The Hypertension–Diabetes Nexus in Jamaica: Sociodemographic, Functional Health and Multimorbidity Patterns in the 2023 Jamaica Survey of Living Conditions
TL;DR
The Jamaican hypertension-diabetes nexus is an ageing, socially differentiated, functionally consequential and multimorbid phenomenon that should integrate socioeconomic vulnerability, functional health and multimorbidity within person-centred NCD care.
Abstract
Background: Globally, hypertension and diabetes mellitus are major contributors to cardiovascular morbidity, disability and premature mortality, with particularly substantial burdens across the Caribbean and Latin America. Although Jamaican studies have examined these conditions separately and within multimorbidity frameworks, limited contemporary evidence integrates hypertension-diabetes coexistence with socioeconomic characteristics, functional health and additional chronic diseases. This study addresses that gap using the 2023 Jamaica Survey of Living Conditions (JSLC).Methods: A cross-sectional secondary analysis was conducted using JSLC 2023 data archived through the SALISES Documentation and Data Centre, The University of the West Indies, Mona Campus, Jamaica. The JSLC is a national cross-sectional probability survey of 4,442 Jamaicans across the 14 parishes. For this study, the analytical dataset comprised 858 cases selected using a hypertension-diabetes filter. Data were analysed using descriptive statistics, cross-tabulations, and Pearson’s chi-square tests.Results: Women constituted 65.0% of participants, while 62.5% were aged 60 years or older. Hypertension was reported by 88.9% and diabetes by 37.5% of the analytical population, while 26.5% were classified with combined hypertension and diabetes. Functional impairment was substantial, with 46.3% reporting some degree of difficulty and 25.7% reporting severe difficulty or complete inability. Arthritis, heart disease, asthma, kidney disease and other chronic conditions further indicated considerable multimorbidity. Combined hypertension and diabetes did not differ significantly by sex (P=.174), although sex was significantly associated with age and socioeconomic group.Conclusion: The Jamaican hypertension-diabetes nexus is an ageing, socially differentiated, functionally consequential and multimorbid phenomenon. The findings extend Caribbean and international literature by demonstrating that cardiometabolic disease management should integrate socioeconomic vulnerability, functional health and multimorbidity within person-centred NCD care.