Ludrick Morris | Death on hire purchase

Jamaica is taking out a loan against the health of its children. The down payment is being made now, in childhood overweight and obesity, rising blood pressure, disturbed blood sugar, fatty liver disease, sleep problems and the emotional burden of weight stigma. The instalments may continue into adulthood, when these same children become the workers, parents and leaders on whom our nation depends.

Every year that we postpone effective prevention and treatment, we allow the problem to accumulate.

The latest Jamaica Global School-based Student Health Survey (GSHS) should be treated as a national warning. In 2026, 31.7 per cent of students aged 13-17 years were overweight, including 15.3 per cent with obesity. In 2017, the corresponding figures were 23.3 per cent and 9.2 per cent. That represents increases of 8.4 percentage points in overweight and 6.1 percentage points in obesity, relative increases of 36.1 per cent and 66.3 per cent, respectively.

The earlier trend is equally troubling. Among students aged 13–15, overweight increased from 21.7 per cent in 2010 to 25.6 per cent in 2017, while obesity rose from 6.0 per cent to 10.1 per cent. The 2026 survey uses ages 13-17, so these figures should not be presented as one perfectly matched series. Nevertheless, the direction is unmistakable.

Nearly one in three students in the 2026 age group was overweight, and approximately one in six to seven was living with obesity. The survey included 3,058 students; its weighted percentages are not a verified national headcount.

Childhood obesity is a chronic, complex disease that can affect multiple organs and systems. Children may develop hypertension, abnormal cholesterol, insulin resistance, type 2 diabetes, fatty liver disease, obstructive sleep apnoea, orthopaedic problems and psychosocial difficulties. Some complications are already present before adulthood.

The consequences extend beyond the clinic. Poor sleep can affect concentration; weight-based bullying can undermine participation and wellbeing; and obesity-related illness can mean repeated medical visits, investigations and treatment. Families bear the costs of transport, medication, lost working time and emotional distress.

Children are not to blame for the environments in which they grow up. Shame is not a treatment. Effective care requires respectful assessment, family support, healthier environments and evidence-based medical management when indicated.

INHERIT TODAY’S ILLNESS

The economic consequences do not begin at retirement age. They begin when preventable illness interrupts education, reduces participation and creates recurring healthcare needs. In adulthood, obesity-related conditions can contribute to increased healthcare expenditure, absenteeism, reduced productivity, disability and premature mortality.

Jamaica’s National School Nutrition Policy cites a projection that the economic cost of overweight and obesity could reach US$1.5 billion annually by 2060, exceeding 5 per cent of GDP. This is a projection, not a current expenditure figure, but it illustrates the scale of the threat. Inaction carries a cost, and that cost is paid repeatedly.

There’s already National School Nutrition Policy approved by Cabinet in 2025. Its implementation is planned over five years, with an estimated cost of J$3.62 billion. The question is whether we will fully fund, implement and enforce what we have already agreed to do.

The policy reaches beyond the canteen. It encompasses the food environment within 200 metres of the school gate or perimeter, provides for regulation of vendors, and seeks to control unhealthy-food marketing. It calls for safe drinking water, nutritious school meals, more locally grown fruits, school gardens, nutrition education and physical activity. It also strengthens links with farmers and provides for health assessments, nutrition counselling and referral.

These are designed to make the healthy choice the normal choice. The 200-metre provision requires the necessary regulatory framework beyond school premises; it should not remain an aspiration.

Healthy food must be made affordable. Government should examine removing or reducing applicable taxes and duties on nutritious foods, targeted subsidies, support for local production and distribution, and healthy-food vouchers or reimbursements for eligible households. Such measures should be costed and evaluated to ensure savings reach families.

A well-designed sugar-sweetened beverage tax could complement these measures, with appropriate revenue supporting school nutrition and healthy-food access. We should also advance front-of-package warning labels, stronger restrictions on unhealthy-food marketing to children, and full implementation of the Baby-Friendly Hospital Initiative and breastfeeding support.

INCOMPLETE SOLUTION

A healthy-food recommendation without affordability is an incomplete solution.

We cannot afford to be pusillanimous in the face of a problem that demands courage. The response must be bold, deliberate, coordinated and sustained.

Government, healthcare professionals, schools, parents, communities, civil society and responsible private-sector partners must act together. We must protect children from commercial practices that undermine health, make healthier choices accessible, and provide treatment for children already living with overweight and obesity.

The Paediatric Association of Jamaica, in collaboration with the Heart Foundation of Jamaica, is advancing ‘Weight a Bit … Turning the Tide on Childhood Obesity in Jamaica’ to mobilise prevention and management through public education, school and community engagement, scientific discussion, policy advocacy and practical action.

Our children should not have to make the down payment on our procrastination. And the adults they become should not be left to pay the balance, with their health, their productivity and, in some cases, their lives.

Dr Ludrick Morris is a consultant paediatrician and president of the Paediatric Association of Jamaica. Send feedback to ludriques@yahoo.com.