global health: where are we going?Economic and Societal Costs of Chronic Disease
Chronic diseases associated with the Westernization of global
diet and lifestyle affect many people in middle age. Very often, this
creates severe financial hardship for individuals and their fami-
lies; in turn, lost earnings and out-of-pocket healthcare payments
undermine the socioeconomic development of communities and
nations.
Consider the fact that by the year 2050, the world’s elderly pop-
ulation—people age sixty years and older—will have more than tri-
pled from 600 million (in the year 2000) to 2 billion.^21 Good health
is essential so that older people can maintain their independence
and participation in family and community life. Good functional
health is also important in the elderly to reduce the healthcare costs
and resources needed from local and national economies, which will
be severely strained by these aging populations.
The Crux of the Dilemma
A difficult concept to grasp is the juxtaposition of overweight
issues and excess calories with under-nutrition in impoverished
settings. Excess calories can keep people alive—at least for a while.
But if they are “empty” calories—not attached to vitamins, miner-
als, fatty acids, fiber, and protective phytochemicals—then they
offer little protection from the chronic diseases that are killing us.
Most Americans think we are the best-nourished people in the
world because we are big and strong (and fat). Yes and no. It’s true
we have more access to foodstuffs and food calories than most
people do. But if we spend our time buying quick, highly processed
refined foods, we get a whole lot of calories without beneficial nu-
trients, and we get fat and/or develop chronic diseases. The health
problem and solution are the same for all economic strata in ur-
ban settings: The “haves” of the world must educate and discipline
themselves to eat low-calorie, nutrient-dense foods and exercise.
The “haves” need to use modern-day technology to their advan-
tage to enhance their access to whole foods and to places where