cut drops – pastry and cakes were the joys of growing up. Many of us also ate too many Gwen Workman specials, along with Martineau drinks, then feasted on pork chops in Carrington Village, fried fish – all the wrong things for growing young people to eat and drink. It was a lifestyle that should not have been encouraged and which, in time, will come back to haunt most of us. These are different days; prevention is better than cure, and nowhere is this more true than in long-term health care.

By encouraging people to change their lifestyles from an early age, to be active, exercise, eat plenty of fruit and vegetables and less red meats, in time this will lead to massive savings on the nation’s health bill. As I have pointed out, the future health and social care bill will dwarf the pensions and global banking crisis by a long stretch. As we get older, the list of diseases and chronic conditions we face can read can an introduction to medicine: cardiovascular, lung cancer, cerebrovascular, respiratory, dementia and Alzheimer’s, flu and pneumonia, prostate cancer, colon cancer, stomach cancer, liver disease, and more.

Analysis and Conclusion:
The fact that people are living longer must be celebrated as a victory for changes in the way we work, better nutrition and the wonders of medical science. These medical advances, from nano-technology, genetically individualised medicines to tele-diagnostics and the other still to be explored discoveries from the Human Genome Project, may or may not extend our longevity even more.

In the end, all these improvements and more will cost the taxpayer and unless we start planning for them now, when they creep up on us – and following generations – it will still come as a shock. Even more damaging will be that the medical tourists in their state-of-the-art clinics and private hospitals will be getting the best treatments, while ordinary Barbadians in their own home nation will have to make do. Living longer does not mean living healthier and this is the major challenge facing more advanced and developing societies. So, what may look like just a few overweight young men and women will in time become a heavy fiscal charge.

In simple economic terms, an ageing population means as a society we must save more, work longer or use the family home to subsidise our retirement incomes. We also have to look at new ways of funding health care, with accidents and emergencies being free at the point of need, and operations and other procedures paid for through independent savings or insurance bonds or medical savings accounts. The macroeconomics of ageing also touches on lifetime saving, growth, retirement and long term care.

One good cultural model of lifetime financial planning is that of the so-called Confucian cultures, in particular Taiwan, China and South Korea, along with Japan. Contrast the savings habits of those heavily leveraged cultures with that of the North American and European cultures. Equally, China has just made it a legal requirement that children must look after their elderly parents, a policy that should be given serious consideration in socially crippled developing nations.

The failure of our health and social care policies is that there is nothing in place to meet the projected needs of an ageing community; and, even more, Barbados should, and could be, a centre of excellence for health and social care, not only in the Eastern Caribbean, but throughout the entire region. We know many of those micro-islands will never be able to set up economically independent medical and healthcare programmes for their citizens and will find it much more economic to buy those services from a well equipped and holistically organised Barbados. The idea of increasing the state retirement age is not the full answer, since there is empirical evidence that a large number of people, especially males who smoke and drink excessively, start developing chronic diseases in their early 60s.

If the gap between the development of chronic disease and the state retirement gap widens, then there is a grey area that must be filled, either by disability benefits or another form of state handout. The truth is that Barbados, for almost all of the post-independence years, found itself on cruise, making no effort and gathering up the tourists’ dollars. But the world has changed and there is now a demand for the public and private sectors to pull their fingers out and do some real work; they are finding this a challenge too far.

So, in typical fashion, they are rushing to the Chinese for cheap renmimbis. However, if they thought European colonialism was terrible, just wait until the Chinese get their feet under the table. At some point even Barbadians must realise that the Chinese think even less of people of African descent than the Europeans. That is a reality we must face at some point. What is rather interesting is that China is also facing a demographic timebomb and by 2030 will have a higher proportion of retired people than the US. It is almost certain that China will go down the increased fertility route to replace its elderly population, then to introduce immigration – especially from new ethnic and religious groups.
In the final analysis, government must pull all heads together as soon as possible to workout solutions to this pending crisis. It must draw on the knowledge and expertise of health economists, demographers, actuaries, policymakers, healthcare providers, and the elderly themselves to come to some conclusion about how we will approach the coming decades.

21 comments

  • One of the best ways to start approaching the next decade is to make Barbados a clean island…no more pesticides in our food and no GMO just in case that turns out to be a horror story. Perhaps a signature on this petition might go a long way to begin the process. Getting proactive now could save our nation.

    http://www.avaaz.org/en/petition/CLEAN_UP_BARBADOS_NO_TO_MONSANTO_YES_TO_ORGANIC/?fcAByeb&pv=2

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  • Hooked on a taste is what it is and it does not matter the level of education.

    Do we blame the masses, the leaders or BOTH?

    How do we fix it or we can’t?

