Health literacy is a measure of the patient’s ability to read, comprehend and act on medical instructions. This research article examines health literacy and health-seeking behaviors among elderly men in Jamaica, in order to inform health policy. This is a descriptive cross-sectional study. A 133-item questionnaire was administered to a random sample of 2,000 men, 55 years and older, in St Catherine, Jamaica. In this study, 56.9% of urban and 44.5% of rural residents were health literate. Only 34.0% of participants purchased medications prescribed by the medical doctor and 19.8% were currently smoking. Despite the reported good self-related health status (74.4%) and high cognitive functionality (94.1%) of the older men, only 7.9% sought medical care outside of experiencing illnesses. Thirty-seven percent of rural participants sought medical care when they were ill compared with 31.9% of their urban counterparts. Thirty-four percent of the participants took the medication as prescribed by the medical doctor; 43% self-reported being diagnosed with cancers such as prostate and colorectal in the last 6 months, 9.6% with hypertension, 5.3% with heart disease, 5.3% with benign prostatic hyperplasia, 5.3% with diabetes mellitus, and 3.8% with kidney/bladder problems. Approximately 14% and 24% of the participants indicated that they were unaware of the signs and symptoms of hypertension and diabetes mellitus, respectively. The elderly men displayed low health literacy and poor health-seeking behavior. These findings can be used to guide the formulation of health policies and intervention programs for elderly men in Jamaica.

Of the 57 million deaths that occurred in the world in 2008, 63 percent were due to chronic noncommunicable diseases (CNCDs), and the majority of those who died were women and elderly people. Objectives: To evaluate health indices of those in the retirement aged cohort and working aged cohort; to determine rates of comorbidity for those in the retirement aged and the working aged cohorts; to compute the prevalence rate of specific chronic non-communicable diseases and to calculate death rates for those in retirement aged and the working aged cohorts. Methods: Jamaica Survey of Living Conditions (JSLC) is a national cross-sectional probability survey that is conducted yearly by two governmental agencies in Jamaica. The current sample is 4313 Jamaicans who are either in the working or retirement aged cohorts from 2007 JSLC survey as well as death statistics from 2002 to 2008. Findings: In 2007, the prevalence rate of deaths that occur due to CNCDs is 50.7% (male, 45.2%; female, 59.5%); 12% of those in the working aged population indicate having an illness compared to 43.2% of those in the retirement aged cohort; 23.7% of retirement aged cohorts reported having diabetes compared to 15% of those in the working aged cohort, and those in the retirement aged cohort imply having hypertension 1.6 times more than those in the working aged cohort. The rate of comorbidity is 20.6% (retirement aged cohort, 27.4%; working aged cohort, 15.6%). The prevalence rate of those with CNCDs is 37.6% for those in the retirement aged cohort and 8.2% for those in the working aged cohort. Conclusion: It is imperative that age, gender, area of residence specific and culturally relevant policies be developed in order

Background:Studies have shown that women's ability to access contraceptive methods depend on their socio-economic, educational, professional status, and the health and well-being of their families and themselves. Therefore, the embarking of the Governments of the Caribbean on important initiatives relating to gynecological matters is very important and timely.Aims:This study aims to examine the perception, attitude and practice of Jamaican women towards the matter of pelvic examination.Patients and Methods:The current study used an extracted sample of 7,168 women in their reproductive years (15-49 yrs) from a study which was undertaken by the National Family Planning Board in 2002 on Reproductive Health. Data was analyzed using SPSS for Windows, Version 16.0 (SPSS Inc.; Chicago, Ill. USA). Logistic regression was used to analyze factors/variables pertaining to Pelvic examination.Results:The findings revealed that older women are more likely to have done a Pelvic examination compared to younger women (χ2 = 675.29, P < 0.001). Age, number of pregnancies that resulted in miscarriages, number of pregnancies that resulted in induced abortion, age of first sexual intercourse, number of years of schooling, area of residence and socio-economic class are statistically significant factors of Pelvic examinations in Jamaica. Therefore, the model had significant predictive power where (χ2 = 1022.79, P < 0.001).Conclusion:The multidimensional nature of the variables, which emerged in the current study, indicate that a multisectoral approach should be used to address low pelvic and Pap smear examination among Jamaican women.

