2. Content
• Title “Is drinking water the correct term”
• Do we ensure complete health with that?
• Is it to enough to provide water for drinking
purposes to achieve Vision 2030?
• Should we change the term “Drinking Water”
for the term “Vitamin G Water”?
• Have we achieved the Millennium
Development Goals for Water
3. Vision 2030
To make “Jamaica the place of choice to raise families,
live, work and do business”
4.
5.
6.
7.
8. Water Related Expected Results(39) Vision 2030
National Outcome Outcome
Expected Result
1 A Healthy and Stable Improve the quality of life
Population Increase average life expectancy
Encourage healthy lifestyles
Primary Health Care
2 World-Class Education and Creative and productive individuals
Training Holistic development of the child
Training of under-trained population
3 Effective Social Protection Identify and create employment and business opportunities
5 Security and Safety Reducing the level of crime and violence in our country
Empowering communities to participate fully in mainstream society
6 Effective Governance Equity, tolerance and respect for human rights and freedoms.
7 A Stable Macroeconomy Financial system stability
Price stability over the long term.
8 An Enabling Business Improve labour productivity and worker satisfaction;
Environment Promote and develop entrepreneurship
9 Strong Economic W&S that contributes competitiveness producers and ↑ quality of life
Infrastructure W&S services for economic and social uses.
10 Energy Security and Reduce dependency on imported petroleum
Efficiency Provide a secure and sustainable energy supply
Diversify energy supply, and increase use of renewable energy
Take advantage of emerging technologies
11 A Technology-Enabled Deepen application of S&T to benefit all aspects national dev
Society Build our capacity for undertaking research and development,
Applying S&T to practical and productive uses.
12 Internationally Competitive Environmental sustainability and food security
Industry Structures Promote use of clean technology
Adopt and adapt new construction technologies
Compliance relevant environmental standards and reg
Reduce sector’s carbon footprint and waste generation
Increase growth of sport
Increase use of Jamaican inputs in tourism
13 Sustainable Management and Env considerations integral factors socio-econ decision making
Use of Environmental and Green economy
Natural Resources Conserve NR; incorporating environ consider dec mak processes;
14 Hazard Risk Reduction and Haz risk manag activ/progr for reducing vulnerability
Adaptation Climate Change Incorporate climate change future economic and land use planning
15 Sustainable Urban and Rural Rundown town centres, urban sprawl, environmental degradation, unsafe and
Development dilapidated housing, planned and unplanned development in ecologically-sensitive
areas, crime and disorder, rural-urban migration, and poverty
Create framework urb & rur dev that supports econ and soc devpmnt
A spatial arrangement of land use that facilitates social and economic development,
respects the environment and satisfies the need for safety, efficiency, aesthetics and
social justice
9. Vitamin
National Outcome Outcome Drinking G
Water Water
Improve the quality of life
Increase average life expectancy
1 A Healthy and Stable Population
E ncourage healthy lifestyles
Primary Health Care
Creative and productive individuals
2 World-Class Education and Training Holistic development of the child
Training of under-trained population
M easures to identify and create employment and business
3 Effective Social Protection
opportunities for the unemployed and underemployed poor
Vitamin
National Outcome Outcome Drinking G
Water Water
Reducing the level of crime and violence in our country
5 Security and Safety Empowering communities to participate fully in mainstream
society
Equity in all spheres of society; and tolerance and respect for
6 Effective Governance
human rights and freedoms.
Financial system stability
7 A Stable M acroeconomy
Price stability over the long term.
Improve labour productivity and worker satisfaction;
8 An Enabling Business Environment
Promote and develop entrepreneurship
Water supply and sanitation infrastructure that contributes to
the competitiveness of our producers and improved quality of life
9 Strong Economic Infrastructure for our people
Provide adequate and safe water supply and sanitation services
for economic and social uses.
