The Health in the Americas+ country profiles are based on the interagency indicators available as of the dates referenced. The sources are referenced in this table. In some cases, the values of the indicators may differ from the most recent data available in the country.
Environmental and social determinants of health
In 2000, the total population of Saint Lucia was 159 500inhabitants; by 2021 this figure had risen to 179 652, representing a 12.6% increase. Regarding the country's demographic profile, in 2021 people over 65 years of age accounted for 9.1% of the total population, an increase of 1.9 percentage points compared to the year 2000. In 2021, there were 101.9 women per 100 men and 49.6 older people (65 years or older) per 100 children under 15 years of age, as can be seen in the country's population pyramids, distributed by age group and sex (Figure 1). Considering the population between 15 and 64 years of age to be potentially active (i.e., potential participants in the labor force), this group represented 72.6% of the total population of the country in 2021 (130 476 people). When these figures are added to the potentially passive population (32 865 under 15 years of age and 16 311 over 65 years of age), the result is a dependency ratio of 37.7 potentially passive people per 100 potentially active people. This ratio was 63.8 in 2000.
Life expectancy at birth was 76.5 years in 2021—lower than the average for the Region of the Americas and 4.4 years higher than in 2000.
Figure 1. Population pyramids, years 2000 and 2021
Between 2000 and 2020, the average number of years of schooling in Saint Lucia increased by 36.3%, reaching an average of 9.8 years in the latest year for which information is available. The unemployment rate in 2021 was 8.5% for the total population. Disaggregated by sex, the rate was 10.7% for women and 6.7% for men. In 2020, 4.4% of the population was living in poverty, defined as the percentage of the population with an income of less than US$ 1.90 per day; this is above the regional average of 3%.
During the period 2000–2021, the country improved its score on the Human Development Index, with an increase of 9.5% from a score of 0.632 to a score of 0.692; during the same period, the index rose 15% internationally and 11% in Latin America (Figure 2).
Figure 2. Human Development Index in the Region of the Americas, 2021
In 2019, public expenditure on health accounted for 4.9% of gross domestic product (GDP) (Figure 3) and 13.7% of total public expenditure, while out-of-pocket spending on health accounted for 23.9% of total health expenditure.
Figure 3. Public expenditure on health as a percentage of gross domestic product in the Region of the Americas, 2019
In 2017, 60% of Saint Lucians had an Internet connection, representing a considerable increase from 2000, when 1.4% of the population had an Internet connection.
Maternal and child health
Between 2003 and 2018, infant mortality in Saint Lucia decreased from 16.5 to 15.8 deaths per 1000 live births, a decrease of 4.2% (Figure 4). The percentage of low-weight births (less than 2500 g) increased from 9.6% to 10.6% between 2000 and 2020, while exclusive breastfeeding in the child population up to 6 months of age was 3.5%, the same value as in 2012.
Regarding the immunization strategy, measles vaccination coverage was 77% in 2021, a decrease of 11 percentage points over 2000.
The maternal mortality ratio for 2017 was estimated at 117 deaths per 100 000 live births, an increase of 36% from the estimated value for 2000 (Figure 5). In relation to fertility, it is estimated women have an average of 1.4 children throughout their reproductive lives. In the specific case of adolescent fertility, there was a 37% decrease, from 57.6 live births per 1000 women aged 15 to 19 years in 2000 to 36.3 in 2021. Between 2009 and 2020, the percentage of pregnant people who received antenatal care decreased from 99% to 93%. In 2020, 100% of births were attended by skilled birth personnel.
Figure 4. Infant mortality per 1000 live births, 1995–2020
Figure 5. Maternal mortality per 100 000 live births, 2000–2017
In 2020 there were 4.4 new cases of tuberculosis per 100 000 population in Saint Lucia. In the same year, the overall tuberculosis mortality rate (age-adjusted and per 100 000 population) was 1.2 (1.2 in women and 1.3 in men).
In 2020, the estimated human immunodeficiency virus (HIV) infection incidence rate (new diagnoses) was 11/4 per 100 000 population. The age-adjusted mortality rate for HIV was 0 per 100 000 population in 2019.
Noncommunicable diseases and risk factors
In Saint Lucia, the prevalence of overweight and obesity among people aged 15 and older was 48.1% in 2016.
Also in 2016, 79,5% of the population reported insufficient physical activity.
In 2015, the reported prevalence of arterial hypertension (high blood pressure) among people aged 18 years or older was 27.1%, an increase of 3.7 percentage points compared to 2000 (25.8%). The prevalence of diabetes mellitus, which stood at 8.2% in 2000, increased to 14.5% in 2014.
In 2019, the adjusted rate of potentially avoidable premature mortality in Saint Lucia was 284.7 deaths per 100 000 population, a decrease of 11.6% from a rate of 322.1 in 2000. This meant that, in 2019, the rate in the country was 25.6% higher than the average rate reported for the Region of the Americas as a whole. Among potentially avoidable premature mortality, the rate for preventable causes was 144.9 per 100 000 population in 2019, which is 5.7% higher than the regional average rate; and the rate for treatable causes was 139.8 per 100 000 population, above the regional average of 89.6.
The overall age-adjusted mortality rate was 6.5 per 1000 population in 2019, a decrease of 9.7% compared to 2000 (7.2 deaths per 1000 population).
