As of May 1, 2010, the Government of Cuba has declared that all travellers must be insured by a valid medical insurance policy prior to entering the country. This requirement applies to foreigners, Cubans living abroad, and foreign citizens who temporarily or occasionally reside in Cuba.

The Travel Health Insurance Association of Canada (THIA) has confirmed that Cuban authorities will accept either a Provincial Health Insurance card or proof of private travel insurance coverage to meet this requirement. Lacking either of these documents, visitors will be obliged to purchase insurance from a Cuban carrier upon arrival.

Travellers should carry the following documentation in compliance with the new requirements:

• Valid Canadian passport
• Cuban Tourist Card or Visa
• Provincial Health Insurance card
• Each family member should have their own
• Should not be relied upon as the only form of medical coverage, as provincial health insurance is extremely limited in terms of out of country coverage and does not pay up front as required by Cuban authorities (Note: you will not be allowed to exit the country with outstanding medical expenses)
• Certificate of travel insurance coverage
• Must include visible policy number and insurer name
• It is recommended that this notice lists all covered dependents as well
• Copy of covered expenses
  

Travellers are urged to contact their insurance carriers to confirm that their benefit plan is recognized by ASISTUR, the official insurance and assistance entity in Cuba. Those who are covered through their employers should do the same.

HealthQuotes.ca has received confirmation that two of Canada’s leading insurers – Standard Life and Sun Life Financial – have made the necessary arrangements with Cuban authorities. Both Europ Assistance (the travel provider of Sun Life Financial) and AXA Assistance (the travel provider of Standard Life) are recognized by ASISTUR.

We are confident that all other major insurers will follow.

For more information, please visit:

• Foreign Affairs and International Trade Canada
• Cuba Tourist Board in Canada
• The Travel Health Insurance Association of Canada
• Cuban Embassy in Canada

Note that travel insurance can be obtained through the HealthQuotes.ca website, or by calling a licensed advisor at 1-800-474-4474.

Recent layoffs at the Nova Scotia office that processes permanent residency cards and citizenship applications are expected to cause delays for immigrants to Canada who are planning to travel abroad this summer.

The Canadian Employment and Immigration Union reports that the contracts of approximately 147 administrative staff have ended and will not be renewed. As a result, the waiting time to process essential legal documentation may increase from 18 to 24 months, affecting the travel plans of immigrants who intend to visit family members outside of Canada.

Permanent residents who expect to travel are advised to review the expiry dates on their permanent residency cards and ensure that they will cover the duration of the trip, as valid documentation is required both to exit and enter the country. In the event that an extension is required, residents are urged to be prepared for a longer than usual processing period and adjust their travel plans accordingly.

Conversely, a representative from federal immigration insists that the layoffs will not cause substantial delays since the additional employees were hired to assist with a backlog to begin with.

Nonetheless, we remind readers to ensure that all travel documents are in place well ahead of time. In addition, travellers are encouraged to arrange for adequate travel insurance coverage prior to departure.

Travel insurance is an essential aspect of your trip. Accidents can happen anywhere, any time, and the peace of mind of having financial security will ensure that you enjoy a safe and pleasant holiday.

We offer a variety of comprehensive options from leading insurers and there are important differences with respect to the coverage available. One of our trained advisors will be glad to assist you in comparing and contrasting the numerous options to find a travel medical plan that best suits your needs.

Please visit www.healthquotes.ca for all of your travel insurance requirements. You can also call us toll-free at 1-800-474-4474 for a free travel consultation.

Although factors such as family history and age cannot be altered, many of the health concerns that can cause cardiovascular disease are controllable. Every Canadian can make the choice to improve their health status, and thus, improve their chances over not becoming ill. In order to lessen the chances of heart disease and/or stroke the following is recommended:

