Unhealthy living a challenge for us all
The parallels between global warming and the public health crisis we currently face from obesity go far beyond both being modern and lethal phenomena.
One clear example is the fact that we appear to be disproportionately carrying the negative consequences of a trend affecting the world as a whole.
More than 58 per cent of women in Samoa are classified as obese, or more than 25 percentage points than the regional average, statistics from the Global Nutrition Report show.
The social costs of this unhealthy living are massive. Close to one-third of people in the nation are diabetic, or suffer from other diseases associated with unhealthy living, such as gout, kidney failure or their many comorbidities. In addition to their human toll, these conditions place a massive and burgeoning cost on our health system, one which is only likely to increase as our currently young population ages. Our unhealthy population carries a burden that threatens to undercut their own health and prosperity as time wears on but also the nation’s as a whole.
An important new paper from Viali Lameko and Penelope Schoeffel provides a forensic account of how these problems came to be but also how they have continued to plague us through the latter half of last century until today.
Writing in the Pacific Health Dialog, they note obesity was rarely a problem in Samoa before the 1960s.
Among the obvious causes of its rise, many relate modernisation of the economy, the food industry and individuals’ dietary consumption patterns in general.
The introduction of cheaper processed, sugary and fatty imported foods has served to undercut the traditional healthy Samoan diet of fresh produce and lean protein.
Indeed, the authors note the idealised picture of Samoans living and eating healthily off the land - be it for their own families or to supply the kitchens of others - is one that is largely outdated.
Today probably less than one-quarter of Samoan households mainly depend on home-grown food for their own subsistence living; those that do find it difficult to keep and attract labour with the lure of overseas and internal migration.
The result? Instead of a population which expends a significant amount of energy obtaining its nutrition through farming and fishing, we have a population leading far more sedentary lifestyles consuming far more readily available imported food such as cheeseburgers and sugary drinks.
Research has shown that in the more than half century until 2007 the amount of food that could be obtained by consumers for the same price shot up by some 900 calories, or nearly half what most global health authorities count as a day’s healthy diet.
That the public health deteriorated over the same period seems not only unsurprising but inevitable, especially when we consider research showing that up to half of Samoan people may have a genetic predisposition to non-chronic diseases.
But it is the article’s analysis of our failures to address these problems that prove to be so powerful.
For decades, the authors note obesity has been framed as a failure of the individual - and so too have attempts to fight its prevalence by medical authorities.
Huge amounts have been spent on Government campaigns exhorting Samoans to simply eat better and live healthier lives, all of which has amounted to very little indeed as our public health problems have only continued to compound.
What the Government has failed to apprehend, the authors note, is that we are living in a society that itself promotes or is conducive to obesity and unhealthy choices and that, amidst a focus on individual behaviour, far too little is being done to address that fact.
Other societies are implementing measures to change the economic equation of grocery shopping to promote healthy choices, such as banning the sale of unhealthy sweets to children or promoting exercise in the workplace.
But in Samoa our minimum wage of $3 an hour is far too low to feed a family a nutritious diet; nearly one-fifth of our population lives below the poverty line; and far too few supermarkets carry fresh food and produce.
A wicked confluence of factors has created this disaster. But the Government has not done nearly enough to help.
Taxes have mainly been seen as an instrument for increasing the Government’s revenue, not improving the health of the population (or averting future expenditure on hospital bills).
Drives to increase agricultural productivity have been almost exclusively undertaken with a view to making Samoa more competitive economically, not better able to provide its people with nutritious food choices.
It is time to stop viewing the growing sickness of our public as a matter for the individuals who bear its costs. Our nation is unhealthy because it is geared to be so and people are left with few other choices.