Author: Nicholas Jennings
SUMMARY OF THE DISSERTATION
Trinidad and Tobago is a high-income country, and one of the English-speaking Caribbean’s Small Island Developing States (SIDS); a unique group of developing countries with similar challenges to their sustainable development. Trinidad and Tobago has moved through a demographic and epidemiological transition – communicable to non-communicable disease – and has a rapidly aging population. In 2019 the population was estimated at 1.4 million of which 18.2% was 60 years and older, this demographic is anticipated to steadily increase to 24.5% by 2030 and 36.5% by 2050. Trinidad and Tobago also has one of the highest rates for morbidity and mortality from non-communicable or chronic diseases, which were estimated to have accounted for 81% of all deaths in 2016. Cardiovascular diseases 33%, cancers 15%, diabetes mellitus 15% and chronic respiratory diseases 3% were among the main causes of death. There is limited palliative care services compared to need and a lack of relevant research activity in Trinidad and Tobago and the Caribbean region. From a public health perspective this presents several important challenges: how to guarantee favourable circumstances in which people can die (for
example, free from avoidable symptoms and problems), how to guarantee access to appropriate health care and end-of-life care for these populations, how to optimise the efficiency and cost effectiveness of available health care resources, and how to develop strategies for health care by non-professional community services. The main objectives of this dissertation are to describe the circumstances under which persons die and to describe the medical care and treatment a person received prior to their death in Trinidad and Tobago.