•    Control Blood Pressure: The single most important stroke risk factor that is controllable; a 10 point drop in blood pressure equals a 40% less chance of having a stroke.
•    Quitting Smoking: Smoking can increase the risk of stroke as much as 2 to 3 times. Quitting can diminish this risk within the first year of cessation; after 5 years of successful abstinence from smoking the risk is diminished to a person that has never smoked before. For non-smokers, it is essential to avoid second- hand smoke which can double the risk of cardiac disease/stroke.
•    Control Cholesterol: The link between high levels of bad cholesterol, LDL and heart disease are stronger than the connection between bad cholesterol levels and stroke. LDL, however, causes hardening of the arteries, which in turn increases the risk of stroke. Keeping cholesterol in a healthy range will usually require being physically active, maintaining a healthy weight, as well as taking any medications prescribed.
•    Exercise: Regular physical activity can be a major factor in reducing the risk of stroke. The right type and amount of exercise can often cut the possibility of having a stroke by half. As well, exercise can lead to other healthy changes.
•    Getting and Maintaining a Healthy Weight: Excessive body weight definitely raises the risk of having a stroke. Healthy eating, along with regular physical exercise, is essential for cardiovascular health. A properly balanced nutritious diet helps to lower body weight and the size of the waist/ The Body Mass Index (BMI) level is good indicator of whether or not the ideal body weight has been reached. High BMI levels for women are to be considered at a high risk of stroke; high BMI coupled with a large waist in males is considered particularly high risk.
•    Normal Blood Sugar Levels: Almost 20% of people who have had a stroke are diabetic. In turn, diabetics have a higher risk of stroke due to that over time; high levels of blood sugar can damage the blood vessels that lead to the brain. Diabetics must manage their disease with extreme care in order to reduce the risk of stroke.
•    Control Atrial Fibrillation: Atrial fibrillation is a heart rhythm disorder that can increase the chance of the formation of blood clots, which can lead to a stroke. It is important to take the medication that is prescribed for this condition.

This and the past 2 blogs have dealt with cardiovascular disease and stroke. As with most other health conditions, a healthy diet and lifestyle is absolutely essential for optimal health. Please remember to notify your health (and life) insurance broker if and when your health status is upgraded due to a healthier lifestyle; you may be entitled to lower insurance premiums.

Ischemic heart disease is the most common type of cardiovascular disease and affects men and women both equally. While factors such as age and/or heredity to contribute to the likelihood of cardiovascular disease, the majority of cases found in Canadians were related to risk factors that are modifiable. The major risk factors for cardiovascular disease are:

•    Smoking: Smoking greatly increases the risk of the development of blocked arteries, blood clots, reduction of oxygen in the blood as well as increased blood pressure. Smoking, either first and/or second hand are harmful to human health in general, and specifically is high-risk for developing ischemic heart disease and stroke. Non-smokers can die just as prematurely from second-hand smoke; smoking nearly doubles the risk of stroke as well. Quitting smoking not only provides immediate but also long lasting health benefits; within hours of smoking cessation the risk of heart attack already begins to decrease.
•    Lack of Exercise: People who are physically inactive have twice the risk of having heart disease as well as a stroke. More than half of the Canadian population reports to being inactive; for those who have already experienced a heart attack, it is vital to have and maintain a healthy level of exercise in order to increase chances of survival.
•    Unhealthy Eating: 56% of Canadians report eating less than 5 servings of fresh fruit and vegetables per day, with the minority only reporting that they eat fresh fruit and vegetables in the amounts recommended in Canada's Food Guide. Not only do fresh fruits and vegetables protect the heart and blood vessels, but they provide fiber and contain anti-oxidants (substances which work against the development of blockage in the arteries).
•    High Cholesterol: Cholesterol is one of the fats in the blood that contributes to the growth of all cells in the body. Too much cholesterol ca lead to blockage of the arteries. There are 2 main types of cholesterol:
1.    Low-density lipoprotein (LDL) cholesterol is most often referred to as "bad cholesterol" because it's high levels contribute to artery blockage.
2.    High-density lipoprotein (HDL) cholesterol is most often referred to as "good cholesterol" because it helps to carry LDL-cholesterol away from the artery walls.
Triglycerides are not a type of cholesterol but they are, however, a type of fat thatis found in the blood and are linked with excess weight, excessive alcohol consumption and/or diabetes.
•    High Blood Pressure (Hypertension): This is the measure of the force (pressure) of blood against the walls of the blood vessels (arteries). The top number of a blood pressure reading represents the pressure when the heart contracts and pushes blood out (systolic) and the bottom number is the lowest pressure when the heart relaxes between beats (diastolic). Blood pressure that is consistently more than 140/90 mmHg is considered high, although for those people who have diabetes, 130/80 mmHg is considered high. High blood pressure can, over an extended period of time, cause scarring that promotes the build-up of fatty plaque which is a substance that can narrow and eventually block the arteries. Fatty plaque also causes strain to the heart, initially causing a thickening of the heart muscle and eventually causing the heart to weaken. Very high blood pressure can cause blood vessels in the brain to burst, resulting in a stroke. While high blood pressure is one of the most important risk factors for cardiovascular diseases, it is also the number one modifiable risk factors for strokes. More than 2.6 million Canadians have been diagnosed with hypertension; there is a possibility that just as many people are living with hypertension and are simply not aware of it. It is expected that more than 90% of people 55-65 with normal blood pressure are expected to develop high blood pressure over their lifetime. In 2007 21 million Canadians visited community physicians due to high blood pressure; blood pressure medication that is prescribed by a physician has also risen. Approximately 2.3 billion dollars a year are spent on direct costs of high blood pressure.
•    Sodium: While the human body does require some sodium in order to function in a healthy manner, too much sodium can lead to high blood pressure, which in turn is a major risk for strokes, heart disease, and/or kidney disease.
•    Obesity/Overweight: Being significantly overweight and/or obese increases the risk of developing a wide range of serious health issues, including heart disease, Type 2 diabetes as well as high blood pressure.
•    Stress: High levels of stress and/or prolonged stress may manifest itself in a physical sense, causing high cholesterol, increased blood pressure, and/or disturbances in heart rhythm. These conditions can all increase the risk of developing heart disease. As well, for some people, living with high levels of stress may cause them to not get enough rest, a proper diet, regular physical exercise etc. which in turn are all factors that can elevate the risks of heart disease.
•    Diabetes: Diabetes occurs when insulin does not control the level of sugar in the body, either because not enough insulin is produced or because the body does not react properly to the insulin that is produced. Insulin is then required to break down sugar in the body. Diabetes increases the risk of high blood pressure, coronary artery disease and strokes, particularly for those whose sugar levels are poorly controlled. Diabetes can result in poor circulation caused by damage to the blood vessels.

