Page 45 - GHES-2-3

Global Health Economics and
Sustainability
Jamaican specialized health-care history

may have changed since this data were collected in 1997. health services. Ironically, this burden is aggravated by
This index underscores the vulnerability of many in its recurrent epidemics and pandemics of viral illnesses,
population to the potential for extreme economic impacts which have contributed to increased inactivity and
from intercurrent health events. In the absence of infectious overeating, as observed during the recent COVID-19
disease, most of these acute events are complications of pandemic. Economic inequalities in these countries
chronic non-communicable diseases. These events typically result in specialized healthcare often having to be paid for
require specialized care with expensive technologies and out-of-pocket or by private insurance, which may not be
are both human resource and capital intensive. possible for many people, predisposing them to significant
Increasing lifespan also brings with it the physical risks of economic compromises. Various economic models
consequences of aging. Degenerative disorders are of health-care systems exist in developed countries, such
the main areas of health expenditure in the developed as those in North America. In some cases, specialized
world; for example, dementia costs the world US$604 healthcare has benefitted from philanthropic and related
billion/year) (WHO & ADI, 2012). Using dementia as mechanisms, helping to reduce the economic burden
an example, there are nearly 35.6 million cases globally, on government health-care systems and, ultimately, on
a number projected to double by 2030 (65.7 million) and patients (Bishop et al., 2010).
triple by 2050 (115.4 million). Currently, 58% of those with Conceptual innovations for increasing funding, including
dementia live in LMICs, and by 2050, more than 70% of not-for-profit funding relevant to upper-middle-income
those afflicted will be in these economically disadvantaged countries like Jamaica, will be explored in a separate
countries (WHO & ADI, 2012). Indeed, as shown in publication. This forthcoming publication will delineate the
Figure 2, Alzheimer’s disease is increasing in prevalence social importance of addressing this issue across all sectors of
and is now the seventh most common cause of death in the economy and social strata (Frumkin, 2010; Islam et al.,
Jamaica. 2006). Together, the present perspective article and the
This increase in dementia cases must be viewed in the separate publication will frame the context for the research
context that extreme longevity is not only possible in Jamaica question that has emerged from this background: “Why
but also a regular occurrence. Recently, Jamaica had the do Jamaica’s high-net-worth entrepreneurs not engage
oldest living person in the world, at the age of 117 years, and significantly in specialized health-care philanthropy?”
over 200 centenarians, with two over the age of 110 years, Answering this question will provide crucial insights into
amongst its population (Jamaica Observer, 2021). Aging, whether Jamaica’s unmet needs in specialized health-care
especially advanced aging, brings with it the inevitability funding can, at least in part, be bridged by philanthropy.
of multiple medical comorbidities, adding complexity
and cost to the life course of such individuals. Quality of Acknowledgments
life often deteriorates in the absence of multidisciplinary None.
specialized care (Foley, 2023; Yang et al., 2022).
Funding
4. Summary
None.
At this time, several impediments exist to advancing
specialized healthcare in countries like Jamaica, including Conflict of interest
the pernicious legacy of its colonial past and slavery. One of The author declares that he has no competing interests.
the most significant impediments may well be the natural
selection that conferred a survival advantage to those slaves Author contributions
and their descendants who were able to conserve sodium
and energy (thrifty gene hypothesis) in settings of scarcity This is a single-authored article.
(Rossier et al., 2017). These genetic advantages become Ethics approval and consent to participate
disadvantages in settings of abundance and inactivity,
leading to the metabolic syndrome associated with central Not applicable.
obesity and its consequences (Hoh et al., 2019).
Consent for publication
Tremendous strides have been made in primary
healthcare, resulting in better health in childhood and Not applicable.
early adulthood. The shift from infections to chronic non- Availability of data
communicable diseases and their numerous complications
has placed an increasing burden on already strained Not applicable.

Volume 2 Issue 3 (2024) 5 https://doi.org/10.36922/ghes.2709