Vitamin
National Outcome Outcome Drinking G
Water Water
Reduce dependency on imported petroleum as its primary
source of energy
Provide a secure and sustainable energy supply
10 Energy Security and Efficiency
Diversify our energy supply, and increase use of renewable
energy
Take advantage of emerging technologies
Deepen the application of science and technology to benefit all
aspects of national development
11 A Technology-Enabled Society Build our capacity for undertaking research and development,
Applying science and technology to practical and productive
uses.
Vitamin
National Outcome Outcome Drinking G
Water Water
Environmental sustainability and food security
Promote the use of clean technology
Adopt and adapt new construction technologies
Internationally Competitive Industry Compliance with relevant environmental standards and
12
Structures regulations
Reduce the sector’s carbon footprint and waste generation
Increase the growth of sport
Increase the use of Jamaican inputs in tourism
Environmental considerations become integral factors in socio-
economic decision making
Sustainable M anagement and Use of Green economy
13
Environmental and Natural Resources Providing an effective regulatory framework for the
conservation of our natural resources; incorporating
environmental considerations into decision making processes;
Vitamin
National Outcome Outcome Drinking G
Water Water
Hazard risk management activities and programmes for
Hazard Risk Reduction and Adaptation to reducing our existing and future vulnerability
14
Climate Change Incorporate climate change scenarios in future economic and
land use planning
Rundown town centres, urban sprawl, environmental
degradation, unsafe and dilapidated housing, planned and
unplanned development in ecologically-sensitive areas, crime and
disorder, rural-urban migration, and poverty
15 Sustainable Urban and Rural Development Create a framework for urban and rural development that
supports the economic and social development
A spatial arrangement of land use that facilitates social and
economic development, respects the environment and satisfies the
need for safety, efficiency, aesthetics and social justice
10. Comparison
Vitamin
National Outcome Expected Result Drinking G
Water Water
Improve the quality of life
Increase average life expectancy
1 A Healthy and Stable Population
E ncourage healthy lifestyles
Primary Health Care
Creative and productive individuals
2 World-Class Education and Training Holistic development of the child
Training of under-trained population
M easures to identify and create employment and business
3 Effective Social Protection
opportunities for the unemployed and underemployed poor
10
11. Vitamin
National Outcome Expected Result Drinking G
Water Water
Reducing the level of crime and violence in our country
5 Security and Safety Empowering communities to participate fully in mainstream
society
Equity in all spheres of society; and tolerance and respect for
6 Effective Governance
human rights and freedoms.
Financial system stability
7 A Stable Macroeconomy
Price stability over the long term.
Improve labour productivity and worker satisfaction;
8 An EnablingBusiness Environment
Promote and develop entrepreneurship
Water supply and sanitation infrastructure that contributes to
the competitiveness of our producers and improved quality of life
9 StrongEconomic Infrastructure for our people
Provide adequate and safe water supply and sanitation services
for economic and social uses.
11
12. Vitamin
National Outcome Expected Result Drinking G
Water Water
Reduce dependency on imported petroleum as its primary
source of energy
Provide a secure and sustainable energy supply
10 Energy Security and Efficiency
Diversify our energy supply, and increase use of renewable
energy
Take advantage of emerging technologies
Deepen the application of science and technology to benefit all
aspects of national development
11 A Technology-Enabled Society Build our capacity for undertaking research and development,
Applying science and technology to practical and productive
uses.
