Over the past 40 years, coronary heart disease (CHD) mortality rates have been decreasing in the developed world, and increasing in the developing world. This flies in the face of the widely accepted notion that CHD and other chronic diseases are generally a problem of the affluent. Heart disease in the developing world poses a threat to the continued success in the fight against poverty.
CHD is known as a “lifestyle disease”, meaning that an individual’s choices significantly affect their risk of developing the disease. For example, smoking, overeating, inactivity, and consumption of fat-rich foods can all increase one’s likelihood of CHD. One must only look to America a few decades ago to see how these habits would initially develop in the wealthy, who generally have greater access to an abundance of food, labor saving devices, and expendable income needed to fuel a smoking habit. It is becoming apparent, however, that when the affluent demand products like cigarettes and washing machines, companies mass-produce them. Once the products are ubiquitous, even lower classes gain access to them. Meanwhile, the wealthy often have greater access to information about how certain behaviors increase their risk of CHD, and have the resources to make other choices. For instance, they may choose to shop at Whole Foods or join a gym. One can only hope that the mass production of such products will result in the same ubiquity that McDonald’s has achieved.
America is not unique in this trend. A disconcertingly similar trend is occurring in developing countries today. For example, studies conducted roughly 50 years ago in India showed that the wealthier populations there were more likely to develop CHD. Recently released studies focusing on the past 15 years suggest that lower-income populations are at an increased risk for CHD due to more frequent smoking, and less access to healthy foods and adequate health care. Widespread public education campaigns, as well as continued efforts in the fight against poverty, are needed to counteract this concerning development.
Poverty, as manifested in malnutrition, not only affects adults’ risk of CHD, but their children’s. A child’s risk of CHD, as well as hypertension and diabetes, increases if their mother suffers from malnutrition while pregnant. This was first observed by Dr. David Barker, who continues to advocate for improved maternal nutrition as a method for combatting many chronic disease. He believes that many chronic diseases are “unnecessary”, stating, “Chronic diseases are not the inevitable lot of humankind. They are the result of the changing pattern of human development. We could readily prevent them, had we the will to do so.”
When one looks at the multitude of efforts aimed at ending poverty and improving maternal health, such as USAID’s Child Survival and Health Grants Program and the Scaling Up Nutrition program, it becomes clear that we, in fact, do have the will to do so.
– Katie Fullerton
Sources: Scaling Up Nutrition, USAID, Wall Street Journal, Oregon Health and Science University
Photo: Healthy Living