World Obesity Day 2021 Childhood Obesity Prevention (COP) in Barbados: Youth Calling for Meaningful, Informed Policy Action
An Anthropological Lens
As a health researcher and advocate, trained in Medical Anthropology, I am in constant search of the ‘Why?’.
Anthropology asks everything about everything and is a journey of exploration and discovery. At the macro-level, it analyses the structures and institutions which form and maintain society (religion, education, law, etc). At the micro-level, it explores how individuals position themselves within this larger society and how they interpret and navigate their own lives.
Medical Anthropology extends these questions to health. Our ‘Health Beliefs’ are shaped by our socialisation and environments in which we live. Our understandings of wellness and infirmity are not universal, even within the same society or household. The ways in which persons treat the same ailment can differ vastly depending on differing knowledge and access to treatments. This is no different in the discourse surrounding obesity and its associated chronic, non-communicable diseases (NCDs).
Clinical approaches (biomedicine) to obesity typically recommend that we modify our diets, increase levels of physical activity, lose weight and reduce our modifiable risk factors for disease (stop smoking, reduce alcohol consumption, reduce stress). Modifying our behaviour is difficult, however, without a supportive environment.
Health and illness have many determinants. Interventions must be multi-faceted, as well as culture and context specific. In the Caribbean, we must consider, among others:
- Our under- and unemployment rates which make healthy living difficult with high living costs.
- Our affinity for larger body types for their aesthetic and ‘well nutrition-ed’ quality.
- Our colonial history and relationship with sugar and mono-crop practices.
- Our geographical vulnerability to natural disasters, exacerbating food and water insecurity.
- The flooding of the market with high calorie, nutrient poor food and beverage options.
- The lack of adequate, appropriate infrastructure to facilitate and encourage physical activity (e.g. well lit, maintained sidewalks and parks)
- Crime, which discourages persons from accessing public areas for exercise and recreation.
These areas, while daunting, are not insurmountable. They demand a robust, multifaceted and multisectoral approach to healthcare and public health intervention. It also demands that we not operate in silos and engage stakeholders to better inform our interventions and policy actions.
COP in Barbados
In the Caribbean, 1 in 3 children are living with overweight and obesity. Barbados is no different.
For the better part of the past 2 years, the Barbados Childhood Obesity Prevention (COP) Coalition has been doing its part to address childhood obesity through policy action. This Coalition comprises several health and non-health oriented civil society organisations and individuals. The Coalition is guided by WHO recommendations which highlight the importance of developing health promoting school environments where making the healthy choice is the easy, obvious one.
Specific COP policy asks include:
- A removal of sugary drinks from schools.
- An unequivocal ban on the sale and marketing of unhealthy foods and beverages in and around schools.
- Increased access to healthy food and beverage options, especially for those with health issues.
- Cheaper healthy food and beverage options.
- Mandatory physical activity sessions which are varied, fun and inclusive.
Centring the Youth Voice
To achieve these policy goals, the Coalition recognises that those directly affected by COP policies – namely children and youth – must be empowered to and supported in providing input at all levels of the policy process. Youth add immeasurable value to any discourse. They have a unique capacity to:
- Identify the root causes of issues, as experts of their own worlds.
- Harness technology in creative ways for innovative solutions.
- Empower and influence others, particularly other youth.
- Form youth coalitions to share and mobilise resources.
- Bridge generational gaps and challenge existing paradigms for better solutions.
The Coalition’s Youth Subcommittee exemplify this potential in their COP advocacy.
In 2020, the Pan American Health Organisation launched stakeholder consultations to develop a multi-sectoral National School Nutrition Policy. Noting the lack of youth in these consultations, the Youth Subcommittee petitioned to be integrated into the consultations and were granted a seat at the table. From there, they made the case for COP-related policies and called for greater youth engagement in future development processes, emphasising “Nothing for us, without us”.
With the advent of Covid-19, the youth advocates took their message to the digital space. Using the hashtags #HealthyCaribbeanYouth, #OuttaMySchool and #SwitchItUp246, they created robust social media posts, videos and infographics, calling on policy makers to implement and enforce healthy school nutrition policies. They also continue to advocate for COP policies via radio programme features, webinars, outreaches, national stakeholder engagements, open letters, and significantly, peer-peer interactions.
Undoubtedly, we see the impact of youth in all spaces. They must be at the centre of any intervention which impacts their lives and livelihoods. This was made abundantly clear by the Minister of Youth, Sports and Community Empowerment, Hon. Dwight Sutherland
Our young people comprise almost 25 per cent of our population…we need to recognise the value which they can bring to the table and in doing so, provide them with the tools and the enabling environment to apply their natural skills and talents to shape Barbados and to move Barbados into a sustainable and prosperous future. Indeed, our youth must be prepared to be global citizens! We are committed to ensuring that our young people are fully engaged in the development of policies which affect them directly, and which affect the country as a whole.”
Minister of Youth, Sports and Community Empowerment, Hon. Dwight Sutherland, International Youth Day 2020
Youth Subcommittee in Action
 Healthy Caribbean Coalition. (2018). Childhood Obesity Fact Sheets. https://www.healthycaribbean.org/obesity-fact-sheets/
 The University of the West Indies. (2015). The Barbados Health of the Nation Survey: Core Findings Policy Brief 1. Miller Publishing. http://www.archive.healthycaribbean.org/newsletters/aug-2015/CDRC_HealthOfTheNationPolicyBrief.pdf
 World Health Organization. (n/d). School and youth health: What is a health promoting school? https://www.who.int/school_youth_health/gshi/hps/en/
 Millstein, R.A. & Sallis, J.S. (2011). Youth advocacy for obesity prevention: The next wave of social change for health. Translational Behavioral Medicine 1(3), 497-505. DOI: 10.1007/s13142-011-0060-0
 Asian Development Bank and Plan International UK. (2018). What’s the evidence? Youth engagement and the Sustainable Development Goals. https://www.adb.org/sites/default/files/publication/466811/youth-engagement-sdgs.pdf
 United Nations Department of Economic and Social Affairs. (2018). World Youth Report – Youth and the 2030 Agenda for Sustainable Development: Executive Summary. http://www.un.org/development/desa/youth/wp-content/uploads/sites/21/2018/12/Executive-Summary_World-Youth-Report_07.12.18-1.pdf
 Pan American Health Organization. (2020). Barbados Developing Nutrition Policy for Nation’s Children. Barbados Developing Nutrition Policy for Nation’s Children – PAHO/WHO | Pan American Health Organization