Cayman Islands
Official Name: Cayman Islands
Capital City: George Town
Official Language: English
Surface: 209.25 km 2
PAHO Subregion: Non-Latin Caribbean
UN 2 digits Code: KY
UN 3 digits Code: CYM
UN Country Code: 136


PAHO Basic Health Indicator Data Base

This is a multidimensional query tool that offers a collection of 108 indicators from 1995 to 2005. The system presents data and indicators on:
- demography
- socioeconomic
- mortality by cause indicators
- morbidity and risk factors
- access, resources and health services coverage.

Selected indicators are disaggregated into age groups, sex and/or urban/rural region. Generated tables can be exported and printed.

The data presented is updated annually with the latest country information.


    The Cayman Islands is a British Overseas Territory comprising three islands: Grand Cayman, Cayman Brac, and Little Cayman. It has an area of 250 km˛ in the western Caribbean Sea, about 240 km south of Cuba and 290 km west of Jamaica. George Town, the capital city, is located on Grand Cayman, the largest and most populous island. According to the 1999 census, the population of the Cayman Islands was 39,020 ( Grand Cayman 37,083 or 95%; Cayman Brac 1,822 or 4.7% and Little Cayman 115 or 0.3%). The Governor, representative of the Queen of the United Kingdom, heads the territorial Government, and presides over the Executive Council in a politically stable government.

    Demography: Estimated population in 2000 was 41,800. Census data showed a 53% increase between 1989 and 1999. The under 15 years population was 19.5% and 8.3% were 60 years and older. The majority (62.2%) of the population is between 20-59 years of age. The census revealed that only 53% of the population were Caymanians, a reduction from 69% in 1989. While the birth rate has declined from 18.0 per 1,000 population in 1991 to 16.3 in 1996 and 15.1 in 2000, the population has been increasing sharply. This is attributed to the rapid increase in the number of foreign work permit holders and their dependents living in the Cayman Islands . This has placed increasing demands on infrastructure including health care provision. The life expectancy at birth in 1999 was 75.0 years for males and 79.0 years for females. The crude birth rate in 2000 was 15.1 per 1,000 population, showing a downward trend from 16.3 in 1996. The annual growth rate for the past decade (1991-2000) was steady, ranging from 3.9% to 5.3%, with an average of 4.5%.

    Economy: The economy is strong, underlined by a constant exchange rate over the past two decades at CI $ .80 to US$ 1.00. GDP estimates 1997 were US$ 1,157 million in 1999 prices, while in GDP growth in 2000 was about 4.5% down from the five-year average of 5.0%. At the end of 1999 the aggregate consumer price index (CPI) stood at 182.1. The size of the labor force was 21,820 persons in 1998 with an unemployment rate of 3.9%; it was 4% in 2000. Growth in the economy was fueled largely by successes in finance and tourism, the two main sectors of the economy. Annual recurring government expenditure nearly doubled from US$ 163 million in 1995 to US$ 317 million in 2000.

    Education: Schooling is free and compulsory for all children between 5 and 16 years old. Health care is provided free of charge to all school children. Adult literacy rate is about 98%.

    Mortality: The crude death rate has remained steady between 3.3 to 3.5 per thousand population, 1996-2000. Death registration is 100% and based on resident population including work-permit-holders and dependents. Important broad groups of death were circulatory system (41 %), neoplasms (23 %), and external causes (11 %), 1996-1999. There were about 25,000 hospitalizations 1996-2000 with an average of 5000 hospitalizations per year. Of these 84 % were at the Cayman Islands Hospital . The other major groups of causes for hospitalization were diseases of the digestive system (11 %); diseases of the genitourinary system (7 %); diseases of the respiratory system (7 %); and diseases of the circulatory system (7 %).