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  • We can’t understand how some hypocrites could pretend to have an interest in the reversal of ill-health and all the deleterious effects therefrom when they themselves are obviously overweight, are not known for the promotion of veganism, they never have a fundamental critique of the corporate food supply systems that KILL people, they never want to see the relationships between the medical establishment and the food industry, they have nothing to say about the obvious collusion between the political class and the corporate elites, they generally have no respect for Pachamama and tend to believe that her resources are infinite. All these are merely symptoms of a generalized failure of capitalism as exacerbated by the industrial revolution.Until that failure is recognized everything else is ignorance.

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  • One can have things it wants and desires: a high level education, a family, friends, etc. One can also have things it truthfully does not want – obesity and poor health. If you truthfully don’t want obesity and poor health, then you simply must not tolerate it, it (obesity) or anything associated with it: high calorie foods and excessive laxation. Admit, I have a weakness for some high calorie foods, but can’t live without my treadmill because I also have a longing for firmness. Fat and flab, it’s just distasteful, but firmness is attractive – stops traffic too. Men by nature like attractive women and women by nature like attractive men.

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  • @Pacha
    The failure is due to human stupidity, greed and corruption!

    While Capitalism is by no means perfect some form of INCENTIVE based system is obviously what works since the Soviet Union, China and India with their Communist/ Socialist Systems FAILED miserably. It is only when these Nations changed to Incentivisation that the standard of living jumped exponentially. This is so because of Human mentality and has nothing to do with race, class or creed.

    The best system has an Incentive base and has elements of Socialist Policies BUT with strict disciplined underpinnings. There are just far too many humans that take advantage of Socialist GIVEAWAY Policies and these types of people have absolutely no intention of working/ contributing they are TAKERS/ BLOODSUCKERS! Please note that it is humans causing the negatives.

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  • @ moneybrain
    The tenor of you remarks can never represent our views. They are tinged with all types of sociological narratives that are deeply detested by us.

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  • TO all vegetarians, pork mouthians, never eat a white meat yet, exercise loving, protein buffed freaks among you, I bring you greetings from a land and clime of the not so distant Bim.

    Slavery, the rights of former slaves and Emaciation.

    Up until the late 1890’s if my history serves me correctly slavery was still being practiced in some parts of what is now considered the last bastions of the free world.

    In the early 20th (the vestiges of?) slavery emanated across a society where food, once rationed by massa, was now available in greater quantities to the emaciated progeny of the slaves and was consequently consumed in glutinous quantities.

    It is in the nature of (a black) man, being without for so long to reach out and touch this once scarce commodity.

    Flesh on one’s skeleton, slowly gave birth to Rotundity for a people who were the walking dead and in my youth, an obese child equated to a child whose parents had money and amazingly fat/obesity was health.

    Even now obesity goes hand in hand with wealth, you will note that I did not say Minister of Finance Buffalo Sinckliar ( do hope that David{BU} adds Sinkliar’s picture to my article)

    As young men, and vllage rams, we were not interested in the sleek, sexy, lithe young things that you fellows now have at your disposal, we wanted the big meat “healthy” girls whose ample breasts and bottoms smacked of the residual memories instilled by a not too distant past of breeding for the increase of massa’s chattel,

    Being fat then was considered a desirable trait and was not a viewed in the context of cholesterol or heart disease, it was considered attractive.

    Removing the perception of “a well covered bouncing momma” from the minds of “former slaves (I am quoting Dr. The Honourable here) while not impossible, is going to be hard.

    Add the issue of men and women wanting to be “anatomically correct”, to the mix, depending on which standard is being used, either that of Amerca with its big bubbuies and anaemic looking asses, or the West Indian standard of handfull breast (depends on the size of your hands, dont it) nice legs and a full botsie, and we have a society where the issue of what we eat is not as important and how we look,

    Women wanting “big botsies” being told that Chefette and Kentucky’s greasy chicken increases their botsie size, will find themselves at Houloute and the Kernel every weekend.

    Or on being told dat a daggering in that area going get their pancake botsie big, will eagerly take to the age-old greek style of birth control.

    It is going to take a while for Health and Wellness to get into the psyche of our people. We Jonesing and his people at the Ministry of Health and its Nutrition Department could help if the latter group of clowns ever use the computers that the IDB gave them.

    Finally what might be even more impactful is the use of anatomically correct mannequins on Tuesdays when, instead of showing the Bajan daytime drama of the Pillsbury Dough Boys, what some call the Live viewing of Parliament, instead of seeking Fat Boy Duguid, and Pornville Char you Muddah, these sleek figurines can be placed on screen as we try a subliminal indoctrination of these impressionable minds.

    Question of the day,

    Do you note how CBC’s Camera’s can never do a close up of any of the speakers?

    A friend of mine at CBC tell me that the only way they can get the camera to focus is on telephoto lens, because they CANT zoom the lenses to get them bloated elephants into the picture.

    Friday, “FEED MY SHEEP” by Lord Nelson statue today, so I got to go put dem ingrunt heavy pots in de back uh de church truck. Yessss we get it back, but it still kicking out a lotta black smoke amd sputtering like de Economy uh Barbados.

