Faculty of Medical Sciences, University of West Indies, Cave Hill Campus, Barbados. alafia.samuels@cavehill
Ethn Health. 2012;17(6):631-49. doi: 10.1080/13557858.2012.752072. Epub 2012 Dec 19.
To explore interactions between disease burden, culture and the policy response to non-communicable diseases (NCDs) within the Caribbean, a region with some of the highest prevalence rates, morbidity and mortality from NCDs in the Americas.
We undertook a wide ranging narrative review, drawing on a variety of peer reviewed, government and intergovernmental literature.
Although the Caribbean is highly diverse, linguistically and ethnically, it is possible to show how 'culture' at the macro-level has been shaped by shared historic, economic and political experiences and ties. We suggest four broad groupings of countries: the English-speaking Caribbean Community (CARICOM); the small island states that are still colonies or departments of colonial powers; three large-Spanish speaking countries; and Haiti, which although part of CARICOM is culturally distinct. We explore how NCD health policies in the region stem from and are influenced by the broad characteristics of these groupings, albeit played out in varied ways in individual countries. For example, the Port of Spain declaration (2007) on NCDs can be understood as the product of the co-operative and collaborative relationships with CARICOM, which are based on a shared broad culture. We note, however, that studies investigating the relationships between the formation of NCD policy and culture (at any level) are scarce.
Within the Caribbean region it is possible to discern relationships between culture at the macro-level and the formation of NCD policy. However, there is little work that directly assesses the interactions between culture and NCD policy formation. The Caribbean with its cultural diversity and high burden of NCDs provides an ideal environment within which to undertake further studies to better understand the interactions between culture and health policy formation.
探索加勒比地区疾病负担、文化与非传染性疾病（NCDs）政策应对之间的相互作用，该地区是非传染性疾病在美洲发病率、发病率和死亡率最高的地区之一。
我们进行了广泛的叙述性综述，借鉴了各种同行评议、政府和政府间文献。
尽管加勒比地区在语言和种族上具有高度多样性，但我们可以展示出“文化”在宏观层面上是如何受到共同的历史、经济和政治经历和联系的影响的。我们建议将国家分为四大类：加勒比共同体（CARICOM）的英语国家；仍是殖民势力殖民地或部门的小岛屿国家；三个大的西班牙语国家；以及海地，尽管它是加勒比共同体的一部分，但在文化上是独特的。我们探讨了该地区的 NCD 健康政策如何源自这些群体的广泛特征，并受到其影响，尽管在个别国家以不同的方式表现出来。例如，可以将 2007 年关于 NCDs 的西班牙港宣言理解为与加勒比共同体合作与合作关系的产物，这种关系基于共同的广泛文化。然而，我们注意到，研究 NCD 政策形成与文化（在任何层面）之间关系的研究很少。
在加勒比地区，可以发现宏观层面的文化与 NCD 政策形成之间的关系。然而，几乎没有工作直接评估文化与 NCD 政策形成之间的相互作用。加勒比地区文化多样性丰富，NCD 负担沉重，为进一步研究提供了理想的环境，以更好地了解文化与卫生政策形成之间的相互作用。