    Analysis by population group
    Children (0-4 years): Infant deaths varied from 0 to 7 per annum, 1991-2000; four infant deaths, 1998 and none, 1999-2000. The average infant mortality rate was 5.9 per thousand live births, 1996-2000. Nine out of 17 infant were neonatal deaths; 10 attributed to pre-maturity, and two to congenital anomalies, 1996-2000. There were 5 stillbirths in 1996, 3 in 1998 and 8 in 2000. The proportion of infants with low birth weights (<2500g) has averaged of 6.9%, 1996-1999.

    Schoolchildren (5-9 years): here was one death among children 1 to 4 years of age, 1996-1999. About 24% of hospitalizations at the Cayman Islands Hospital during 1996-1999 were under 5 years of age. 58% of these admissions were newborn infants as nearly all deliveries take place in the hospitals. Admissions included 1,490 children under 5 years of age. Main causes for admission were: diseases of the respiratory system (26%), certain infectious and parasitic diseases (15%), diseases of the digestive system (14%) and diseases of the genitourinary system (7%). School health screenings (627) in 2000, revealed students had (3 doses) of DPT and Polio vaccines; and 99.7% at least one dose of MMR vaccine (96% had two doses); 96.3% had four doses of DPT and Polio vaccines. Children tested for anemia were 482 and only one child had Hb less than 10 gm. One child in the age group 5-9 years acquired HIV through mother-to-child-transmission and died of AIDS. A total of 578 children were hospitalized. Principal causes of admission were diseases of the respiratory system (21%) and diseases of the digestive system (19%). Gastroenteritis contributed 62 admissions.

    Adolescents (10-14 and 15-19 years): One death due to malignant neoplasm of the liver and one due to infantile hemiplegi occurred among 10-14 year-olds 1996-1999. Hospitalizations in this age group were 316. Main causes for admission were external causes (23%), diseases of the respiratory system (13%), and diseases of the digestive system (16%). The proportion of teenage mothers (15-19 years) declined from 8.4% in the 1992-1995 to 5.5%, 1996-1999, when three births occurred to females less than 15 years of age. All 8 deaths among the 15-19 year-olds were male, 1996-1999; six due to motor vehicle accidents and two due to homicides. In this period, there were 548 hospitalizations. Among females principal reasons for admission were: normal delivery (31%), other obstetric causes (20%), genitourinary diseases (8%), and diseases of the digestive system (8%). For males they were due to external causes (35%) and diseases of the digestive system (17%). There were no suicides. Conditions related to pregnancy, childbirth and the puerperium accounted for 18% of hospitalizations.

    Adults (20-59 years): Mothers between 20-44 years delivered 99% of live births, 1996-1999. There were 93 deaths among the 25-59 year-old age group, 9.4 per 10,000 population (19.2%), 1996-1999. Males comprised 70% of deaths in this age group of which there were cardiovascular diseases (18), neoplasms (16) and external causes (23). For females were: cardiovascular diseases (7), neoplasms (6) and external causes (10). During 1996-1999, 48% of hospitalizations were in the 20-59 year- old age group. While 73% of these were females (3,800), 24 % of the female hospitalizations were for normal delivery and management of obstetric causes (28%); genitourinary diseases (14%) and diseases of the digestive system (12%). Among males, main causes of admission were diseases of the digestive system (21%), external causes (20%), diseases of the circulatory system (12%) and mental and behavioral disorders (6%). A national drug and alcohol survey in 2000 revealed that alcohol and tobacco were by far the most commonly used substances. Approximately 3.5 % reported using marijuana in the last year, and 2.9% reported having ever used cocaine.

