Anand Ram­per­sad

Par­tic­i­pa­tion in sport and phys­i­cal ac­tiv­i­ty (PA) has the po­ten­tial to con­tribute to a healthy lifestyle and so­ci­ety. How­ev­er, a worth­while con­tri­bu­tion would on­ly be ben­e­fi­cial if sport and phys­i­cal ac­tiv­i­ty is ap­proached in a strate­gic man­ner and prop­er­ly in­te­grat­ed with oth­er mea­sures for achiev­ing a health so­ci­ety.

This was iden­ti­fied by CARI­COM at its POS Re­gion­al Sum­mit on Chron­ic Non-Com­mu­ni­ca­ble Dis­eases (NCDs) in Sep­tem­ber 2007. The 14 points de­c­la­ra­tion in­clud­ed two points on sport and phys­i­cal ac­tiv­i­ty:

�2 "That we will man­date the re-in­tro­duc­tion of phys­i­cal ed­u­ca­tion in our schools where nec­es­sary, pro­vide in­cen­tives and re­sources to ef­fect this pol­i­cy and en­sure that our ed­u­ca­tion sec­tors pro­mote pro­grammes aimed at pro­vid­ing healthy school meals and pro­mote healthy eat­ing;

�2 "That we will pro­mote poli­cies and ac­tions aimed at in­creas­ing phys­i­cal ac­tiv­i­ty in the en­tire pop­u­la­tion, e.g. at work sites, through sport, es­pe­cial­ly mass ac­tiv­i­ties, as ve­hi­cles for im­prov­ing the health of the pop­u­la­tion and con­flict res­o­lu­tion and in this con­text we com­mit to in­creas­ing ad­e­quate pub­lic fa­cil­i­ties such as parks and oth­er recre­ation­al spaces to en­cour­age phys­i­cal ac­tiv­i­ty by the widest cross-sec­tion of our cit­i­zens."

A NCD Progress In­di­ca­tor Sta­tus/Ca­pac­i­ty by Coun­try in Im­ple­ment­ing the NCD sum­mit De­c­la­ra­tion was drawn up. Phys­i­cal Ac­tiv­i­ty was to be mea­sured by three in­di­ca­tors:

�2 Manda­to­ry Phys­i­cal PA in all grades in schools to which T&T in­di­cat­ed was 'in place';

�2 Manda­to­ry pro­vi­sion for PA in new hous­ing de­vel­op­ments to which T&T in­di­cat­ed 'not in place'; and

�2 On­go­ing, mass Phys­i­cal Ac­tiv­i­ty or New Pub­lic PA spaces to which T&T in­di­cat­ed 'in place'.

How­ev­er by 2015, the Caribbean Pub­lic Health Agency (CARPHA) an­nounced at its meet­ing in Do­mini­ca (March 2015) that the re­gion is fac­ing a child­hood obe­si­ty epi­dem­ic notwith­stand­ing im­prove­ments in the over­all health sta­tus of chil­dren and young peo­ple over re­cent decades.

Very alarm­ing­ly, CARPHA states "that least 1 in every 5 of our chil­dren car­ry un­healthy weights and risk de­vel­op­ing non-com­mu­ni­ca­ble dis­eases (NCDs), like di­a­betes and car­dio­vas­cu­lar dis­eases, lat­er in life." The Re­port al­so states that such re­al­i­ty would re­sult in "high­er life­time health costs for the in­di­vid­ual and the state." bit.ly/24vLOA1

In 2016, Min­is­ter Deyals­ingh in a very alarm­ing pro­nounce­ment stat­ed that obe­si­ty among chil­dren had in­creased by 100 per cent in the last 15 years and that "Sug­ar is not the on­ly cul­prit. The oth­er cul­prit is in­ac­tiv­i­ty...," bit.ly/1KVuHkX

This ob­ser­va­tion re­in­forces the view of for­mer Min­is­ter of Health Dr Faud Khan who stat­ed there was a grow­ing "fat" so­ci­ety syn­drome among the adult and young pop­u­la­tion which was re­lat­ed to sev­er­al so­cio-eco­nom­ic fac­tors.

The CARPHA Re­port 2015 and PANAM STEPS Re­port 2012 re­it­er­at­ed the points of the CARI­COM Re­port on NCDs 2007 sug­gest­ing that in ad­di­tion to main­tain­ing a healthy di­et, phys­i­cal ac­tiv­i­ty is im­por­tant in es­tab­lish­ing an over­all healthy lifestyle and so­ci­ety.

As PA is on­ly one com­po­nent to ad­dress­ing the grow­ing obe­si­ty among the pop­u­la­tion, base­line da­ta can be de­rived from the in­di­ca­tors for PA stat­ed in the CARI­COM NCDs Re­port 2007. This base­line da­ta can serve as the ba­sis up­on which strate­gic mea­sures can be tak­en as well as al­low for ef­fec­tive mon­i­tor­ing and eval­u­a­tion.

For these in­di­ca­tors to be ef­fec­tive sev­er­al points should be con­sid­ered when de­vel­op­ing a sport and phys­i­cal ac­tiv­i­ty frame­work for a healthy so­ci­ety.

First­ly, there must be a clear ad­vo­cate for pro­mot­ing the ben­e­fits of sport and phys­i­cal ac­tiv­i­ty and in­creas­ing par­tic­i­pa­tion rates across the pop­u­la­tion. There must be a col­lab­o­ra­tive ef­fort by var­i­ous min­istries such as Health, Sport and Youth Af­fairs, Ed­u­ca­tion, Com­mu­ni­ty De­vel­op­ment, the THA, pri­vate sport­ing as­so­ci­a­tions and the pri­vate sec­tor.

Sec­ond­ly, it is crit­i­cal that prop­er mon­i­tor­ing and eval­u­at­ing mech­a­nisms are utilised to as­sess mea­sures im­ple­ment­ed. Such an ap­proach will re­quire the use of rigid per­for­mance bench­marks and stan­dards. It is im­por­tant not as­sume that once peo­ple be­come ac­tive there will be a re­lat­ed de­crease in obe­si­ty lev­els.

Third­ly, the pro­vi­sion of parks and recre­ation­al grounds as have been done will not au­to­mat­i­cal­ly re­sult in us­age by com­mu­ni­ties. For ef­fec­tive us­age, there will need to be some form of strate­gic in­ter­ven­tion to en­cour­age par­tic­i­pa­tion and pro­mote vol­un­tary com­mu­ni­ty us­age there­after. In­volve­ment has to come from par­ents, guardians, sport and phys­i­cal clubs, com­mu­ni­ty groups and the pri­vate sec­tor. Fur­ther­more, the as­sess­ment of the mea­sures has to be ex­tend­ed in­to these ar­eas to en­sure de­sired goals are achieved.

The rec­om­men­da­tions of the CARPHA Re­port 2015, PANAM STEPS Re­port 2012 and CARI­COM NCDs Re­port 2007 must form part of the dis­cus­sion to de­vel­op a health­i­er so­ci­ety. In ad­di­tion to a health­i­er so­ci­ety, the costs of health may al­so take a nose­dive which will be wel­come in light of grow­ing eco­nom­ic chal­lenges.