Introduction: Hypertension is a common and serious health problem in many developed and developing countries; yet self-management practices of hypertensive have never been empirical examined in the Caribbean. Objectives: This research seeks to: 1) examine the knowledge level on hypertensive among hypertensive patients at a hypertensive clinic in urban St. Andrew; 2) evaluate the knowledge level on hypertension among the sampled respondents differ based on particular sociodemographic characteristics; 3) determine the factors that influence knowledge level on hypertension among hypertensive patients at an urban clinic in St. Andrew, Jamaica; 4) examine the self-care management practices level among hypertensive patients at a hypertensive clinic in urban St. Andrew, Jamaica; 5) evaluate self-care management practices among the sampled respondents differ based on particular socio-demographic characteristics, and 6) determine the knowledge on hypertension influence self-care management practices level among hypertensive patients at a hypertensive clinic in urban St. Andrew, Jamaica. Methods: Convenience sampling was used to collected data from 50 hypertensive patients in clinic in an Urban Jamaican Hospital. The data were entered, retrieved and analysed using SPSS for Windows version 19.0. Findings: The average knowledge of hypertension index was 34.7 ± 2.11 compared to 23.4 ± 3.2 for self-care management. The number of medications taken and the length of time being diagnosed with the health condition influence the knowledge level the individual has on the disease, with those factors accounting for 44.1 percentages of the variance in knowledge level on hypertension. Conclusion: The findings provide key ingredients to effect policies changes and social interventions.

Introduction: The Jamaica Constabulary Force (JCF) established in 1867 as a paramilitary organization and over its 148 year history, the institution has sought to address various crimes and it appears that all its policy efforts have come to nought. In seeking to combat the crime pandemic in the society, the entity has been accused of corruption, abuses, professional misconduct and excessive use of power. With such accusations and claims, there has been a negative image of the JCF and so it has sought to inco-operate the user as a part of policing strategy. To date, there has been no empirical research undertaken on service quality in the JCF.

The aim of the current study was to examine the good health status of older and oldest elderly Jamaicans as well as to determine predictors of this health status. A sub-sample of 1,069 respondents (42.4 percent men and 57.6 percent women) who indicated being 75 years and older were used for this study. This is extracted from a larger nationally cross-sectional survey of 25,018 respondents in 2002. The stratified multistage probability sampling technique was used to draw the survey respondents, which reflects the socio-demographic characteristic of the Jamaican population, and makes the sample generalizable on the population. A self-administered questionnaire was used to collect the data from the sample; and the interviewers were trained to collect data. The data were entered, stored and retrieved in SPSS 16.0. Descriptive statistics were used to examine the demographic characteristics of the sample; chi-square was used to investigate non-metric variables, and logistic regression was the multivariate technique chosen to determine predictors of good health status. Two factors were found to be statistically significant predictors of good health status of older and oldest elderly respondents. These were area of residence and sex of respondents. Older and oldest elderly men reported a greater good health status than old and oldest elderly women (OR = 1.410; 95% CI: 1.048-1.897). On the other hand, there was no statistical difference between the self-reported diagnosed (chronic) recurring illness and age cohort of the sample. Rural older and oldest elderly respondents indicated the lowest good health status (OR = 1.00) compared to other residents (urban: OR = 1.670; 95% CI: 1.071-2.606; and other town dwellers: OR = 1.847; 95% CI: 1.327-2.572). Good health of this age cohort is not influenced by income or social standing, and there is a need to examine lifestyle risk factors; disease indicators and psychological conditions, as this may provide more answers to the good health of Jamaicans 75 years and older. A quantitative assessment has provided us with answers, but it is clear from the findings that more information is needed on this age cohort. The researcher recommends the use of qualitative methodologies to provide in-depth understanding of those factors that determine good health of this age cohort.

