Noncommunicable diseases (NCDs) now account for the majority of global deaths and disability, yet progress in prevention and control remains insufficient, uneven, and structurally constrained. This volume develops an integrated systems framework to explain why chronic diseases — cardiovascular conditions, diabetes, cancers, chronic kidney disease, respiratory disorders, and related metabolic syndromes — continue to rise despite decades of global commitments. Synthesizing evidence across epidemiology, developmental biology, commercial determinants, psychosocial science, food-system analysis, governance, and planetary health, the book introduces a novel typology of “NCD gaps” spanning four domains: burden–response alignment, health-system performance, structural and developmental determinants, and psychosocial and temporal coherence.
The Caribbean region, particularly its Small Island Developing States (SIDS), is presented as a global microcosm where structural vulnerabilities, import-dependent food environments, climate instability, commercial saturation, and intergenerational stress converge to accelerate early-onset NCD patterns. The book offers a strengthened Port-of-Spain Declaration 2.0 (POS-2.0) as a governance architecture for regional transformation.
Integrating developmental origins (DOHaD), trauma-informed perspectives, climate–health interactions, and systems-level policy design, the volume articulates a forward-looking vision for “coherent health futures” grounded in biological, social, ecological, and institutional alignment. The framework aims to guide global health practitioners, Caribbean policymakers, researchers, and intergovernmental bodies in developing durable, multi-level strategies for NCD prevention and control.