When deaths are categorized into three main groups, it is observed that, in 2019, the age-adjusted mortality rate from communicable diseases was 63.4 per 100 000 population (72.6 per 100 000 in men and 54.5 per 100 000 in women), while the age-adjusted mortality rate from noncommunicable diseases was 520.0 per 100 000 population (622.6 per 100 000 in men and 423.4 per 100 000 in women). The rate of age-adjusted mortality from external causes was 72.5 per 100 000 population (119.0 per 100 000 in men and 27.9 per 100 000 in women), including road traffic accidents (27.1 per 100 000 population), homicides (18.6 per 100 000 population) and suicides (6.8 per 100 000 population). In 2000, the percentage distribution of causes was 79.8% for noncommunicable diseases, 9.8% for communicable diseases, and 10.4% for external causes; in 2019, the percentages were 82.1%%, 7.9%%, and 10.0%%, respectively (Figure 6).
Figure 6. Proportional mortality in Saint Lucia, 2000 and 2019
Regarding cancer mortality from tumors, in 2019, the adjusted mortality rate from prostate cancer was 46.1 per 100 000 men; lung cancer, 14.7 per 100 000; and colorectal cancer, 10.3 per 100 000. In women, these values were 22.5 deaths per 100 000 for breast cancer, 2.4 per 100 000 for lung cancer, and 8.6 per 100 000 for colorectal cancer.
The health situation and the COVID-19 pandemic
In 2020, Saint Lucia ranked 42nd in the Region of the Americas in terms of the number of deaths from COVID-19, and 10th in 2021, with a cumulative 1 642,7 deaths per million population over the two years (Figure 7). According to estimates by the World Health Organization, there was a total of 111 excess deaths in 2020, or 61,9 per 100 000 population; a total of 480 deaths were estimated in 2021, for an excess mortality rate of 267 per 100 000.
As of 31 December 2021, at least one dose of COVID-19 vaccine had been given to 32% of the country's population. As of 20 June 2022 (latest available data), 30% of the population had completed the vaccination schedule. The vaccination campaign began on 20 February 2021, and five types of COVID-19 vaccine have been used to date.
Figure 7. Cumulative COVID-19 deaths in the Region of the Americas, to 31 December 2022
Measures to achieve universal health coverage
The Government of Saint Lucia has developed the Medium Term Development Strategy (2020–2023). The report on this strategy focuses on the interconnected nature of development planning by ensuring economic, social, and environmental considerations are incorporated and mainstreamed into Saint Lucia's national planning framework. Health care is one of six development areas (along with agriculture, infrastructure, tourism, citizen security, and education). The report recognizes that improved healthcare financing is a priority. Out-of-pocket health expenditure is high, accounting for almost half of all health spending in 2014, while public health expenditure is recorded at below 4% of GDP.
Fewer than one-quarter of Saint Lucians are covered by private health insurance. Current health care reforms are guided by the goal that health care must be universally accessible, affordable, equitable, and sustainable, and of the highest international quality standard for the populace – this universal accessibility represents an adoption of the global move toward universal health coverage.
Accessibility of tertiary care has received a recent boost with the construction of the now operational Owen King European Union Hospital. The Government Health System Strengthening Project, with World Bank financing, will help to ensure that at least 100 000 people on the island of 180 000 people are registered to the national health scheme. It also aims that at least 60% of people living with diabetes or hypertension are treated according to national protocols in public primary healthcare facilities.
Challenges related to population health
The Saint Lucia population is aging, and the pace of this aging is predicted to increase. In 1980, the proportion of Saint Lucia's population aged 65 and older was 5.0%. This proportion doubled to an estimated 10.3% by 2020, and is predicted to almost triple to 29.6% by 2060. This future increase of 19.3 percentage points represents the fastest rise in older adults in the Caribbean, well above the regional averages for the Caribbean of 10.7 percentage points, and above the average for the Americas of 13.7 percentage points.
There has been important progress in reducing the burden of neonatal disorders and HIV/AIDS, both down by over one-half since 2000. Diarrheal diseases, dietary iron deficiency, and lower respiratory infections were each reduced by over one-quarter. These successes contribute to a disease burden increasingly dominated by noncommunicable diseases. Cardiovascular diseases, diabetes, and cancers in 2019 were the top three causes of death and disability, collectively accounting for over 40% of all healthy life lost. Including all other noncommunicable diseases raises this burden to 80% of all healthy life lost. Diabetes accounts for almost 10% of all healthy life lost and is a national concern. The burden of diabetes has increased by more than one-quarter since 2000, is driven by nationally high rates of obesity and physical inactivity, and requires lifelong comprehensive care that is onerous for those living with the condition and for healthcare financing. Intentional and unintentional injuries have become an increasing concern in recent years. Solutions to the prevention and control of noncommunicable diseases and injuries require multisectoral cooperation.
COVID-19 pandemic response
Saint Lucia experienced four COVID-19 outbreak surges between April 2020 and May 2022, with over 350 confirmed deaths by May 2022 concentrated in these outbreak periods. The vaccination program in cooperation with international partners represents a major ongoing COVID-19 policy. COVID-19 is one example of an external pressure, and these pressures are recognized as a major risk to ongoing healthcare improvements. With the onset of COVID-19, the Government of Saint Lucia accelerated the move to the Owen King European Union Hospital, while reserving the Victoria Hospital as a respiratory medical facility. In addition, the Health System Strengthening Project primary healthcare centers will be equipped to serve as the first point of detection for infectious diseases.