Deborah Chen | For the sake of our health, where do we go from here?

The end of the year is often regarded as a time for deep reflection – an extensive analysis of where we are, how satisfied we are, what progress we’ve made, and where we go next. All in all, how do we make things better?

For 2022, there were both great opportunities and huge challenges, especially as it relates to the health of Jamaicans. We continue to witness exacerbated rates of non-communicable diseases (NCDs) and experienced major changes in our lifestyle practices as we grappled with a global pandemic. The continuous surge in these lifestyle diseases has far-reaching health implications, but our future social and economic development is also being seriously affected. It is therefore incumbent that cost-effective, evidence-based interventions are prioritised to reduce the multiplicity of ill effects and premature death from NCDs. We must continue to act to promote healthier diets and physical activity, reduce alcohol use and quit tobacco use. This year we have made tremendous steps collectively, with the Government, through the ministries of health and education, and local organisations, made strides towards improving the health of Jamaicans.

HIGHLIGHTS, OPPORTUNITIES AND CHALLENGES

School Nutrition Policy

The month of May brought a burst of excitement for healthy food policy advocates across Jamaica, through the announcement of the green paper of the National School Nutrition Policy. This joint paper between the Ministry of Health & Wellness and the Ministry of Education and Youth includes recommendations for regulating the sale, provision or marketing of foods that are high in fat, sugar and/or salt (HFSS) in the school environment. It also includes sponsorships, grants and donations of HFSS brands.

With the booming rates of obesity in Jamaican youth, it goes without saying that schools can play an important role in obesity prevention. Schoolchildren consume a significant proportion of their meals while in school. Measures targeting school nutrition may lead to beneficial changes in health outcomes, academic performance and, most importantly, dietary behaviours.

We are hopeful that the school nutrition policy will finally come to fruition prior to the 2023/2024 academic year. Based on ministerial advisory, Jamaica can expect the next staging of the policy as a white paper to be finalised by end of March 2023. This policy will be a critical tool in helping to minimise the rates and impact of obesity and its related diseases among our youth.

Front-of-Package Labelling

In the second quarter of 2022, the Heart Foundation of Jamaica’s Global Health Advocacy Project, and its partners, have increased efforts around educating the public on healthy eating options and healthy food policies, such as front-of-package warning labels (FOPWLs), with particular focus on protecting the health of Jamaican children. FOPWLs are simple, clearly visible labels that warn or inform consumers of what is in their food, thereby allowing them to make healthier choices. In Jamaica, there has been much noise around this labelling system, specifically the ‘High In’ black octagon model, which has been scientifically proven to allow consumers to correctly, quickly, and easily identify products with unhealthy nutritional profiles, thereby enabling them to make healthier food choices and potentially reduce the prevalence of NCDs and obesity.

Just last year, the Cabinet took the decision to support front-of-package labelling despite no direct call for a specific model. Jamaicans were also alarmed by the controversy around Jamaica’s vote and position regarding a labelling model and standards. Nonetheless, October 2022’s resubmission of votes for the standard presents an opportunity for us to rethink the greater good and benefits of such a policy. We must continue to act and garner public and partner support for the implementation of the ‘High-in’ Black Octagon FOPWL in Jamaica. A local study done by the Pan American Health Organization (PAHO), the Ministry of Health & Wellness and the University of Technology, Jamaica shows this is the best model for our population. This FOPWL model was proven to be nine times more effective in helping Jamaicans correctly identify when a product contains excessive amounts of critical nutrients; it is of superior efficacy in correctly identifying the least harmful products; and, it increased consumers’ intention to purchase the least harmful option.

Taxation of Unhealthy Food Products

Taxes on ultra-processed pre-packaged foods and beverages, such as sugary soft drinks, have been implemented in many places. In the UK, the Soft Drinks Industry Levy (commonly known as the ‘sugar tax’) was introduced in March 2018 and adds a charge of 18 to 24 pence per litre on drinks, depending on the quantity of sugar that they contain. Such a tax has been effective at reducing the consumption of sugary drinks, and at encouraging the food and beverage industry to reformulate and reduce the amount of sugar in the drinks they produce.

In Jamaica, the minister of finance announced in early 2022 that the Government was able to finance the 2022/2023 budget through a dividend payout by the Bank of Jamaica, and as such, there will be no new taxes. However, with the current global economic crisis and its impacts on our local economy, which has already been contending with increasing inflation, this presents a perfect opportunity to employ the use of ‘corrective taxes’ to offset the drawbacks associated with the economic crisis. Despite this stance, the Jamaican Economy Panel (JEP) made a call for SSB taxes in the local print media.

A tax on unhealthy foods may not be broadly appealing, but it can provide welcomed benefits. For example, in US cities where the tax is employed, millions of dollars in revenue are being collected by local governments. Tax revenues are earmarked to fund health promotion initiatives in low-income communities, health education, parks and recreation development, improved drinking water access, pre-kindergarten education, and chronic disease prevention. This is compelling and supportive evidence for Jamaica to explore a policy that levies taxes on unhealthy foods, as expressed by the JEP.

Corporate Social Responsibility

This year has not been without challenges. The most disturbing has been the continuous and pervasive unhealthy food marketing to our children under the guise of corporate social responsibility (CSR). Yearly, we notice the rampant efforts of the food and beverage industry, including alcohol producers, in targeting the sports sector by offering sponsorships, signing local sports professionals as brand ambassadors, or even sponsoring marathon sessions.

Our society faces many serious problems such as poverty, disease and environmental destruction, among others. It is proven that some economic systems have undesirable effects on public health. However, we must recognise that food marketing is often disguised as philanthropy, including corporate scholarships and sponsorships, but they must be responsible. As such, it is imperative that we continue to highlight the relationship between CSR and public health, with a view to increase advocacy for corporate entities to account for how their business operations affect public health.

NEXT STEPS

As we close out 2022, we must admit our gratefulness for the many insights gained and help with paving the way to shape and build a healthier Jamaica. We recognise that we are not alone, and we look forward to embarking upon another eventful journey in 2023.

We need to advance the following:

• Direct efforts towards creating healthier future generations with health education as a key component

• Increased availability of healthier food options

• Ramp up efforts and support for the finalisation and implementation of the national school nutrition policy

• Continued advocacy for the implementation of ‘High in’ octagonal front-of-package warning labels, a key tool in the fight against NCDs

• The restriction of the marketing of unhealthy foods, especially to children

• Active participation of youth in national development

• The unintentional consequences of corporate social responsibility and conflicts of interest.

We look forward to continuing and strengthening partnerships with our current stakeholders, as every single action matters. For every inspirational breakthrough, drawbacks will be expected. However, we will continue to respond with renewed unity and commitment to defend and expand our scope of evidence-based health policies that put the health of Jamaicans first.

For 2023, let us continue to aspire to create a national movement strong enough to help Jamaicans stay informed, stay engaged, and stay healthy.

- Deborah Chen is the executive director of the Heart Foundation of Jamaica. Send feedback to ghapjm@gmail.com.