17/06/2025
This sounds the alarm!
The St. Maarten STEPS survey has confirmed what public health professionals have long feared: obesity has reached critical levels on the island, with nearly three-quarters (73.6%) of adults classified as overweight and almost 44% falling into the category of obese. The findings, drawn from 2,042 participants aged 18 to 69, mark the clearest national snapshot yet of the islandโs growing noncommunicable disease (NCD) burden. Women, in particular, are disproportionately affected, with 51.6% classified as obese, compared to 34.0% of men.
This steep rise in unhealthy body weight is not an isolated issue. It is intricately linked with a range of other health risks and lifestyle patterns, which, taken together, paint a scary picture of public health in St. Maarten. Conducted between August 2023 and October 2024, the STEPS survey, coordinated under the World Health Organization framework, is the countryโs most comprehensive tool for tracking the key behavioral and biological risk factors for chronic illness. A follow-up survey is planned for 2028, but the 2023 results already signal an urgent call for national intervention.
๐๐ก๐ ๐๐๐๐ฌ๐ข๐ญ๐ฒ ๐๐๐: ๐๐ข๐๐ญ, ๐๐ง๐๐๐ญ๐ข๐ฏ๐ข๐ญ๐ฒ, ๐๐ง๐ ๐๐ข๐ฌ๐๐๐ฌ๐
Behind the staggering obesity rates lie a mix of poor dietary habits, sedentary lifestyles, and systemic inattention to preventive care. The survey shows that 93.4% of the population consumes fewer than five servings of fruits and vegetables daily, a WHO-recommended baseline. In parallel, 65.7% of adults report engaging in no leisure-time physical activity at all, a figure that rises to nearly 70% among women.
Worse still, vigorous physical activity is virtually absent: only 26.3% of adults reported doing any form of it, and a staggering 87.4% of women reported none. This gender disparity is a thread that runs through much of the data, with women generally showing higher prevalence of obesity, diabetes, and high cholesterol, metabolic risk factors that feed directly into chronic diseases such as heart disease and stroke.
๐๐จ๐๐๐๐๐จ ๐๐ง๐ ๐๐ฅ๐๐จ๐ก๐จ๐ฅ: ๐ ๐๐๐ฅ๐-๐๐จ๐ฆ๐ข๐ง๐๐ญ๐๐ ๐๐ข๐ฌ๐ค ๐๐ซ๐จ๐๐ข๐ฅ๐
While women disproportionately shoulder the burden of weight-related conditions, men in Sint Maarten show markedly higher rates of substance-related risk. 16.9% of men smoke to***co, compared to just 6.8% of women, and 11.0% report daily smoking, versus 4.2% of women. Workplace exposure to secondhand smoke remains a concern, particularly for men, 17.9% of whom report regular exposure, compared to 10.8% of women.
Alcohol consumption follows a similar trend. Over half of all men (52.7%) reported drinking alcohol in the past month, compared to 28.1% of women. Notably, 19.1% of men engage in heavy episodic drinking, defined as six or more drinks in one sitting, compared to 8.9% of women. These gendered patterns of behavior reinforce the need for targeted health education and gender-sensitive policy responses.
๐๐ฒ๐ฉ๐๐ซ๐ญ๐๐ง๐ฌ๐ข๐จ๐ง: ๐๐ข๐ฅ๐๐ง๐ญ, ๐๐ข๐๐๐ฌ๐ฉ๐ซ๐๐๐, ๐๐ง๐ ๐๐จ๐จ๐ซ๐ฅ๐ฒ ๐๐จ๐ง๐ญ๐ซ๐จ๐ฅ๐ฅ๐๐
36.1% of adults in St. Maarten have hypertension, and while prevalence is evenly split between sexes, men are more likely to have uncontrolled hypertension (high blood pressure/the silent killer), 30.0% compared to 25.2% in women. Alarmingly, only 24.3% of hypertensive individuals have their condition under control. Despite more women being diagnosed and treated, control rates remain low, pointing to a breakdown not just in awareness, but in long-term care and follow-through.
This finding is particularly worrying when paired with the high prevalence of obesity and diabetes, both major contributors to cardiovascular disease (CVD). These interconnected conditions are pushing a significant segment of the population toward serious and preventable chronic illness.
๐๐ข๐๐๐๐ญ๐๐ฌ ๐๐ง๐ ๐๐ก๐จ๐ฅ๐๐ฌ๐ญ๐๐ซ๐จ๐ฅ: ๐ ๐๐จ๐ฎ๐๐ฅ๐ ๐๐ฎ๐ซ๐๐๐ง ๐๐จ๐ซ ๐๐จ๐ฆ๐๐ง
Diabetes affects 14.5% of adults, with a higher burden among women (16.0%) than men (12.3%). Among those with diabetes, 74.3% were previously diagnosed, and nearly 69% are receiving treatment, a relatively positive note, though still far from universal. Meanwhile, 35.8% of adults have elevated total cholesterol, with a significant gender disparity: 42.5% of women versus 26.2% of men. These statistics reinforce the trend of women bearing a disproportionate share of the islandโs metabolic disease burden.
๐๐๐ฒ๐๐ซ๐๐ ๐๐ข๐ฌ๐ค๐ฌ ๐๐ง๐ ๐ ๐๐จ๐ฉ๐ฎ๐ฅ๐๐ญ๐ข๐จ๐ง ๐๐ญ ๐๐ข๐ฌ๐ค
Perhaps the most alarming insight from the survey is the coexistence of multiple risk factors within individuals. Less than 1% of the population is free of NCD risk factors. Nearly half, 47.5%, have three or more, with women again more likely (52.0%) than men (41.8%) to fall into this high-risk category. This accumulation of risks makes early detection, preventive care, and community-based health promotion more urgent than ever.
Among adults aged 40 to 69, 5.6% are already at high risk of developing cardiovascular disease within 10 years or have already been diagnosed with CVD. That figure, while seemingly modest, represents hundreds of individuals living with or on the brink of life-threatening conditions.
๐๐๐ซ๐ฏ๐ข๐๐๐ฅ ๐๐๐ง๐๐๐ซ ๐๐๐ซ๐๐๐ง๐ข๐ง๐ : ๐๐จ๐๐๐ฌ๐ญ ๐๐๐ข๐ง๐ฌ, ๐๐จ๐จ๐ฆ ๐๐จ๐ซ ๐๐ซ๐จ๐ ๐ซ๐๐ฌ๐ฌ
On a more focused note, 42.4% of women aged 30 to 49 reported having had a cervical cancer screening at least once. However, only 32.1% of those had been screened within the past year. This indicates that while awareness may be improving, regular preventive practices are still lagging and must be integrated into a stronger public health framework.
St. Maarten is grappling with a deeply rooted public health challenge, one that cannot be solved through medical treatment alone. The convergence of poor dietary habits, low physical activity, substance use, and systemic gaps in healthcare points to the need for a multisectoral response.
From strengthening school-based nutrition education and expanding access to recreational facilities, to reforming the national food environment and improving access to regular screenings and follow-up care, the island requires a strategic, well-funded plan. Parliament and the Executive branch must recognize that noncommunicable diseases are not isolated health problems, they are economic, social, and developmental threats.
St. Maarten aims to conduct the next STEPS survey in 2028 (funding permitting).