    Elderly (60 years and more): In 1999 8.3% of the population was 60 years of age and older. A survey in 2000 revealed that of those aged 60 years and over 18% were current smokers. During the 1996-1999 period, 75% of all deaths occurred in this age group leading causes of death were: diseases of the circulatory system (47%) and neoplasms (24%). During this period 17% of hospitalizations were for persons 60 years and older; females accounted for 54% of admissions. Their main admission causes were diseases of the circulatory system (25%), diseases of the digestive system (14%) diseases of the respiratory system (13%), diseases of the eye (12%), external causes (8%), diseases of the genitourinary system (7%), diseases of the musculoskeletal system (6%) and neoplasms (6%). Among males main admissions causes were diseases of the circulatory system (19%), diseases of the digestive system (12%), diseases of the respiratory system (9%), diseases of the eye (7%), diseases of the genitourinary system (6%), neoplasms (5%), external causes (5%), and diseases of the musculoskeleton system (4%).

    Family health: The marriage rate in 1998 was 8.0 per 1,000 population . Teenage mothers constituted 10 % of new mothers during this period and a parenting program for young parents was ongoing. Workers' health : Occupational health hazards are minimal; there are no major industries using heavy equipment, and no major accidents in the construction industry. Compulsory schooling precludes employment of children under sixteen years old.

    The disabled: About 52 disabled children attended a special public education facility. The common conditions of the handicap among these children were: mentally challenged (24), genetic disorders (5), cerebral palsy (7) and mental retardation (3). Eighty children are in an early intervention program.

    Analysis by type of health problem
    Natural disasters: Hurricane Mitch occurred in 1997, but damage was minimal.

    Vector-Borne diseases: Dengue, yellow fever, and malaria are not endemic. No Aedes aegypti mosquitoes have been found since 1996. There have been few cases of malaria since 1995, but 12 were reported in 1997. Imported dengue cases ranged from one to four in the same period.

    Diseases preventable by immunization: There were 7 cases of whooping cough among children 5-10 years in 1999. During 1997 there was an outbreak of rubella with 78 cases, and 7 in 1998 and 10 cases in 2000. There are about 2-4 cases of mumps reported each year, but none in 2000. Reported cases of Hepatitis B were 2 in 1998, one each in 1999 and 2000. There were three reported cases of Hepatitis C in 1998 and none in 1999 and 2000. All blood for transfusion is screened for HIV, VDRL, Hepatitis B & C, and Human T Lymphotropic Virus type I HTL.

    Cholera and other intestinal diseases: There is no cholera. Reported cases of gastroenteritis among children under 5 years were 155 in 2000. There were no epidemics of food borne illness during 1996-2000. Food poisoning cases occur sporadically, especially due to ciguatera; 13 cases were reported in 2000. Amoebiasis and ankylostomiasis are not endemic.

    Chronic communicable diseases: There were three TB cases in 1998, 2 in 1999 and 5 in 2000. None of the TB cases had HIV co-infection, 1996-2000. There were no cases of leprosy. Acute respiratory infections: About 5% of deaths were due to acute respiratory tract infections (ARI)- all aged 60 years and over, 1996-1999. During this period 2% of hospitalizations were due to ARI.

    Zoonoses: Rabies is not endemic in the Cayman Islands . One case of human leptospirosis was confirmed in 1998 and one in 2000.

    HIV/AIDS: From 1985- 2000, there were 54 HIV positives; 29 developed AIDS and 23 died. There were 15 new HIV infections and 10 AIDS cases during 1996-1999. Sexually transmitted infections: There were reported cases of gonococcal diseases (138) and syphilis (146 cases) in 1999.

    Nutritional and metabolic diseases: The percentage of newborns weighing less than 2,500g at birth averaged 7%, 1996-1999. Obesity among children and adults is a cause of concern.

    Cardiovascular diseases: Diseases of the circulatory system accounted for 41% of deaths or 133 per 100,000, 1996-1999 - among males it comprised 38% and among females 43% . Ischemic heart diseases were 47% of these deaths, and cerbrovascular disease 17%. These conditions were reponsible for 7% of hospital admissions, 1996-1999.

