Nuffield Centre for International Health and Development, University of Leeds, Leeds, United Kingdom.
Front Public Health. 2022 Aug 30;10:926672. doi: 10.3389/fpubh.2022.926672. eCollection 2022.
The 2020 Global Nutrition Report highlights that despite improvements in select nutrition indicators, progress is too slow to meet the 2025 Global Nutrition Targets. While the Latin America and the Caribbean (LAC) region has achieved the greatest global reduction in undernutrition (stunting, underweight, and wasting) in the past decade, it also has the highest prevalence of people with overweight worldwide. Since the early 2000s, the region has mounted increasingly comprehensive and multi-sectoral policy interventions to address nutritional health outcomes. The Bahamas is one such LAC country that has used consistent policy responses to address evolving nutritional challenges in its population. After addressing the initial problems of undernutrition in the 1970s and 80s, however, overconsumption of unhealthy foods has led to a rising prevalence of obesity which The Bahamas has grappled with since the early 2000s.
This study develops a timeline of obesity-related health policy responses and explores the macrosocial factors and conditions which facilitated or constrained public health policy responses to obesity in The Bahamas over a 20-year period.
This multi-method case study was conducted between 2019 and 2021. A document review of health policies was combined with secondary analysis of a range of other documents and semi-structured interviews with key actors (policymakers, health workers, scholars, and members of the public). Data sources for secondary data analysis included policy documents, national survey data on obesity, national and regional newspaper websites, and the Digital Library of the Caribbean database. An adapted framework approach was used for the analysis of semi-structured interviews.
Between 2000 and 2019, a series of national policies and community-level interventions were enacted to address the prevalence of obesity. Building on previous interventions, obtaining multi-sectoral collaboration, and community buy-in for policy action contributed to reducing obesity prevalence from 49.2 to 43.7% between 2012 and 2019. There are, however, constraining factors, such as political and multi-sectoral challenges and gaps in legislative mandates and financing.
Sustained multilevel interventions are effective in addressing the prevalence of obesity. To maintain progress, there is a need to implement gender-specific responses while ensuring accessibility, availability, and affordability of nutritious food for all.
2020 年全球营养报告强调，尽管在一些营养指标上有所改善，但进展缓慢，无法实现 2025 年全球营养目标。虽然拉丁美洲和加勒比地区（LAC）在过去十年中实现了全球范围内营养不良（发育迟缓、体重不足和消瘦）的最大降幅，但该地区也是全球超重人口比例最高的地区。自 21 世纪初以来，该地区采取了越来越全面和多部门的政策干预措施，以改善营养健康状况。巴哈马就是这样一个 LAC 国家，它一直采取一致的政策应对措施，应对其人口中不断变化的营养挑战。然而，在 20 世纪 70 年代和 80 年代解决了最初的营养不足问题之后，过度消费不健康食品导致肥胖率上升，巴哈马自 21 世纪初以来一直在努力应对这一问题。
本研究制定了与肥胖相关的健康政策应对措施时间表，并探讨了 20 年来促进或限制巴哈马公共卫生政策应对肥胖的宏观社会因素和条件。
本多方法案例研究于 2019 年至 2021 年进行。对健康政策进行了文件审查，并结合对一系列其他文件的二次分析以及对关键行为者（决策者、卫生工作者、学者和公众）的半结构化访谈。二次数据分析的数据来源包括政策文件、关于肥胖的国家调查数据、国家和地区报纸网站以及加勒比数字图书馆数据库。采用经过改编的框架方法对半结构化访谈进行分析。
2000 年至 2019 年期间，出台了一系列国家政策和社区一级干预措施，以解决肥胖症的流行问题。在以前的干预措施的基础上，争取多部门合作和社区对政策行动的支持，有助于将肥胖症的流行率从 2012 年的 49.2%降至 2019 年的 43.7%。然而，也存在一些制约因素，如政治和多部门挑战以及立法任务和资金方面的差距。
持续的多层次干预措施在解决肥胖症的流行方面是有效的。为了保持进展，需要实施针对特定性别的应对措施，同时确保所有人都能获得营养食品的可及性、可用性和可负担性。
