74.6% Of Population Either Overweight Or Obese

Speaking in the House of Assembly on today [July 10], Minister of Health, Seniors and Environment Jeanne Atherden said the results of the ‘STEPS to a Well Bermuda’ survey results are available, and they show that  74.6% of our population is either overweight or obese, which the Minister called an “astounding and worrisome fact.”

Minister Atherden said, “This was Bermuda’s first experience with the World Health Organization’s chronic disease risk factor surveillance survey. The STEPS to a Well Bermuda survey was at its mid-way point last July and a dozen or so determined interviewers were in the field each day, battling the heat and trying to stay encouraged throughout the labor-intensive process of conducting the survey.

“Well, they succeeded. The survey process was completed in December 2014 and the results have been analyzed and are now available to be shared. 1,195 households participated in the STEPS survey.

“Regrettably, the STEPS survey found that 74.6% of our population is either overweight or obese. This is an astounding and worrisome fact, though not surprising. We have looked in the proverbial mirror, and we are not fit. Bermudians will need to acknowledge this fact and make weight reduction and fitness a priority in our lives.

“Another relevant finding from the survey was the number of individuals who reported 3 or more chronic disease risk factors which was 42% of the total population aged 18 and over. Of those with an NCD, the number who had missed work or restricted their usual activities in the past month due to an NCD was 8.2%. This fact is one small illustration of the impact of NCDs beyond the individual effects.

“The STEPS to a Well Bermuda Fact Sheets will allow us an overview of each of the chronic disease risk factors addressed in the survey so we can move forward as community to prevent and control chronic diseases on the island.”

The Minister’s full statement follows below:

Mr. Speaker, and Honorable colleagues,

A year ago, almost to the day, I rose to share an update on the STEPS to a Well Bermuda survey. As you will recall, this was Bermuda’s first experience with the World Health Organization’s chronic disease risk factor surveillance survey. The STEPS to a Well Bermuda survey was at its mid-way point last July and a dozen or so determined interviewers were in the field each day, battling the heat and trying to stay encouraged throughout the labor-intensive process of conducting the survey. Well, they succeeded!

The survey process was completed in December 2014 and the results have been analyzed and are now available to be shared.

Mr Speaker, I must again acknowledge the determined STEPS interviewers because it is due to their perseverance that I can stand before you today to share some of the results of this important population survey. Also, we have to thank the many citizens of Bermuda who welcomed the STEPS interviewers into their homes and who cooperated with the detailed health and lifestyle questionnaire, and the physical and biochemical measurements.

In the end, 1195 households participated in the STEPS survey. Participants were surveyed in their homes initially for STEPS one and two. In STEP 1 of the survey, social, demographic and lifestyle information were gathered. And in STEP 2 physical measurements such as weight, height, waist circumference, and blood pressures were measured.

Following the first two steps of the process was STEP 3, consisting of biochemical measurements. Ultimately, 467 individuals completed STEP 3, meaning that they attended a clinic for the biochemical measurements. In STEP 3, laboratory tests were done for fasting blood glucose and cholesterol.

Although this was our first experience with the STEPS survey protocol, Bermuda was able to include an optional module, STEP 4a. The Oral Health Section of the Department of Health conducted oral health screenings on a subset of the STEPS participants, and we will shortly have information from those assessments to add to the large amount of population health information gathered in this process.

Mr. Speaker, I am very pleased to stand before you today to share just a few of the interesting results of the survey, and to announce that a summary of the STEPS data, in the form of a Fact Sheet, is being made available on the website www.health.gov.bm. The detailed survey findings, summarized from over 250 questions or data points, will be made available and disseminated in the community in stages over the next several weeks.

The vast amount of information obtained from a population survey requires a communication plan. The quantity of information is large, the interpretations can be complex at times, and the implications for community action must be consulted on fully.