12
13. Vitamin
National Outcome Expected Result Drinking G
Water Water
Environmental sustainability and food security
Promote the use of clean technology
Adopt and adapt new construction technologies
Internationally Competitive Industry Compliance with relevant environmental standards and
12
Structures regulations
Reduce the sector’s carbon footprint and waste generation
Increase the growth of sport
Increase the use of Jamaican inputs in tourism
Environmental considerations become integral factors in socio-
economic decision making
Sustainable M anagement and Use of Green economy
13
Environmental and Natural Resources Providing an effective regulatory framework for the
conservation of our natural resources; incorporating
environmental considerations into decision making processes;
13
14. Vitamin
National Outcome Expected Result Drinking G
Water Water
Hazard risk management activities and programmes for
Hazard Risk Reduction and Adaptation to reducing our existing and future vulnerability
14
Climate Change Incorporate climate change scenarios in future economic and
land use planning
Rundown town centres, urban sprawl, environmental
degradation, unsafe and dilapidated housing, planned and
unplanned development in ecologically-sensitive areas, crime and
disorder, rural-urban migration, and poverty
15 Sustainable Urban and Rural Development Create a framework for urban and rural development that
supports the economic and social development
A spatial arrangement of land use that facilitates social and
economic development, respects the environment and satisfies the
need for safety, efficiency, aesthetics and social justice
14
15. Millennium Development Goals
Table Drinking water coverage estimates
Urban (%) Rural (%) Total (%)
1990 2010 1990 2010 1990 2010
Piped onto premises 89 91 34 47 61 70
Other improved 9 7 54 41 32 23
source
Other unimproved 2 2 1 8 1 5
Surface water 0 0 11 4 6 2
Target 7.C:
Halve, by 2015, the proportion of the population without
sustainable access to safe drinking water and basic sanitation.
Jamaica Goal was to reach 97.5% (in 1990 95%)
15
16. Joint Monitoring Programme UNICEF/WHO
• Improved Water
– An improved drinking-water source is
defined as one that, by nature of its
construction or through active
intervention, is protected from outside
contamination, in particular from
contamination with faecal matter.
16
17. • "Improved" sources of • "Unimproved" sources
drinking-water: of drinking-water:
• Piped water into dwelling [ v ] • Unprotected spring [ v ]
• Piped water to yard/plot [ v ] • Unprotected dug well [ v ]
• Public tap or standpipe [ v ] • Cart with small
• Tubewell or borehole [ v ] tank/drum [ v ]
• Protected dug well [ v ] • Tanker-truck [ v ]
• Protected spring [ v ] • Surface water [ v ]
• Rainwater [ v ] • Bottled water [ v ]
17
19. Water Supply by Source
3.6 2.2
11.1
5.9
16.0 57.3
Piped into Dwelling
Piped into Yard
Standpipe
Catchment
Protected Source = 94.2% Spring or River
Unprotected Source = 5.8% Trucked Water/Water Truck
19
28. Health Definition
• The World Health Organization (WHO) states
health is
‘A state of complete physical, mental, and social
wellbeing, and not merely the absence of disease
or infirmity’
28
38. Burden of Non Communicable
Diseases (NCD)
• NCDs have resulted in a large direct and indirect
economic burden for individuals in Jamaica.
• An average individual suffering from an NCD
spends approximately one-third of household
income (JM$ 55,503) on healthcare services and
pharmaceutical purchases.
• Direct healthcare costs associated with NCDs are
regressive and impose a greater burden on
poor households than better-off households.
39. Present Health Conditions and
Threats
• Chronic Diseases↑
• Obesity ↑
• Mental Health ↑
• Violence ↑
• Sedentarism ↑
• Junk Food ↑
• Energy Consumption per capita ↑
• Environmental Pollution ↑
41. Obesity and overweight
major risk factors for NCDs
Source: WHO 2012
DIABETES 44%
CVD 23% (mainly heart d and stroke)
CANCER 41% (Breast, endometrial, Colon)
HYPERTENSION
Cholesterol, Dyslipidemia, LDL
Gall stone disease
Glucose intolerance
Skin problems
Respiratory problems
Sleeping problems-Apnea
Psychological Problems depression, dementia
Musculoskeletal disorders:
Arthritis, Osteoporosis
41
42. Obesity Burden and its NCDs cause:
• Premature death
• Long term Morbidity
• S. Disability
• Loss of Productivity
• Reduction in quality life
• High economic Burden-programs-PHC-
• 77% of the cost of illness from obesity C Fray-Aiken-ERU-UWI
• Can occupy an enormous % of MOH budget
42
43. Disease Condition Evolution
(2001 – 2008)
Table 1. Prevalence of selected conditions in Jamaica Health and
Lifestyle Survey 1 (JHLS–1) compared to Jamaica Health and
Lifestyle Survey 2 (JHLS–2).
