Is wealth a disadvantage to health?

It is now widely accepted that there are “diseases for the rich” and “diseases for the poor”. The World health Organisation’s (WHO) 2011 report, published on June 28, 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, on June 29, this newspaper published an article derived from the WHO data under the catchy headline: “The rich more likely to die from heart disease”.

Does it mean wealth is a disadvantage to health?

Before we go any further, don’t be afraid of getting rich. Get money, loads of it, in sacks and all that, until you start stinking of it. The “really wealthy” are not the victims of heart disease. It is the “average rich” who are being killed by their money.

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 in poverty, like me, you were indoctrinated with the idea that 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 the high income, middle income and low income categories.

According to the WHO report, the highest number of those who die from “Western diseases” are from medium income countries as opposed to high income states.

This is contrary to the notion that wealth per se is the risk factor for heart disease.

They say “in life, little health is dangerous”. The same is true for wealth and health; little wealth is dangerous to your health. Therefore, look for big money; do not settle for average.

For example, in 2008, the WHO reported that out of 1,000 deaths worldwide, 39 people would die from stroke and heart-related diseases in high income countries like the United Arab Emirates, United Kingdom and United States of America.

A sad and contrasting picture was painted from deaths in middle income countries such as South Africa, Nigeria, Thailand and Tunisia. Out of 1,000 people who would die worldwide, 179 would die from the same diseases — that is stroke and heart-related diseases — in these countries.

This means that the number of people from the middle class category dying from “Western diseases” is more than four times higher than that from the high income category.

“Kenya, together with Zambia, Zimbabwe and Tanzania, are in the low income category and the majority of deaths will be caused by pneumonia and diarrhoea,” said the report.

Ideally, most of the so-called “the rich” in the low income countries fall in the middle class category globally. This may explain why the rich in the low income countries have the highest prevalence of “Western diseases”.

According to a WHO study published in 2009, the US is in the high income category, but most of the Americans that succumb to stroke and heart-related ailments are the less wealthy.

In another study, two universities from the USA, University of Michigan and University of North Carolina, in conjunction with two other universities from Canada, compared wealth and the prevalence of obesity, hypertension and related diseases.

Surprisingly, there was an inverse relationship between wealth and these diseases, meaning that the less wealthy were more likely to suffer from these illnesses than the wealthy. Therefore, the less wealthy in high income countries 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.

These factors are divided into two categories: major and contributing. The major risk factors are those that have been proven to increase the 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, smoking, physical inactivity, heredity and age. Contributing factors include stress and alcohol.

Clearly, the major and contributing factors for heart disease are results of lifestyle. The poor cannot afford these lifestyles, but, as they say, “poverty is not permanent”.

Low income populations work extra hard to get out of the lower income cadre while envying the 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, i.e. eating on the go, fatty foods, processed foods, ready-to-eat foods, high alcohol consumption, a sedentary lifestyle and smoking.

On the other hand, the high income countries enjoyed these foods and lifestyles while in the middle income category and they witnessed first-hand the adverse consequences among their populations and peers.

It is like an action movie; high income countries and middle income countries are cruising in opposite directions on life’s super highway. Rich countries are cutting back on deadly foods such as high saturated fats, processed foods and high alcohol content drinks, and sedentary lifestyles.

Meanwhile, the emerging economies and the middle class in rich countries are embracing these renegade lifestyles full throttle.

For example, the biggest supermarket in the United Kingdom and Ireland, Tesco, does not stock any solid cooking fat or hydrogenated cooking fats, which are associated with high levels of trans fats and saturated fats.

On the other hand, solid cooking fats occupy the biggest shelf space in supermarkets in Kenya. Also, beer sold in developing countries has a higher alcohol content than that from the developed countries.

“I have to enjoy life.” “I don’t have to live a boring life.” “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 a 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 were from low income countries, 2 million from high income countries and 10 million from middle income countries,” adds the WHO report.

“Imagine a diverse international group of 1,000 individuals, women, men and children, from all over the globe who died in 2008. Of those, 1,000 people, 677 were from middle-income countries, 163 would have come from low-income countries, and 160 from high-income countries.”

Many will argue that with wealth you can afford the medication, but health is not a financial muscle competition. Prevention pays more dividends than struggling to cure.

So, how do you overcome the risk posed by average wealth to your health?

Understanding the consequences of different lifestyles brought about by wealth is key to coping well. The majority move from the low to the middle income category of wealth ill-prepared to cope with what money throws at them.

It is important for governments and other agencies to educate their people on the relationship between health and wealth and, if possible, entrench the course in the school curriculum.

Simple lifestyles worthy copying include cutting salt intake, adopting a 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.

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