Diseases of affluence
Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.
Examples of diseases of affluence include mostly chronic non-communicable diseases and other physical health conditions for which personal lifestyles and societal conditions associated with economic development are believed to be an important risk factor—such as type 2 diabetes, asthma, coronary heart disease, cerebrovascular disease, peripheral vascular disease, obesity, hypertension, cancer, alcoholism, gout, and some types of allergy. They may also be considered to include depression and other mental health conditions associated with increased social isolation and lower levels of psychological well-being observed in many developed countries. Many of these conditions are interrelated, for example obesity is thought to be a partial cause of many other illnesses.
In contrast, the diseases of poverty have tended to be largely infectious diseases, or the result of poor living conditions. These include tuberculosis, malaria, and intestinal diseases. Increasingly, research is finding that diseases thought to be diseases of affluence also appear in large part in the poor. These diseases include obesity and cardiovascular disease and, coupled with infectious diseases, these further increase global health inequalities.
Diseases of affluence started to become more prevalent in developing countries as diseases of poverty decline, longevity increases, and lifestyles change. In 2008, nearly 80% of deaths due to NCDs—including heart disease, strokes, chronic lung diseases, cancers and diabetes—occurred in low- and middle-income countries.
Main instances
According to the World Health Organization, the top 10 causes of deaths in 2019 were from:- Ischemic heart diseases
- Stroke
- Chronic obstructive pulmonary disease
- Lower respiratory infections
- Neonatal conditions
- Trachea, bronchus, lung cancers
- Alzheimer's disease and other dementias
- Diarrheal diseases
- Diabetes
- Kidney diseases
Causes
Factors associated with the increase of these conditions and illnesses appear to be things that are a direct result of technological advances. They include:- Less strenuous physical exercise, often through increased use of motor vehicles
- Irregular exercise as a result of office jobs involving no physical labor.
- Easy accessibility in society to large amounts of low-cost food
- * More food generally, with much less physical exertion expended to obtain a moderate amount of food
- * Higher consumption of vegetable oils and high sugar-containing foods
- * Higher consumption of meat and dairy products
- * Higher consumption of refined grains and products made of such, like white bread and white rice.
- **A notable historical example is that of Beriberi, a thiamin deficiency syndrome which was long known as a disease of the wealthy in east Asia: Brown rice and other cereal grains are a good source of thiamin, while white rice is not. Because of the labor and waste involved, white rice was long seen as a luxury, meaning a thiamin-deficient diet was something only the rich could afford. Eventually, however, the development of motorized rice-polishing equipment brought luxury—and disease—to the masses.
- * More foods which are processed, cooked, and commercially provided
- Prolonged periods of little activity
- Greater use of alcohol and tobacco
- Longer lifespans
- * Reduced exposure to infectious agents throughout life
- Increased cleanliness. The hygiene hypothesis postulates that children of affluent families are now exposed to fewer antigens than has been normal in the past, giving rise to increased prevalence of allergy and autoimmune diseases.
Diabetes mellitus
According to WHO the prevalence of diabetes has quadrupled from 1980 to 422 million adults. The global prevalence of diabetes has increased from 4.7% in 1980 to 8.5% in 2014. Diabetes has been a major cause for blindness, kidney failure, heart attack, stroke and lower limb amputation.
Prevalence in countries of affluence
The Centers of Disease Control and Prevention released a report in 2015 indicating that more than 100 million Americans have diabetes or pre-diabetes. Diabetes was the seventh leading cause of death in the United States in 2015. In developed countries like the United States, the risk for diabetes is seen in people with low socioeconomic status. Socioeconomic status is defined by the education and the income level of a person. The prevalence of diabetes varies by education level. Of those diagnosed with diabetes:12.6% of adults had less than a high school education, 9.5% had a high school education and 7.2% had more than high school education.Differences in diabetes prevalence are seen in the population and ethnic groups in the US. Diabetes is more common in non-Hispanic whites who are less educated and have a lower income. It is also more common in less educated Hispanics. The highest prevalence of diabetes is seen in the southeast, southern and Appalachian portion of the United States. In the United States the prevalence of diabetes is increasing in children and adolescents. In 2015, 25 million people were diagnosed with diabetes, of which 193,000 were children. The total direct and indirect cost of diagnosed diabetes in US in 2012 was $245 billion.
In 2009, the Canadian Diabetes Association estimated that diagnosed diabetes will increase from 1.3 million in 2000 to 2.5 million in 2010 and 3.7 million in 2020. Diabetes was the 7th leading cause of death in Canada in 2015. Like United States, diabetes in more prevalent in the low socioeconomic group of people in Canada.
According to the International Diabetes Federation, more than 58 million people are diagnosed with diabetes in the European Union Region, and this will go up to 66.7 million by 2045. Similar to other affluent countries like America and Canada, diabetes is more prevalent in the poorer parts of Europe like Central and Eastern Europe.
In Australia according to self-reported data, 1 in 7 adults or approximately 1.2 million people had diabetes in 2014–2015. People who were living in remote or socioeconomically disadvantaged areas were 4 times more likely to develop type 2 diabetes as compared to non-indigenous Australians. Australia incurred $20.8 million in direct costs towards hospitalization, medication, and out-patient treatment towards diabetes. In 2015, $1.2 billion were lost in Australia's Gross Domestic Product due to diabetes.
In these countries of affluence, diabetes is prevalent in low socioeconomic groups of people as there is abundance of unhealthy food choices, high energy rich food, and decreased physical activity. More affluent people are typically more educated and have tools to counter unhealthy foods, such as access to healthy food, physical trainers, and parks and fitness centers.
Risk factors
and being overweight is one of the main risk factors of type 2 diabetes. Other risk factors include lack of physical activity, genetic predisposition, being over 45 years old, tobacco use, high blood pressure and high cholesterol. In United States, the prevalence of obesity was 39.8% in adults and 18.5% in children and adolescents in 2015–2016. In Australia in 2014–2015, 2 out 3 adults or 63% were overweight or obese. Also, 2 out of 3 adults did little or no exercise. According to the World Health Organization, Europe had the 2nd highest proportion of overweight or obese people in 2014 behind the Americas.In developing countries
According to WHO the prevalence of diabetes is rising more in the middle and low income countries. Over the next 25 years, the number of people with diabetes in developing countries will increase by over 150%. Diabetes is typically seen in people above the retirement age in developed countries, but in developing countries people in the age of 35–64 are mostly affected. Although, diabetes is considered a disease of affluence affecting the developed countries, there is more loss of life and premature death among people with diabetes in the developing countries. Asia accounts for 60% of the world's diabetic population. In 1980 less than 1% of Chinese adults were affected by diabetes, but by 2008 the prevalence was 10%. It is predicted that by 2030 diabetes may affect 79.4 million people in India, 42.3 million people in China and 30.3 million in United States.These changes are the result of developing nations having rapid economic development. This rapid economic development has caused a change in the lifestyle and food habits leading to over-nutrition, increased intake of fast food causing increase in weight, and insulin resistance. Compared to the west, obesity in Asia is low. India has very low prevalence of obesity, but a very high prevalence of diabetes suggesting that diabetes may occur at a lower BMI in Indians as compared to the Europeans. Smoking increases the risk for diabetes by 45%. In developing countries around 50–60% adult males are regular smokers, increasing their risk for diabetes. In developing countries, diabetes is more commonly seen in the more urbanized areas. The prevalence of diabetes in rural population is 1/4th that of urban population for countries like India, Bangladesh, Nepal, Bhutan and Sri Lanka.