Disease Condition JHLS–1 JHLS–2
(2001) (2008)
Diabetes mellitus 7.2 (6.0–8.3) 7.9 (6.7–9.0)
Hypertension* 20.9 (18.4–23.2) 25.2 (23.3–27.2)
Prehypertension 29.9 (27.1–32.7) 35.3 (32.6–37.9)
High cholesterol 14.6 (12.7–16.5) 11.7 (10.2–13.1)
*p < 0.05; JHLS–1 was conducted from 2000–2001 and JHLS–
22007–2008. 43
45. Twenty Highest Female Obesity Prevalence and Twenty Lowest Female Obesity
Prevalence Countries
Ranking Most Obese Prevalence Ranking Least Obese Prevalence
1 Nauru 81.9 1 Ethiopia 0.03
2 Tonga 80.8 2 Eritrea 0.2
3 Micronesia 78.5 3 Sri Lanka 0.2
4 Cook Islands 72.5 4 Bangladesh 0.3
5 Samoa 72.4 5 Nepal 0.4
6 Niue 70.1 6 Cambodia 0.5
7 Kuwait 66.6 7 Viet Nam 1.1
8 Barbados 62.7 8 Dem Republic of the Congo 1.7
9 Palau 61.9 9 Japan 1.7
10 Trinidad and Tobago 60.7 10 Rwanda 1.7
11 Dominica 60.0 11 Central African Republic 2.1
12 Egypt 59.4 12 Zambia 2.2
13 United States 54.8 13 Burkina Faso 2.3
14 Jamaica 52.6 14 Uganda 2.4
15 United Arab Emirates 52.4 15 Afghanistan 2.9
16 Jordan 52.2 16 India 3.0
17 Nicaragua 51.2 17 Malawi 3.1
18 Mexico 51.1 18 Kenya 3.1
19 Malta 50.6 19 Burundi 3.2
20 Seychelles 50.4 20 Papua New Guinea 3.2
46.
47. Climate Change Impacts
• Higher temperatures
– 2 oC
• Higher Relative Humidity
– 2.2% from 1973 to 2003
• Rising seas
• Increased risk of drought, fire and floods
• Stronger storms and increased storm damage
• Changing landscapes
• More heat-related illness and disease
• Economic losses
• Wildlife at risk
It is expected an increase of 1.5 to 2.8o Celsius increase in
temperature by 2050 and 2080
52. Health Impacts
• Increase on water use: bath and laundry
• Change on quality
• Higher groundwater table
• Increase in chronic diseases
• Increase in violence
• Increase in vector borne diseases
• Impacts on physical activity
• Impacts on occupational Health
• Sick Building Syndrome
53. Hot Temperatures Effects
• Increase aggression by
– directly increasing feelings of hostility and
– indirectly increasing aggressive thoughts.
• Body exhibits changes (increased heart rate, blood
circulation and sweating, and metabolic changes) associated
with sympathetic nervous system activity, which
in turn is linked to fight-or-flight responses.
• Increases testosterone production, tilting that
equation towards fight.
54. Ranson Study in USA
(2012)
• Across a variety of offenses, higher temperatures cause more
crime.
• For most categories of violent crimes, this relationship appears
approximately linear through the entire range of temperatures
experienced in in-sample counties.
• He has estimated that between 2010 and 2099, climate change
will cause an additional 30,000 murders, 200,000 cases of
rape, 1.4 million aggravated assaults, 2.2 million simple
assaults, 400,000 robberies, 3.2 million burglaries, 3.0 million
cases of larceny, and 1.3 million cases of vehicle theft in the
United States.
