Lifestyle Diseases – It’s Time for a Rebrand
Non-communicable diseases are a global killer, but do 33 million people a year really choose to get sick?
Heart disease. Cancer. Lung disease. Diabetes. Together, these diseases kill 33 million people a year, and they can all — in one way or another — be linked back to the way we live our lives.
Photo Credit: Pixabay
The food we eat, the alcohol we drink, the exercise we do (or don’t do). It’s easy to see why this group of non-communicable diseases (NCDs) are referred to as “lifestyle” diseases.
The problem is that the term “lifestyle” is about as slippery as it gets. Sure, in academic circles its nuances and levels (individual, cultural, structural, global) are recognised and debated. But this isn’t happening in the public sphere. Whether intentional or not, the word “lifestyle” comes with some heavy assumptions, particularly around the notion of choice.
That is, it implies that we have one.
If only things were that simple. The truth is that when it comes to health, the choices we make are often not our own. There is a reason that poverty is linked with poor health outcomes, that education yields longer life spans, and that a person’s gender and ethnic background can impact the quality of care they receive. They’re called the “social determinants” of health, and a major tenet of public health policy is to tackle them.
Lesser known, perhaps, are the commercial determinants. That is the market, trade, and business practices that impact our health. Food is the perfect example. Processed and ultra-processed products are fast taking over our shopping baskets. Rarely are they healthy. And even when different options do exist, are individuals really to blame for not buying them?
Let’s assume — for the sake of argument — that you’re lucky enough to live within a 15-minute bus journey of a shop that sells fresh ingredients (fun fact: 3.3 million people in the UK don’t). Even if you make it past the showcase of tasty treats (deliberately) stacked up near the entrance, did you take the time, or understand, the gobbledegook they call a nutrition label?
Congratulations if you’re someone that does. Many do not. On to the checkout now. Now remember, if the chocolates in the cashier’s queue don’t get you, then record-high food inflation rates will.
It is all so subtle that it’s easy to condemn people for making the wrong “choice”. But let me ask you this: when was your last supermarket shop fancy-free?
Of course, it doesn’t all come down to society and commerce. We have to put biology in the mix too. As human beings, we are programmed to crave sugar, salt, and fat. There’s also a genetic link. So yes, people with a family history of obesity are more likely to struggle with it in later life. So are people who are bornprematurely.
Did you know that preterm birth has been shown to increase the risk of diabetes too?
There are also times when life just gives you lemons. I speak from personal experience here.
Three years ago, my husband was diagnosed with Type 1 diabetes, or LADA (Latent Autoimmune Diabetes in Adults) if we’re going to get technical about it. We were lucky. In his case, a stock-standard diagnosis of Type 2 (the so-called “lifestyle” kind) fit so badly, that it warranted further investigation. A lot of people don’t get this chance. In fact, research suggests that up to 40% of adults with Type 1 diabetes might have been misdiagnosed with Type 2.
Why?
Could it be, as others have hypothesised, that adult diabetes is now so heavily associated with “lifestyle” that when a patient presents in a higher weight class, the diagnosis is all but automatic? I mean, look at them. The proof is quite literally in the pudding.
“If we want to stop the upward trend, we’ve got to stop using loaded, victim-blaming terms like “lifestyle diseases”.”
In arguing the above, I am not trying to absolve individuals from all responsibility. To be sure, we all have a stake in the choices we make. But it’s not nearly as big as you would think. The reality is that our lifestyles are heavily influenced by a complex combination of social, commercial, and biological factors. To fail to acknowledge them is to lay the blame at the feet of the individual and to absolve those in a position of power — governments and commercial leaders — of their responsibility to do right by the people they serve.
There are no free passes here.
NCDs are set to rise. Fast. If we want to stop the upward trend, we’ve got to stop using loaded, victim-blaming terms like “lifestyle diseases”. The words we use matter, and we can use ours to recognise the complexity of the situation at hand, and make sure that political and commercial leaders step up, stop trying to blame the individual, and start treating the underlying cause.
