Asia: An unhealthy status symbol
Western lifestyles including calorie-rich diets and little physical exercise are a status symbol in Asia, yet the habit comes at significant costs to the region’s health
© Seymour Institute
In the coming decades, the Asian middle class will be the key driver of global consumption for goods such as cars, clothing, housing and technology, as well as services such as education and health insurance. As people become wealthier, their dietary options also widen and they consume excessive salt and more calories from cholesterol and saturated fats.
In China, the burgeoning middle class are eating more foods derived from livestock and wheat. Imported foreign foods are a powerful status symbol, but this comes at a price. Results of a three-decade survey recently released by the European Society for Cardiology highlighted the consequences of a preference for fizzy drinks, burgers and pizza, combined with a lack of physical activity in the eastern province of Shandong: in, 17% of boys younger than 19 were obese and 9% of girls – up from under 1% for both genders in.
Such shifting consumption patterns increase the risks of cardiovascular disease and strokes. These – plus cancer and cerebrovascular and chronic diseases – could be reduced by changes in diet and decreases in what the WHO describes as the “tobacco-use epidemic ” in the region.
ASTOUNDING SPEED
While Asia is following the disease patterns of the industrialized West, where it differs is the speed of transition. As has been highlighted in PROJECT M , Asia is going through the fastest demographic shift ever recorded. Currently, South Korea is the world’s fastest-aging country, but it is heading a closely bunched pack that includes Bangladesh, China, Singapore, Thailand and Vietnam. Many Asian countries now have more working-aged people and fewer dependents than at any point in history.
According to a recent report, Shaping the Future (United Nations,), 68% of people are of working age and only 32% dependents. This offers a unique make-or-break opportunity for rapid economic growth, but it also means, notes Eduardo Banzon, senior health specialist with the Asian Development Bank, that demographic change that took up to 150 years in Europe and North America may take only five decades in many Asia-Pacific countries.
This has important implications for healthcare systems. As this change takes place, the parallel shift in the causes of ill health is also occurring. “The problem emerging now is that countries are not yet rich enough to manage the aging of the population in the same way that the Europeans have done,” he adds.
To be clear, the rise of NCDs in Asia is a sign of success as it is evidence that people are now living long enough to die of diseases that typically hit in old age. But, even as Asian countries prepare to meet rising rates of NCDs, many face unfinished business: the rates of communicable diseases remain high. In India, for example, two-fifths of children under five are malnourished even as obesity rates are exploding.
This presents health systems with a double burden, says Irina A. Nikolic, senior health specialist in the World Bank Group Global Health Practice: how to maintain and further the gains made against communicable diseases while addressing NCDs. Systems in the West have had generations to adapt to a gradual rise in NCDs. Those in Asia need to juggle an effective approach to both in a far shorter time frame.
While some Asian countries, such as Japan and Singapore, have healthcare systems that are among the most advanced in the world, others – such as Indonesia – are only now extending basic health services to all citizens. Threadbare health systems will struggle with the rise of NCDs, but others designed to address acute care needs that come with communicable diseases will also need fundamental adjustments, as chronic NCDs can require decades of care and medication.
Such considerations should influence policymakers in each country in prioritizing resources to deal with the current and future burden of disease. Where they can take inspiration from is in recent triumphs in tackling communicable diseases. If systems can adjust to tackling NCDs with the same vigor, then in the next decades billions of people could indeed benefit from a better quality of life, for longer.
Read more on the rise of non-communicable diseases in part one of this article .