57. Wet Bulb Globe Temperature
• American College of Sports Medicine,
developed the concept of Wet Bulb Globe
Temperature (WBGT) from Temperature and
Relative Humidity;
• MOH Australia using WBGT has estimated the
Risk of health illness and developed advices
58. Wet Bulb Globe Temperature (WBGT) from Temperature and
Relative Humidity and Risk for Heath Illness
Low Moderate-High High – Very High Extreme
59. WGBT and Risk of Thermal Injury
Risk of Recommendation
Thermal
WGBT Injury
<18 Minimal Unlimited Activity
Keep Alert for possible increases in the
18 - 23 Moderate Indexand for symptoms of heat stress
Active exercise for unacclimatised persons
23 - 28 High should be restricted
Active execise for all should be restricted,
28 - 30 Very High except well acclimatised
> 30 Extreme All training should be stopped
The higher the reading the greater the risk of thermal injury
60. Kingston Assessment
• Use Temperature and Relative Humidity to
calculate WBGT for each month and different
hours:
– 4:00
– 6:00
– 13:00
– 18:00
– 20:00
61. Table . Climate Change Risk of Thermal Injury during different hours of the year
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
4:00 29 29 30 31 31 33 32 33 32 33 31 30
6:00 29 28 29 30 31 32 32 32 32 32 31 30
13:00 32 32 33 34 35 35 36 36 36 35 34 33
18:00 31 31 32 32 33 34 34 34 34 34 33 32
20:00 30 29 30 32 33 33 34 34 34 33 32 31
62. “Impact of Climate Change on Occupational
Health and Safety: Are we prepared?”
Dr. Homero Silva-Serrano
Professor of Public Health Environment and Climate Change
School of Public Health and Health Technology
University of Technology, Jamaica
67. Preventive Measures
Humidex Respone
Provide 15 minutes relief per hour
Provide adequate cool (10 - 15 oC) water
38 - 39
At leas 1 cup (240 ml.) of water every 20 minutes
Workers with symptoms should seek medical attention
Provide 30 minutes relief per hour in addition to the
40-42
provisions listed above
if feasible, provide 45 minutes relief per hour in addition
to the provisions listed above
43 - 44
If a 75% relief period is not feasible then stop working
until Humidex is 42 or less
45 or over Stop working until Humidex is 44 or less
68. Table No Working Risk Conditions with Climate Change
Working Risk Conditions With Climate Change
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
4:00 35 35 36 38 39 41 40 41 40 40 38 37
6:00 35 34 35 37 38 40 40 40 40 40 38 36
10:00 40 39 39 42 43 44 44 45 44 45 43 41
13:00 40 40 41 42 44 45 45 46 45 44 43 40
16:00 40 39 40 42 43 44 43 45 45 45 43 42
18:00 39 39 40 41 41 43 43 44 43 42 41 41
20:00 37 36 37 40 41 42 43 43 43 42 40 38
Table . Working Risk Conditions With Climate Change and Urban
Heath Island Effect
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
4:00 41 41 42 44 45 47 46 47 46 47 44 43
6:00 41 40 41 43 44 46 46 46 46 46 44 42
10:00 45 43 45 46 50 51 51 52 50 50 50 46
13:00 45 45 46 48 49 51 53 53 51 50 50 47
16:00 45 45 46 47 48 51 53 51 51 50 49 47
18:00 45 44 46 46 47 49 48 50 49 48 47 47
20:00 42 42 43 46 47 48 49 49 49 48 46 44
69. The solution to Reduce Obesity
• Reduce input of calories
– improving nutrition
– changes in food availability and variety
– and providing enough nutritional information on what
we eat
• Increase output of calories = increasing
physical activity
– Providing public parks with facilities
– providing regulations for infrastructure for physical
activity and its enforcement;
– change personal life style behaviors toward physical
exercise.
71. Table 2. Impacts on Health by 10kg weight loss
Health Condition Impact
20-25% fall in total mortality
Mortality
40-50% fall in obesity related
cancer deaths
Fall of 10mmHG systolic pressure
Blood Pressure
Fall of 20 mmHg diastolic
pressure
Fall by 10% in total cholesterol
Lipids
Fall by 15% LDL cholesterol
Fall by 30% triglycerides
Increase by 8% in HDL
cholesterol
Fall of 30-50% in fasting blood
Diabetes
glucose
Fall of 15% in HbA1c
71
73. Not much progress has been achieved in
increasing physical activity
Source: Strategic Plan of Action for the Prevent and Control of NCDs for Countries in the Caribbean
Communities 2011-2015 73
74. Physical Activity level of Jamaicans 15-74 yrs. old
Men more physically active
than women
74
75.