The third and final blog in this series will provide information on how to lower the risks of cardiovascular disease as well as the current treatment methods; this blog will be available within the next 10-14 days.

Canadians all across the country spent the weekend celebrating Valentine's Day on Saturday. And while the majority of men and women enjoyed affairs of the heart this weekend not enough are taking care of their heart. In fact, Health Canada states that although mortality rates have been reduced in the past forty years, heart disease is still one of the leading causes of death in Canadians. 1.6 millions Canadians are estimated to be living with either heart disease or those who are living with the effects of a stroke.

Anyone who gets a diagnosis for heart/cardiovascular disease should know that this disease is preventable and manageable, especially when it comes to making changes for a healthier lifestyle. There are 6 different types of cardiovascular disease (cardiovascular disease refers to more than one disease of the circulatory system, including the heart and blood vessels, whether the blood vessels are affecting the lungs, brain, kidneys, etc. These 6 are the leading cause of death in Canadians:

•    Ischemic Heart Disease: This is the most common type of cardiovascular disease in Canadians and other industrialized countries; this refers to problems with the circulation of blood to the heart muscle. A partial blockage of one or more of the coronary arteries can result in a lack of enough oxygenated blood (ischemia) which then causes symptoms such as angina (chest pain) and dyspnea (shortness of breath).An artery's complete blockage causes necrosis (damage to the tissues) and/or a myocardial infarction (heart attack).
•    Cerebrovascular (Stroke): This refers to a problem with the circulation of blood in the blood vessels of the brain. A blockage with effects lasting less than 24 hours is known as a transient ischemic attack. Complete blockage with long-term effects is known as a cerebrovascular thrombosis (clot). It is also common for a blood vessel in the brain bursting which results in long term effects on health.
•    Peripheral Vascular Disease: This disease affects the circulation found primarily in the legs; patients with this disease typically complain of pain in their calves, especially when walking.
•    Heart Failure: This occurs when the pumping action of the heart cannot provide enough blood to the rest of the body as it is needed, resulting in damage to the heart muscle (i.e. from a heart attack) or from excessive, chronic abuse of alcohol, or because of a heart muscle known as cardiomyopathy. People with heart failure usually complain of shortness of breath as well as leg swelling.
•    Rheumatic Heart Disease: This was once more common among Canadians, but now is more prevalent in many poor countries. This disease begins in childhood with a bacterial infection which affects joints and heart valves; the heart problems appear many years later, in which often the heart valves require to be replaced via surgery. Other infections can also occur attacking the inner tissues of the heart including valves (endocarditic) and the outer tissues overlying the heart (pericarditis).
•    Congenital Heart Disease: This begins because of a problem with the structure of the heart due to a birth defect. These anatomical defects can be as minor as a small hole in one of the inside walls of the heart or they can be as major and complex which can affect the way blood flows through the heart and lungs. Some congenital heart problems can be fatal unless immediately corrected by surgery, others cause disability in varying degrees and can be treated by surgery later in life with either one or more surgeries.

This blog dealt with identifying the major types of cardiac disease; the next blog will address treatment and identification issues surrounding cardiac disease.