The communication plan we have devised consists of first publicizing the STEPS to a Well Bermuda Fact Sheet, followed by sequential release of detailed information. Each week between now and the end of October, we will focus on one or two health issues addressed by the survey.

This serial roll-out of information and recommendations to the public will also be accompanied by small stakeholder consultations to advance our understanding of the results and to plan interventions. The stakeholder groups will include Department of National Drug Control, Public Health partners, such as Bermuda Diabetes Association and Bermuda Heart Foundation, and specific groups of health care providers, among others.

Mr. Speaker, we will all recall that the purpose of the STEPS survey was not simply to find out information on the health and chronic disease risk factors of the community, but also to be able to utilize this health information to create appropriate interventions to improve our health.

That is precisely the intention of the Epidemiology and Surveillance Unit of the Ministry. We will systematically share the STEPS data findings and organize collaborative discussions to plan appropriate preventive actions.

Today, as a brief preview, I will share a few of the findings I found especially relevant. I encourage the members of this Honorable House, and all the members of the public, to go to the government website to review the Fact Sheet which summarizes the findings and gives a good overview of the chronic disease risk factor status of our island.

Mr. Speaker, risk factors are so important because “the risk factors of today are the diseases of tomorrow.” We can predicate our future population health challenges by studying the risk factor survey data we have from STEPS to a Well Bermuda.

Unfortunately, one key finding demonstrates that our concerns about the threat of chronic disease are entirely warranted because our rates of obesity and overweight are extremely high. As we know, obesity and overweight are important drivers of the epidemic of diabetes, hypertension, heart disease and chronic kidney disease.

Regrettably, the STEPS survey found that 74.6% of our population is either overweight or obese. This is an astounding and worrisome fact, though not surprising. We have looked in the proverbial mirror, and we are not fit. Bermudians will need to acknowledge this fact and make weight reduction and fitness a priority in our lives.

Interestingly enough, this figure is higher than previous surveys which did not actually measure weight and height to calculate Body Mass Index. As I have said, the STEPS survey protocol included actual physical measurements which offer us an accurate accounting of our obesity and overweight prevalence.

As a result, we must accept that halting the rise in obesity and overweight will need to be a top priority for all individuals, families, schools and workplaces on the island. The STEPS data on Body Mass Index leads us to this conclusion.

The STEPS data Fact Sheet shares the information, and as a community we will need to digest this information and agree on specific lines of action.

Mr. Speaker, another relevant finding from the survey was the number of individuals who reported 3 or more chronic disease risk factors which was 42% of the total population aged 18 and over. Of those with an NCD, the number who had missed work or restricted their usual activities in the past month due to an NCD was 8.2%. This fact is one small illustration of the impact of NCDs beyond the individual effects.

Another consideration is the economic impact of NCDs, both in terms of lost productivity from disability and premature death, and the healthcare cost of medical complications. Health economists have shown that health spending harms an economy by lowering GDP and employment and increasing inflation. Prevention of chronic health conditions is a key strategy which we must adopt.

The STEPS to a Well Bermuda Fact Sheets will allow us an overview of each of the chronic disease risk factors addressed in the survey so we can move forward as community to prevent and control chronic diseases on the island. I refer the community to the website: www.health.gov.bm to view the summary information and encourage each of us to begin thinking and planning how to address the health risks before us.

Mr Speaker, in closing, this Ministry cannot emphasize enough our gratitude for the willing participation of the community in this undertaking, and for the persistence of our STEPS survey interviewers and organizers. We would not have been able to establish a population health baseline for important chronic disease risk factors without their cooperation in the STEPS survey.

Last, but hardly least, we acknowledge the support of our public health partners locally and abroad, the Bermuda Diabetes Association, the Bermuda Hospitals Board, Bermuda Heart Foundation, Bermuda Cancer and Health, the Pan American Health Organization, and the many supporters within the Department of Health.
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Thank you, Mr. Speaker.

The STEPS factsheet follows below [PDF here]:

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