76. Some Calculations
Source: Professor Homero Silva Serrano
WHO Guideline is 12 m2/person
Kingston has 0.6 m2/person that means about
5 % of what is required
Montego Bay IDB estimated 0.69 m2/person
USA is 64 m2/person
76
80. Temperature Reduction using Trees
• Shading. by blocking solar radiation, trees
prevent structures and surfaces from
heating up beyond the ambient air
temperature (Direct Effect).
• Evapotranspiration. Summer reduction of
air temperature by evaporative cooling as
water passes through plant leaves is
important for comfort and for reducing air
conditioning needs (Indirect Effect).
81. Shading
(Direct Effect)
• Shading can reduce summer air
conditioning costs by 15 to 35 percent,
• As much as 50 percent or more in certain
specific situations.
• Simply shading the air conditioner – by
using shrubs or vine-covered trellis – can
save up to 10 percent in annual cooling
energy costs
82. Evapotranspiration
(Indirect Effect)
Trees transpire up to 100 gallons of water in a day
In a hot dry climate, This
cooling effect equal that of
5 air conditioners running
for 20 hours
When the effects of evapotranspiration
are combined with the effect of
strategically placed shade, temperatures
can drop by as much as 9 oF in the
immediate vicinity of the trees.
82
83. Contribution of Vitamin G to Human Health and Wellbeing
Component of health Contribution of parks
Physical Provide a variety of settings and infrastructure for
various levels of formal and informal sport and
recreation, for all skill levels and abilities e.g.
picnicking, walking, dog training, running, cycling,
ball games, sailing, surfing, photography,
birdwatching, bushwalking, rock climbing, camping
Mental Make nature available for restoration from mental
fatigue; solitude and quiet; artistic inspiration and
expression; educational development (e.g. natural and
cultural history)
Spiritual Preserve the natural environment for contemplation,
reflection and inspiration; invoke a sense of place;
facilitate feeling a connection to something beyond
human concerns
Social Provide settings for people to enhance their social
networks and personal relationships from couples and
families, to social clubs and organisations of all sizes,
from casual picnicking to events days and festivals
Environmental Preserve ecosystems and biodiversity, provide clean air
and water, maintain ecosystem function, and foster
human involvement in the natural environment
(Friends of Parks groups, etc.) 83
Jamaica have experienced an epidemiological transitions over the past 60 year, this is a illustrative table which show the leading causes of death in jamaica for selected years between 1945 and 2004, the top 5 leading causes of death including . Largely rooted in our lifestyle. CNDs accounted for 56% of death annually.“Urbanization and socioeconomic transition are linked to Obesity and Cardio-metabolic Risk among Youth” (Sodjinou R et al., 2008)
What are the complications of being obese and overweight?Obesity directly contributes to 44% of the burden of diabetes, to 23% of the burden of CVD and to 41%Obesity also contributes to the burden of hypertension, mental health and musculoskeletal disorders …….Obesity and overweight are major risk factor for non-communicable disease namelyNCDs are considered as the common health consequences of overweight and obesity (3)
More males enrolled on sports such as playing football in public facilities than women doing any physical activity. In order to reduce the impact of the risk factors found in the last JHLS survey 2008, it is very important to focus on the features and conditions that determine the accessibility and use of public facilities. Hence, it becomes necessary to reevaluate current park facilities, conditions, designs/layouts, and financing Accordingly, the comparison of 2000 and 2008 JHLS Surveys shows few changes in health related behaviors and on the contrary, risk factors are on the rise. For example sedentary lifestyle increased from 17% to 30%, obesity from 20% to 25%, diabetes 8% and hypertension 30% (30). The increase of health risk factors in Jamaica continue to trigger, among the public health diaspora, discussions about how public health can be improved through the built environment with focus on facilities, conditions, safe, and easy access to public parks to engage in physical activity. In the midst of the obesity and violence crisis, parks without maintenance and lack of good conditions and security are becoming unsafe and unattractive places for physical activity and