By Karen Berger | Posted December 10 2010
Is it possible that as a nation becomes richer, its people become less healthy?
As it turns out, people in developing countries aren’t vulnerable only to diseases of poverty — cholera, gastrointestinal diseases, malaria, meningitis, yellow fever, and a host of others. Indeed, in fast-developing countries, increasing wealth is associated with the increase of another group of diseases, often called “prosperity diseases.”
In India, it turns out that the race to join the middle class is also a race toward health risks usually associated with wealth, not poverty. Increasing globalization means changing lifestyles: People who once ate locally-grown fresh fruits and vegetables now eat less healthful foods. People who once did physical farm labor now sit at desks. The result: soaring rates of type II diabetes and heart disease, and an increase in risk factors such as high cholesterol, high blood sugar, high blood pressure, tobacco use, poor diets, and sedentary lifestyles.
According to Mark Pendergrast, author of Inside the Outbreaks, a study of the CDC’s Epidemic Intelligence Service, lifestyle-related diseases such as type II diabetes and heart disease have reached epidemic proportions globally, and are expected to be the focus of much of the CDC’s epidemiology work in the next decade.
But a worker education program implemented in India shows that a low-tech program can change behaviors that lead to these lifestyle diseases, according to a study published in the Journal of the American College of Cardiology.
Introduced at six industrial worksites through India, the four-year education initiative involved nearly 6,000 workers and their families. The program included individual counseling, educational materials (videos, work-place posters, booklets, and fliers), and motivational sessions designed to establish a workplace group dynamic that encouraged healthy behaviors in the following areas:
*Diet: The program encouraged consuming of fiber, fresh fruits and vegetables, and limiting the intake of salt and oil. The result: daily fruit consumption almost doubled, and the use of salt in cooking dropped by more than half.
*Weight and Fitness: Workers learned the definition of healthy weight and were encouraged to exercise. The result: daily physical activity reported by participants jumped.
*Smoking: Workers educated about the dangers of smoking, and given materials to help them quit. The result: tobacco use fell from 39 to 29 percent.
The study reported that most key risk factors for lifestyle diseases declined compared with the control group, including blood sugar levels (down 9.4 percent), systolic blood pressure (down 2.8 percent), and reductions in body weight, LDL “bad” cholesterol, and blood sugar. As measured by the Framingham 10-year risk criteria, the proportion of workers at increased risk for cardiovascular disease (10 percent risk or higher over the next decade) fell by from 34.1 percent to 26.8 percent in the intervention group.
For policy makers, these findings are important. As countries participate in globalization and develop more western-style jobs and western-style habits, their workers develop western-style maladies. Early intervention – in this program, at an annual cost of only $7.30 per worker — can mean that as a country develops its economic health, it doesn’t have to sacrifice the health of its workers.
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Consult these resources for more information on heart health, type-II diabetes, and smoking.
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