Over the last 2 decades (1988)(1989)(1990)(1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007), poverty in Jamaica has fallen by 67.5%, and this is within the context of a 194.7% increase in inflation for 2007 over 2006. It does not abate there, as Jamaicans are reporting more health conditions in a 4-week period (15.5% in 2007) and at the same time this corresponds to a decline in the percentage of people seeking medical care. Older people's health status is of increasing concern, given the high rates of prostate cancer, genitourinary disorders, hypertension, diabetes mellitus and the presence of risk factors such as smoking. Yet, there is a dearth of studies on the health status of older people in the two poor quintiles. This study examined 1) the health status of those elderly Jamaicans who were in the two poor quintiles and 2) factors that are associated with their health status. A sample of 1,149 elderly respondents, with an average age of 72.6 years (SD = 8.7 years) were extracted from a total survey of 25,018 Jamaicans. The initial survey sample was selected from a stratified probability sampling frame of Jamaicans. An administered questionnaire was used to collect the data. Descriptive statistics were used to examine background information on the sample, and stepwise logistic regression was used to ascertain the factors which are associated with health status. The health status of older poor people was influenced by 6 factors, and those factors accounted for 26.6% of the variability in health status: Health insurance coverage (OR = 13.90; 95% CI: 7.98-24.19), age of respondents (OR = 7.98; 95% CI: 1.02-1.06), and secondary level education (OR=1.82; 95% CI: 1.35-2.45). Males are less likely to report good health status than females (OR = 0.56; 95% CI: 0.42-0.75). Older people in Jamaica do not purchase health insurance coverage as a preventative measure but as a curative measure. Health insurance coverage in this study does not indicate good health but is a proxy of poor health status. The demand of the health services in Jamaica in the future must be geared towards a particular age cohort and certain health conditions, and not only to the general population, as the social determinants which give rise to inequities are not the same, even among the same age cohort.

The purpose of the current study was to model the health insurance coverage of Jamaicans; and to identify the determinants, strength and predictive power of the model in order to aid clinicians and other health practitioners in understanding those who have health insurance coverage. This study utilized secondary data taken from the dataset of the Jamaica Survey of Living Conditions which was collected between July and October 2002. It was a nationally representative stratified random sample survey of 25,018 respondents, with 50.7% females and 49.3% males. The data was collected by way of a self-administered questionnaire. The non-response rate for the survey was 29.7% with 20.5% not responding to particular questions, 9.0% not participating in the survey and another 0.2% being rejected due to data cleaning. The current research extracted 16,118 people 15 years and older from the survey sample of 25,018 respondents in order to model the determinants of private health insurance coverage in Jamaica. Data were stored, retrieved and analyzed using SPSS for Windows 15.0. A p-value of less than 0.05 was used to establish statistical significance. Descriptive analysis was used to provide baseline information on the sample, and cross-tabulations were used to examine some non-metric variables. Logistic regression was used to identify, determine and establish those factors that influence private health insurance coverage in Jamaica. This study found that approximately 12% of Jamaicans had private health insurance coverage, of which the least health insurance was owned by rural residents (7.5%). Using logistic regression, the findings revealed that twelve variables emerged as statistically significant determinants of health insurance coverage in this sample. These variables are social standing (two weal- thiest quintile: OR = 1.68, 95% CI = 1.23 – 2.30), income (OR = 1.00, 95%CI = 1.00 – 1.00), durable goods (OR = 1.16, 95% CI = 1.12 – 1.19), marital status (married: OR = 1.97, 95% CI = 1.61 – 2.42), area of residence (Peri-urban: OR = 1.45, 95% CI = 1.199 – 1.75; urban: OR = 1.83, 95% CI = 1.40 – 2.40), education (secondary: OR = 1.57, 95% CI = 1.20 – 2.06; tertiary: OR = 9.03, 95% CI = 6.47 – 12.59), social support (OR = 0.64, 95% CI = 0.53 – 0.76), crowding (OR = 1.14, 95% CI = 1.02 – 1.28), psychological conditions (negative affective: OR = 0.97, 95% CI = 0.94 – 1.00; positive affective: OR = 1.11, 95% CI = 1.06 – 1.16), number of males in household (OR = 0.85, 95% CI = 0.77 – 0.93), living arrangements (OR = 0.62, 95% CI = 0.41 – 0.92) and retirement benefits (OR = 1.55, 95% CI = 1.03 – 2.35). This study highlighted the need to address preventative care for the wealthiest, rural residents and the fact that social support is crucial to health care, as well as the fact that medical care costs are borne by the extended family and other social groups in which the individual is (or was) a member, which explains the low demand for health insurance in Jamaica. Private health care in Jamaica is substantially determined by affor...