    Malignant neoplasms: Malignant neoplasms were 110, a mortality rate of 74 per 100,000, 1996-1999, where trachea, bronchi & lungs contributed 23%, prostrate (15%) and female breast 11%. However, neoplasms accounted for only 1.6% of hospitalizations, 1996-1999. A total of 606 neoplasms were diagnosed, 1992-2000, female (283) and male (323). Neoplasms of the skin accounted for 42% of cases.

    Accidents and violence: Traffic accidents were 124 per 10,000 population in 1999 compared to 330 in 1995. There were 28 fatal accidents 1995-1999. A seat belt law was introduced in 1998. The incidence of assaults: 4.2 per 1000 population in 1995 and 7.2 in 1999. External causes contributed 11% of deaths of which 29% were due to motor vehicle accidents and accidental drowning (27%). External causes accounted for 8% of hospitalizations, 1996-1999.

    Mental disorders: Mental and behavioral disorders accounted for 2% of hospitalizations 1996-1999. Thirteen patients were sent abroad for psychiatric care in the year 2000. Oral health: The decayed, missing, or filled teeth index (DMFT) of the 12-year old age group was 0.9 in 1999. The DMFT for 5 and 6 year olds was 2.1 in 1998. Reemerging diseases: There were three cases of meningococcal meningitis (1 in 1999 and 2 in 2000).

    National health policies and plans: Major achievements of the Strategic Plan for Health were: construction of a 124 bed hospital (1999) in Grand Cayman, construction of new health centers in the four districts (1995-97), legislation of health insurance law (1997) and development of quality assurance programs.The National Youth Policy approved in 2000 promotes healthy lifestyles for youth.

    Health sector reform: In 2000, the Health Services Department (HSD) is responsible for all Government health care services. In 1997, health insurance coverage for employees and their dependents was made mandatory.

    Institutional organization of the health systems: HSD provides all public health care. The department operates two hospitals, a public health unit, four district health centers and a general practice clinic at the Cayman Islands Hospital , a dental clinic (including school dental services), the Lions Eye Clinic and a clinic in Little Cayman . A private hospital with 18 beds opened in 2000 and various private outpatient clinics provide health care locally. Primary health care is provided through the district health centers. In 1999 general practice services were transferred to the community health services. The Government operates the 124 bed Cayman Islands Hospital in Grand Cayman and the 18- bed Faith Hospital in Cayman Brac, the only two in-patient facilities. In 2000 a center for inpatient substance abuse clients was opened. An Intersectional Committee oversees an Emergency Relief Plan.

    Health legislation: The Health Insurance Law enacted in 1997 provides health insurance organized through their employer for all employees and their dependents. The National Drug Council Law enacted in 1997 provides for the establishment of the National Drug Council.

    Private health sector: An 18 bed private hospital was commissioned in the year 2000 and there are 19 private outpatient health care facilities. There were 41 doctors in full time private practice, providing family health or specialized treatment. Private physicians use public hospital services.

    Health insurance: Basic health insurance covers emergency care, hospitalizations and few outpatient services. Additional health insurance is provided by private companies, but regulated by government. In 2000, the Government contracted a health insurance company to provide health insurance to all its employees and their dependents.

    Regulatory actions: Construction of any facility requires planning approval with referral to the Environmental Health Department and appropriate health professionals.

    Certification: Only licensed health professionals are eligible to practice. An increase in health professionals over the years has led to draft legislation to develop professional councils to regulate practices.

    Basic health markets: Drugs and other medical equipment are not manufactured. The Pharmacy Law revised in 1999 provides controls for the importation and dispensing of drugs. Approval of the Health Practitioners' Board is required for the use of drugs and medical equipment not produced in the USA or UK .

    Environment: The Department of Environmental Health (DEH) has the responsibility of monitoring and ensuring quality of the environment. DEH provides management of solid and hazardous waste and monitors water quality and conducts campaigns on awareness of waste reduction/recycling; food safety; cistern care; rodent control; anti- littering; and hurricane preparedness information. The DEH laboratory monitors accommodations and food premises, and monitors recreational water.

