Fighting the obesity epidemic requires an all-of-government approach that includes both taxes and proactive health policies

According to the World Health Organization (WHO), 39% of adults are overweight (with a Body Mass Index, or BMI, above 25), and 13% are obese (BMI above 30). This prevalence of obesity puts people at greater risk for cardiovascular diseases, diabetes and musculoskeletal disorders. In the case of Jamaica, almost a quarter of the adult population is considered obese, with obesity being more prevalent amongst women than amongst men.

Mr. Ian Stein, PAHO/WHO Representative in Jamaica, comments that “Jamaica has seen an increase in the levels of obesity not only among adults, where females are more affected but there has also been a worrying increase in the levels of childhood and adolescent obesity. The plentiful availability of low-cost, high-fat, high-sugar, high-salt, energy-dense and micronutrient-poor foods exacerbates the risk of obesity and increases the chance of developing non-communicable diseases.”

The JEP panellists collectively agreed that the challenge of obesity deserves to be the subject of public policy, and the single-highest priority area for intervention is in education. Only through education will it be possible to achieve the kind of generational change required to address the root causes of obesity. However, several other areas also play a crucial role, including the agricultural sector, which has to be supported to fully provide the type of food Jamaicans need to make healthy choices.

Finally, there is the issue of taxation. The experience from Mexico, which introduced a tax on sugary drinks in 2014, has been studied extensively and indicated that in response, consumption moved away from sugary drinks towards alternatives with less sugar. Most JEP panellists agree that a policy that levies taxes on highly caloric foods should be explored in Jamaica. A majority of panellists who agree, also added that it would be optimal to earmark the receipts from such a tax to provide further support to the healthcare sector, which has suffered a lot from the COVID-19 pandemic.

Dr. Nadine McCloud, Head of the Economics Department at UWI Mona and co-founder of the JEP, comments that "Taxation can address public policy challenges when a particular practice should be discouraged. However, such a tax would likely be quite regressive. Because the poorest quintile spends a more significant portion of its budget [more than the wealthiest quintile] on the kinds of foods or drinks that this policy would aim to discourage, such a tax would have undesirable side effects. While this is not a reason to reject it, one should consider such effects in the implementation process. A combination of taxes on poor dietary foods and subsidies to reduce prices and render producers more efficient in increasing the supply of the more healthful foods can engender more social benefits."

Beyond fiscal policy, there are also other instruments that the government can use to address the obesity question. The Ministry of Health and Wellness is already pursuing several such initiatives as providing factual information, promoting increased levels of physical activity for all and several policies, such as restricting sugar-sweetened beverages in schools and encouraging front-of-package nutritional labels that help young people choose healthier diets.

Nevertheless, when asked about the expansion of existing programmes or the introduction of new ones, the JEP panellists endorsed several specific ideas. Most importantly, they believe that obesity-inducing diets result from foods that are largely available and accessible. Internationally, there are well-documented examples of food deserts, where it is hard to access healthy options. Addressing this food-environment challenge is one way to induce people to make healthier choices. Another option returns to the critical role played by the educational sector: if children are exposed to healthier diets, research has shown that there are long-term positive impacts. The evidence suggests using the government's influence over school diets to improve what is on offer can be a key instrument.

Responding to the survey results, Dr. Garry Conille, United Nations Resident Coordinator, shared that "as a medical doctor, I can only endorse these results. The most important way in which behaviour can be changed is through education. This cannot be done in the short term, but it requires a long-term approach that includes both information and providing young people with quality foods that can help them make the right choices. Linking the education system with the food production system in the country will also provide for potential spillover effects for the overall economy as well."

The Jamaican Economy Panel is part of a partnership between the United Nations Resident Coordinator's Office (UNRCO) and the Department of Economics at The University of the West Indies (UWI) Mona. The JEP brings together a select group of economic and public sector experts to address monthly socio-economic questions. These questions help to highlight relevant economic issues and the collective expertise of the panellists.

The full results of this month's discussion are available here.