Ministerial Statement to the

House of Assembly

by the Minister of Health, Seniors and Environment

The Honourable Jeanne J. Atherden, JP, MP

On 18th July, 2014




Mr. Speaker,


Once again, I rise this morning to offer an important message about the experiences from the front lines of our chronic disease risk factor survey. 


The STEPS to a Well Bermuda survey is ongoing in the community, and has made significant headway in uncovering the facts about of our island’s health status.


There are urgent questions to answer about our people’s health and these answers will guide future planning of health services and policies.  Mr. Speaker, we need these answers.


Already, at the midway point in the data collection, individuals have been identified who are at risk for chronic diseases or who have conditions which put them at risk of serious health complications, such as obesity, elevated blood pressure or abnormal blood glucose levels.  Over 25% of individuals have been found to have fasting blood glucose in the upper normal range (101-125 mg/dl).


This is important information.


However, the survey reaches out to all segments of the community, even those with good health and regular access to care.  It is a population survey and the goal is to describe the health of our population, not just a given individual.


Everyone selected to participate should willingly do so for the sake of the community.


Identifying the risk factors in our population and documenting these is essential work if we are to reverse the trend of rising chronic diseases, complications, disability and premature death.  We need this information to put in place services and policies to address our health issues.


However, I want to report today that progress on completing the survey has hit a road bump.  There has been surprising resistance by some in the community to being surveyed and an unanticipated drop in the number of active interviewers.


Mr. Speaker,


The Epidemiology and Surveillance Unit (or ESU) of the Ministry is coordinating the survey and they report that our community households have shown less than 70% acceptance rate of participation when selected, and that nearly 50% of those who participate in the initial two steps of the process do not complete all four steps.


These rates of participation reduce the amount of information collected and weaken the statistical power of this important population study.  We cannot let this happen.  The STEPS survey is an undertaking so basic and essential to the ultimate wellbeing of the community that it must be completed, and soon.


Mr. Speaker,


I am pleased to say that this is NOT the end of the story, because there is a solid plan to get around the current bump in the road.  All research efforts expect challenges, and we must be prepared to regroup and deal with them – both the expected challenges and the unexpected ones.


This morning I would like to share the plan of the STEPS survey organizers with this Honorable House and the people of Bermuda.  The plan is to revitalize the survey outreach efforts and to rally support among the community to participate fully and complete the data collection by the one year mark, approximately December 2014.


Mr. Speaker,


What is needed to guarantee timely completion of this survey is the willing participation of the people of Bermuda in the STEPS to a Well Bermuda survey.


We are asking, encouraging and urging all those who are selected by the random household selection process, to eagerly agree to participate and to complete all four steps of this historic and important health survey.


This effort is so important to our island’s health system and financial wellbeing that I appeal to each person, across all social, economic, political groups, and every other demographic, to participate fully when asked.


Mr. Speaker,


I want to make it clear once again how very, very important the information obtained by the STEPS survey is to the future of the country.  When we all come to understand the true value of this survey, we anticipate an immediate upswing in participation.


Just over a week ago I attended a meeting in Washington DC at the Pan American Health Organization offices (PAHO) with the Health Ministers of the UK Overseas Territories and their support persons.  The focus of this consultation was on the critical need to address the escalation of chronic diseases in the region which threaten the health, social and economic stability of our countries.


It was noted that when over 60% of the adult population is overweight or obese, and over 10 or 15% have diabetes, for example, or other serious chronic diseases, the health, productivity and vibrancy of the community is threatened.  The cost of health care spirals to unsustainable levels as ours has, and the wellbeing of the nation is at risk.



Mr. Speaker,


The message was clear, that an essential first step in tackling the problems of chronic disease in countries is quantifying the problem and identifying the prevalence of the risk factors leading to these diseases.


Remember, the risk factors of today are the diseases of tomorrow.  Any country which is seriously addressing these health and economic threats, has performed, or is in the process of conducting, a STEPS-like chronic disease risk factor survey.


Bermuda is in the company of all the other UK Overseas Territories, and the worldwide community of nations, in trying to assess its population health status.


We must do this.


So, Mr. Speaker,


I restate that the plan of the STEPS to a Well Bermuda survey coordinators is to intensify its outreach to the community by again contacting the households yet to be surveyed making it as convenient as possible for them to participate.


Participants will be encouraged to undertake the short survey and assessment on the spot or to attend the Saturday morning “One Stop” STEPS survey sessions now taking place at the Hamilton Health Center on Victoria Street from 9am to noon.


This new arrangement is to facilitate easy completion of all four steps of the survey in a short span of time.  Participants are given an appointment and can then be interviewed, have their physical measurements, blood pressure and blood glucose checked.  They can also complete their oral health screening and physical activity assessments.  The process is quick, easy and the information obtained is so very important to the country.



Mr. Speaker,


This is an historic survey for Bermuda and we know it will provide essential health information about our community.  However, we need the help of all selected households in the community to successfully complete the survey and provide this vital information.


We are calling on these households and the diligent interviewers working in the field to help us complete this important undertaking.


Thank you, Mr. Speaker.