Why do some people develop more chronic diseases? Let's talk about this profound truth

Have you ever wondered why some people in our society are more likely to develop long-term, chronic diseases like diabetes, high blood pressure, heart disease, asthma, and cancer than others? Some may think that this is because of their genes, something that is inherited. But that is not the truth. This is mainly due to the inequalities in the society we live in. We are talking about that deep, but very important topic today.

The cause of this is not a disease, but our social system.

Simply put, a person's health is influenced not only by their lifestyle, but also by many other factors, such as the environment they live in, their economic status, their education, and the support they receive from society. In medicine, we call this the "Social Determinants of Health."

Experts point out that if a certain group of people develops chronic diseases more often, there is no evidence to find a biological reason for it. That is, we cannot say genetically that "people of the afternoon race develop diabetes more often." However, when we look at the conditions in which they live, we clearly see those disease patterns.

Think about someone living in an urban slum, or someone living in a remote village or plantation. The challenges they face are very different from those faced by someone living in Colombo 7. This difference is what causes the difference in health status.

The link between poverty and chronic disease

Poverty is not just about not having money. It is a major factor that determines your lifespan and health. There are several reasons why people with low incomes are more likely to have health problems:

• Malnutrition: Since people do not have the money to buy fresh vegetables, fruits, and nutritious foods, they turn to easily available starchy and oily foods that are low in nutritional value to satisfy their hunger.
• Exposure to toxins: People with economic difficulties are more exposed to toxic substances such as lead-based paint in old houses and toxic fumes from factories.
• Severe mental stress: The mental stress that arises from constantly thinking about tomorrow's meal, the needs of the children, and the burden of debt can imbalance the body's hormones and open the door to a host of diseases.

Additionally, it is difficult for someone who is struggling to earn a living to go to a clinic that is far away, having to lose their job and spend money on bus fare. This results in people avoiding seeing a doctor and getting medicine when the illness is still young. Finally, when the illness becomes severe, they have to go to the Emergency Treatment Unit (ETU). Then the illness is difficult to treat, expensive, and they do not get the personal attention that a doctor who knows your medical history can provide.

How our environment affects our health

People who live in areas with polluted air from traffic fumes and factory smoke are at a higher risk of developing respiratory diseases. Imagine a person who lives on a busy road. That person breathes polluted air all day long.

Prolonged exposure to such polluted air increases the risk of diseases such as asthma, chronic obstructive pulmonary disease (COPD), and lung cancer .

'Eat well, exercise' - does this advice work for everyone?

We often hear advice from health promotion programs such as "eat nutritious food," "exercise daily," "reduce stress," and "get enough sleep." These tips are important. But the question is, can everyone do these things?

How practical is it to tell a man who comes home tired after working all day, "Exercise"? How realistic is it to tell a family who is struggling to make ends meet, "Eat salmon and fruit"?

When people are given this advice, they may feel guilty about not being able to do those things. But the real problem is not that the person is lazy or careless. It is that there are larger social and economic issues that are affecting their lives to the point where they cannot do those things.

On the other hand, severe psychological stress caused by social discrimination and marginalization due to poverty directly leads to conditions such as diabetes, high blood pressure, and mental illness.

So we need to change this conversation. Instead of asking, "Why are these people getting so sick?", the question we need to ask is, "What is wrong with our social system and healthcare system that allows this situation to occur and persist?"