Impact of poverty, not seeking medical care, unemployment, inflation, self-reported illness, and health insurance on mortality in Jamaica.
BACKGROUND
An extensive review of the literature revealed that no study exists that has examined poverty, not seeking medical care, inflation, self-reported illness, and mortality in Jamaica. The current study will bridge the gap by providing an investigation of poverty; not seeking medical care; illness; health insurance coverage; inflation and mortality in Jamaica.


METHODS
Using two decades (1988-2007), the current study used three sets of secondary data published by the (1) Planning Institute of Jamaica and the Statistical Institute of Jamaica (Jamaica Survey of Living Conditions) (2) the Statistical Institute of Jamaica (Demographic Statistics) and (3) the Bank of Jamaica (Economic Report). Scatter diagrams were used to examine correlations between the particular dependent and independent variables. For the current study, a number of hypotheses were tested to provide explanation morality in Jamaica.


RESULTS
The average percent of Jamaicans not seeking medical care over the last 2 decades was 41.9%; and the figure has been steadily declining over the last 5 years. In 1990, the most Jamaicans who did not seek medical care were 61.4% and this fell to 52.3% in 1991; 49.1% in 1992 and 48.2% the proceeding year. Based on the percentages, in the early 1990s (1990-1994), the percent of Jamaicans not seeking medical care was close to 50% and in the latter part of the decade, the figure was in the region of 30% and the low as 31.6% in 1999. In 2006, the percent of Jamaicans not seeking medical care despite being ill was 30% and this increased by 4% the following year. Concomitantly, poverty fell by 3.1 times over the 2 decades to 9.9% in 2007, while inflation increased by 1.9 times, self-reported illness was 15.5% in 2007 with mortality averaging 15,776 year of the 2 decades. There is a significant statistical correlation between not seeking medical-care and prevalence of poverty (r = 0.759, p< 0.05). There is a statistical correlation between not seeking medical care and unemployment; but the association is a non-linear one. The relationship between mortality and unemployment was an unsure one, with there being no clear linear or non-linear correlation. The findings revealed that there is a strong direct association between not seeking medical care and inflation rate (r = 0.752). A strong negative statistical correlation was found between mortality and prevalence of poverty (r=0.717). There is a non-linear statistical association between not seeking medical care and illness/injury.


CONCLUSIONS
Not seeking medical care is not a good indicator of premature mortality; but that this percentage must be excess of 55%. While this study cannot confirm a clear rate of premature mortality, there are some indications that this occurs beyond a certain level of not seeking care for illness.
Department of Community Health and Psychiatry, Faculty of Medial Sciences, The University of the West Indies, Andrew, Jamaica WI.
Paul Andrew
PA
Bourne