It is now widely accepted that there are ‘diseases for the rich’ or ‘western diseases’ and ‘diseases for the poor’.
World health organization’s (WHO) 2011 report published on 28th June 2011 showed that, the rich are most likely to die from stroke and heart related diseases while the poor are likely to die from pneumonia and diarrhoea. The report analysed the top ten killers in the world.
The following day, June 29th, Daily Nation newspaper published an article derived from the WHO data with a catchy title ‘The rich more likely to die from heart disease’. Does it mean wealth is a disadvantage to health?
Don’t be afraid of getting rich, fearing to die from heart diseases. Get money and get loads of it in sacks until you start stinking money. The ‘real wealthy’ are not the victims of heart diseases but the ‘average rich’.
Everybody including me wants to be rich. But, wealth has long been erroneously associated with many socially unacceptable outcomes such as mysterious early deaths.
If you grew up under abject poverty like me, mostly likely, you were indoctrinated with an idea that, the rich people are bad and should perish in hell without reprieve.
No wonder reading any negative news associated with the rich triggers some egotistical contentment to the poor and debilitating fear to the rich.
When health and wealth are put in the same sentence, it is very important to differentiate between those that are in high income, middle income and low income category.
According to WHO report, highest number of those that die from ‘western diseases’ are from medium income countries as opposed to high income countries.
This is contrary to the notion that wealth per se is the risk factor for heart diseases.
As the say ‘in life, little wisdom is dangerous’ the same is true for wealth and health, ‘Little wealth is dangerous to your health’. For that matter look for big money do not settle for average.
For example, WHO reported that 39 people died from stroke and heart related diseases out of 1000 that died world wide in 2008 were from high income countries like United Arab Emirates, United Kingdom and United States of America will.
A sad and contrasting picture is painted from deaths in middle income countries such as South Africa, Nigeria, Thailand and Tunisia. Out of 1000 people who die world wide, 179 will die from the same diseases, that is stroke and heart related diseases will come from these countries. Meaning the number of people from middle class category that will die from ‘western diseases’ is three times higher than that from high income category.
‘Kenya together with Zambia, Zimbabwe and Tanzania are on the low income category and the majority will die from pneumonia and diarrhoea’ says the report.
Ideally, high number of the so called ‘the rich’ in the low income countries fall in the middle class category globally. This may explain why the rich among the low income countries have the highest prevalence of ‘western diseases’.
According to World Health Organisation, United States of America is on high income category, but majority of Americans that succumb to stroke and heart related diseases are the less wealthy. This is according to a study published in 2009.
Two universities in American, University of Michigan and University of North Carolina in conjunction with two other universities from Canada compared wealth and prevalence of obesity, hypertension and related diseases. Surprisingly there was an inverse relationship between wealth and these diseases. Meaning that less wealthy were more likely to suffer from them than the wealthy. Therefore the less wealthy in high income countries, somehow fall in the middle income category globally
To understand why the middle income populations are most likely to suffer from stroke and heart related diseases, it is essential to outline the key risk factors.
Risk factors are divided into two categories: major and contributing. Major risk factors are those that have been proven to increase risk of heart disease. Contributing risk factors are those that doctors think can lead to an increased risk of heart disease, but their exact role has not been defined.
Major risk factors include high blood pressure, high blood cholesterol, Diabetes, obesity, overweight, smoking, physical inactivity, heredity and age. Contributing factors include stress and alcohol.
Clearly, the major and contributing factors of heart diseases are results of lifestyles. The poor cannot afford these lifestyles, however, as they say, ‘poverty is not permanent’.
Low income populations work extra hard to get out of the lower income cadre, while envying lifestyles of the middle income populations. As soon as they join the middle income category, they desperately imitate what they perceive as lifestyles of the rich. That is; eating on the go, fatty foods, processed foods, ready to eat foods, high alcohol consumption, sedentary lifestyle and smoking.
On the other hand, the high income countries have always enjoyed these foods and lifestyles while in the middle income category and they have witnessed first hand the adverse consequences among their populations and peers.
It is like an action movie, the high income countries and middle income countries are cruising in opposite directions on a life super highway. The rich countries are cutting on deadly foods such as high saturated fats, processed foods, high alcohol content drinks and sedentary lifestyles. Meanwhile, the emerging economies and the middle class among rich countries are embracing these renegade lifestyles full throttle.
For example, the biggest supermarket in UK and Ireland, Tesco does not stock any solid cooking fat or hydrogenated cooking fats which are associated with high trans and saturated fats. On the other hand, solid cooking fats occupy the biggest shelf space in supermarkets in Kenya. Also beer drinks sold in developing countries have higher alcohol content than their counterparts in developed countries.
‘I have to enjoy life’, ‘I don’t have to live a boring life’, and ‘I have to live like a rich man’. These are common justifications among the middle class when engaging in life shattering lifestyles.
The fact that the rich are most likely to die from heart diseases is an half- truth. It is true that the highest percentage of deaths in rich countries is due to heart diseases, but the actual numbers cannot lie. ‘Out of 13 million people who died from stroke and heart related diseases worldwide, in 2008, 1 million was from low income countries, 2 million were from high income countries compared to 10 million (five times) from middle income countries’ adds the WHO report.
In the high income countries, the low income population is at the highest risk of heart diseases. In the middle income countries, the majority are at risk. In low income countries, the so called ‘the rich’ are at the highest risk.
‘Imagine a diverse international group of 1000 individuals of the women, men and children from all over the globe who died in 2008. Of those 1000 people, 677 were from middle-income countries, 163 would have come from low-income countries, and 160 from high-income countries’ World Health Organisation further painted a very gloomy image for the middle income category.
Therefore ‘Little or average wealth is a disadvantage to your health’.
Many will argue that with wealth you can afford the medication. Health is not a financial muscle competition. Prevention pays dividends than struggling to cure.
How to overcome risk posed by average wealth to Health
Understanding the consequences of different lifestyles brought about by wealth is key to coping well. Majority move from low to middle income category of wealth ill-prepared to cope with what wealth throws at them.
It is important for governments and other agencies to educate their people on relationship between health and wealth and if possible entrench the course in school curriculum.
Simple lifestyles worthy copying including cutting salt intake, adopting regular exercise regime, cutting back on fatty foods and in particular saturated and trans fats, moderate alcohol consumption and balancing between work and social activities.