    Food: The DEH food surveillance program monitors imported food containers. Animal regulations (2001 revision) provide measures for controlling the importation of animals and meats. The Environmental Health Laboratory is equipped for food analysis and monitoring.

    Health promotion: The National Strategic Plan for Health provides for the development of programs to encourage community and self help. Health promotion activities target disease prevention, healthy lifestyle, health skills, and the environment. A wellness assessment survey was carried out among the Health Services Staff in 2000.

    Disease prevention and control: Government offers immunizations to resident children. The 18-month DPT booster was introduced in 1999. In 1999, laboratory confirmation of suspected cases of rubella was initiated. As of 1997 Hepatitis B vaccine has been part of the Childhood Immunization Schedule.

    Epidemiological surveillance: Notifiable diseases are under surveillance. Laboratory samples for testing for dengue, measles, sero-grouping of meningococcal meningitis etc, samples are sent to CAREC or to a lab in the U.S.A.

    Water and sewerage: The Water Authority (WAC) protects the water and sewage infrastructure. In addition, WAC approved private companies provide potable water. Population with piped water supply was to 90% in 2000 up from 70 % in 1995. Water quality is monitored by companies and by DEH. WAC operates a sewage system for tourist hotels, while all other sewage treatment and disposal is through septic tanks or soak-away fields. Septage collection services are available privately and excreta are treated at WAC's treatment plant. Excreta disposal is available to 99.5% of population.

    Solid waste: Residential solid waste collection occurs 2-3 times per week. All three Islands have sanitary landfills. DEH has provided a recycling project since 1995. Infectious waste is collected from hospitals and medical offices and incinerated.

    Patient services: There are strategically located ambulance services. Services offered through district health centers include daily treatment by nurses, and clinics by doctors in the areas of general practice, psychiatry, nutrition counseling, child welfare, health education, and drug counseling. There are a total of 32 outpatient health care facilities (13 public and 19 private).

    Diagnostic services: All public and private hospitals have radiological and laboratory facilities. Services include the addition of two-CT Scans and one MRI unit. There are four mammography units. Blood Banking facilities are at government hospitals; all blood donations are screened.

    Mental health: Mental Health Service is offered via outpatient and inpatient clinic services. Psychiatric inpatient acute care was provided to 135 patients in 2000.

    Eye care: There are two full time ophthalmologists in public service and four in private practice. Laser treatment was introduced in 1999.

    Decompression: A decompression chamber for diving emergencies is located at the Cayman Islands Hospital .

    Reproductive health: Prenatal and postnatal care and family planning services are including PAP Smears, achieving 91% of the target in 1999. Emergency contraception is made available at all health centers during the year 2000.

    Health supplies: All drugs, reagents and equipment are imported. Vaccines are procured through PAHO's Revolving Fund. The national formulary includes all essential drugs.

    Human resources: Human resources per 10,000 population were: 20 physicians; 7 midwives; 63 nurses; 4 pharmacists; 3 dentists; and 7 community health nurses. Local training is available for practical nurses and emergency medical technicians. There is no unemployment for Caymanian health professionals. Opportunities for continuing education are provided locally as well as overseas.

    Health research and technology: In 1999 research on gene localization of non-progressive cerebella ataxia was initiated with a US institution. Health needs assessment was conducted in 2000. Oral health screening was conducted among 5 and 6 year olds in 1998 and 12 year olds in 1999. Access to scientific documentation is readily available through the Internet and international organizations.

    Financing: The health sector expenditure rose from 9.9% of the total government expenditure in 1994 to 14.8% in the year 2000. Per capita government health expenditure in 2000 was US$ 1143 compared to US$ 552 in 1995.

    External health technical cooperation and financing: PAHO, CAREC and CFNI provide support for training in the form of fellowships and workshops. This funding amounts to US$ 25,000 per annum. There is no external funding for health care delivery in the Cayman Islands .