    De madam got to be cooking still doah, cause I ent hear de buzzer yet, or she pun de phone wid sista Headley, de roving licmout lou reporter.

    Hey, hey hey, I gine recommend she fuh dat job uh editor in Chief at de nation she is a real officious ting, all up in you business and each half uh she botsie is 3 times de size uh she head which mek she a good candidate fuh dis article

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  • @Pacha
    At least people with my view believe in freedom, unlike the bastards in the former Soviet Union/ China/ N Korea/ Cuba who imprison their peeps within their country! WHY?

    I believe you have the right to live in the society and economic environment in which you choose, JUST NOT IMPOSE that philosophy on me and force me to give up 50% of my income in tax to support a system that I know will ultimately fail because it is not practical. It is totally counterproductive to be switching systems every few years between the left leaning and right leaning.

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  • @MB
    You remained confused. There is no measurable difference between the controllers in the countries you mentioned and the West, relative to their peoples.

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  • Pacha
    Obviously spoken by a person who has NOT been to Cuba or studied the NK Cult leadership!

    I do have an inkling of what you desire to point out though.

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  • @MB
    Your argumentation is dated. In fact, this writer has been to all the countries you mentioned, some several times.That is why we can state boldly that NONE of the world systems are working for the people. While you remain misguided by forces which you pretend to be right.

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  • @Pacha
    I am having a lil difficulty believing you have visited Nth K! My apologies if you indeed have. I never said that any current system is perfect for the masses. Singapore is probably somewhat close.

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  • @MB
    The NK cult leadership is no better or worse than the Obama cult leadership, its the same plantation.

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  • @Pacha
    Only in the sense that neither is perfect!

    99.99999999999999999% of humans who have been exposed to the reality of both systems via documentary evidence of day to day opportunity, freedom etc would quickly choose to live on the US Plantation.

    I would make many changes to the US system, please note I could live there if I desired to since I have loads of family there, but I migrated to Canada. The Americans think it is the best Nation on Earth and apparently the 12MN illegals agree BUT I see plenty flaws.

    When you have the opportunity please briefly share your vision of the nation you would design.

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  • Tell that to the 150MM Americans living at or below poverty. The 50MM poor people. The two million mainly Black and Chicano men in jail. The eviscerated of the middle classes. On the other hand, the .000000000001 of the riches people who have more wealth than the rest. Tell them. We just put some hot licks on yuh on the other stream.

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  • St George's Dragon

    Wikipedia says 16% of the US population is below the poverty line. That would include “at the poverty line”. I make that 50 million not 150 million. Incidentally, the figure in Barbados is 13.9%. Does that make us a richer nation than the US?
    You are low on the jail numbers though, it is more like 2.25 million.
    I am another one who would like you to set out what your vision is for the way forward. You have firm ideas about what is not right but I see no ideas about what to put in the place of what is wrong.
    And by the way, why the plural – who are the “we” you post as?

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  • @St George’s Dragon

    And what is wrong with promoting ideas?

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  • “WE” the ability to take blame off oneself and include others very seldom if at at all does one give “praise” by using”WE” nine times out of ten it would be “I” now this article makes some very glaring observations concerning the health of a nation and its catastrophic financial burden to govt if not controlled individually as in the long term everyone would have to share the burden .

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  • @ St. George Dragon

    We have previously proffered several ideas for the transformation of societies but you Bajans seem to believe that we have to restate our propositions every time and that merely asking questions could deter us or win the argument by our non-response. We have said that the government of Barbados should be run like a cooperative. That no one man should be a maximum leader and that collective responsibility should mean that every member of the cabinet is PM for shorter periods of time though all will be responsible for promises made etc. In other word we have to stop this nonsense of surrendering our power to political elites once every five years. People must retain their power always. That we should forever remove the artificial construction of the DLP/BLP duopoly because it has outlived its usefulness. Both parties should be outlawed as postulated by our friend Baffy. That politicians will only learn to fear the people when the people have the power over their own government on a day to day basis and where ‘leaders’ could be dismissed at short order by popular referenda or by the internal workings of an open government. That healthy fear is the best way holding them to account. This is in the political sphere. Now, we have radical ideas for all other environments as well, understand their contentedness but lack the energy to school you further. Since we’ve responded we trust that you would stop hiding behind stupid questions and make an articulate rejoinder that has the potential for a similar level of transformation. It will be people like you who continue to locate Barbados as a squatter on the doorsteps of a fail capitalist construct.

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  • @ St. George Dragon
    You seem representative of the schooled but highly uneducated. Those numbers we gave are correct. A more sophisticated interpretation must be informed by the level of benefits paid by the USA government, the level of State benefits paid, an idea about what income level constitutes the poverty line in the USA, and the technical difference between the poverty line and poor. We are asserting that 150MM Americans are poor or living below the poverty line.

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  • Yes, we forgot the tens of millions of the working poor – minimum wage workers relative to the cost of living.

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