Research released in March this year has found South Africa to be the unhealthiest country on Earth.
The Indigo Wellness Index, one of the most comprehensive rankings to date, was based on 10 measures, namely healthy life expectancy, blood pressure, blood glucose (diabetes risk), obesity, depression, happiness, alcohol use, tobacco use, inactivity (too little exercise), and government spending on healthcare.
Dr Riekie Smit, an aesthetic medicine practitioner from Pretoria with a special interest in weight management, said that this research highlighted the need to invest in health education and development.
Although fully aware of the unhealthy lifestyles led by millions of South Africans, Dr Smit was nevertheless shocked that the results showed South Africa to be the unhealthiest country globally, out of the 191 countries included in the study.
“People will need to start realising that their health is not only the responsibility of their doctor or the health institute they visit, it’s their own responsibility to keep themselves healthy,” she said.
Drawing on her international experience and speaking to numerous doctors from around the globe, Dr Smit said that she is always surprised at how the attitude towards health varies across different cultures and countries.
South Africans can be very lazy and expect their doctor or a tablet to fix their health problems. Changing lifestyle, diet and habits are not viewed as the first step to curing diseases by our population,” she said.
Many South Africans are simply oblivious to the fact that leading healthier lives can decrease the need for medical intervention.
Of all 10 health measures included in the study, Dr Smit said that our obesity rate is alarming and needs to be addressed urgently, with interventions to change the way South Africans approach this issue.
In fact, the World Health Organisation has found that more than 28 per cent of adults in South Africa are obese, the highest obesity rate among the sub-Saharan African countries.
People who are obese, compared to those with a normal or healthy weight, are at increased risk for many serious diseases and health conditions, including high blood pressure (hypertension), Type 2 diabetes, sleep apnoea and breathing problems, coronary heart disease, stroke, some cancers, osteoarthritis and many others.
“Both government and private health sectors will need to start developing systems to encourage patients to improve their lifestyles, diet, activity levels and addictions. This is vital to reduce the excess load on both public and private health care. We simply do not have enough doctors and healthcare facilities to manage our unhealthy population,” she said.
Dr Smit added that some of the private medical insurance companies have already implemented such systems of rewarding healthy behaviour, with very positive outcomes.
“This type of approach should be taken by other private health institutions or insurance companies and more importantly, it should be implemented in the public health sector also. This type of approach, of encouraging or rewarding healthy choices, should address all the points where our health showed low scores according to this research in order to get people more involved in their own health,” Dr Smit explained.
Recent statistics from the World Health Organisation show that South Africans have a 26 per cent probability of dying from cardiovascular disease, cancer, diabetes, or chronic respiratory disease between the ages of 30 and 71. Reacting to this, Dr Smit said that there is no doubt that both improvement in lifestyle and weight loss will have a huge impact.
“Numerous studies have proved this, with evidence that a weight loss of just 5 to 10 per cent of body weight reduces the risk of developing cardiovascular diseases, metabolic syndrome and diabetes (22 per cent reduction), lowers cholesterol and blood pressure levels, and decreases the possibility of inflammation, sleep apnoea, and psychological problems, among many other conditions,” she said.
In fact, some studies have shown a decrease in the incidence of diabetes of as much as 40 to 60 per cent as a result of a 10 per cent reduction in body weight.
Dr Smit said that this evidence should really alert members of the public to the fact that it’s their lifestyle choices that have the largest impact on their health, and not the quality of their healthcare.
This should also alert public and private healthcare institutions to how important it is to encourage a healthy lifestyle among their patients”, she said.
In terms of doctor-patient intervention, many patients might benefit more from lifestyle and health education than just receiving a quick prescription, but many doctors are too busy for this.
Dr Smit said the solution could include pharmaceutical companies giving doctors assistance where possible in order to minimise the time spent on health consultations.
“In my practice, I have found the iLiveLite programme, developed by iNova Pharmaceuticals, very helpful. The programme gives the patients access to a website and printed materials with advice and an eating programme developed by a dietitian and focused on weight loss,” she said.
“Other systems that are useful are health and fitness apps with points awarded, and competitive rewards systems. I often encourage my patients to start using these apps in combination with fitness trackers. These methods can take a lot of responsibility off the shoulders of health care providers,” she said, and explained that there are numerous applications for health, diet and exercise available that give you your own personal ‘life coach’ at sometimes no cost or very low cost.
Dr Smit doesn’t believe that our unhealthy situation is beyond repair, and hopes that these new statistics will alert the various healthcare systems in South Africa to take urgent steps.
As individuals, we also need to start taking active steps to improve our health and the health of our families.
“My advice for people reading this would be to start with immediate effect to actively improve their health. There is so much easily accessible information available today and therefore no excuse. The first step would be to visit your health care providers for a health screening and examination. Their advice would be of immense value,” she said.
For many, the thought of losing even 5 to 10 per cent of their weight can be very intimidating. But medical research has shown that there is strong and consistent evidence that overweight and obese patients in well-designed programmes can achieve a weight loss of as much as 10 per cent.
Dr Smit said that where necessary, pharmaceutical intervention can be helpful.
