Screening men in the Toledo district of southern Belize for elevated blood pressure and blood sugar

Belize is a small country in Central America that has largely completed its epidemiological transition. Consequently, the Belizean burden of disease is increasingly composed of chronic illness, especially diabetes and hypertension. Recently, Belizean progress towards Sustainable Development Goal 3 (Good Health and Wellbeing) has slowed. Belizean men have 275 cardiac and 60 diabetes related deaths per 100,000 per year which are the third and fifth highest incidence in the Americas. Prevalence of raised fasting glucose is 8.5% in men (third highest in the Americas). Overall, 24% of Belizeans have an elevated blood pressure. In men, 20.3% have an elevated blood pressure. (12 ^th highest in the Americas). The objective of this study was to screen men in the Toledo district for both conditions. During visits to two local villages and at four health fairs held in the Punta Gorda town square, men were invited to have their blood pressure and blood sugar checked. Data was collected from 103 men. Systolic blood pressure ≥ 140mm/Hg was seen in 32 (31.1%) of men while diastolic blood pressure ≥ 90m mm/Hg was seen in 26 (25.2%) of men screened. Eight subjects (7.8%) had a random blood glucose ≥ 200mg/dl meriting further evaluation to rule out diabetes. Blood pressure and blood sugar were both statistically higher in men taking antihypertensive or antiglycemic medication. Hypertension and diabetes are common in men in the Toledo District and neither condition is well controlled in most men. Facilitators and barriers to control are largely related to social determinants of health. Men’s opinions about health and healthcare are often gender specific. Interventions to improve care in this setting should increase their focus on the social determinants of health and the gender specific beliefs and preferences men may have.