The South Asian health timebomb

Asian communities in UK are likely to have a heart attack 10 years earlier than their white counterparts in the UK.

These are bare and startling facts about our heritage and way of life – the risk of dyingprematurely from coronary heart disease is 50 per cent higher in the South Asian immigrants from India, Pakistan, Bangladesh and Sri Lanka than in the Caucasian population.

Health inequalites in ethnic groups in the UK is widening.

Morbidity and mortality from coronary heart disease and diabetes in South Asians have declined at a slower rate than in Caucasians.

The worrying trend is that second and third-generation Asians seem to be displaying many of the same risk characteristics that make them prone to coronary heart disease and diabetes as their parents. Scientific evidence shows that more than 80 per cent of the global burden of coronary heart disease and diabetes, irrespective of the ethnic origin, can be attributed to diet, lack of exercise and lifestyle. As a majority ethnic community in the UK, we are too unhealthy, we die too early and the burden of care on our families and the state is far too much. We can and we must improve this.

The coalition government has released what it intends to do about public health issues through its Choosing Health white paper, which has some welcome initiatives but is marred by missed opportunities.

It does not go far enough in tackling the causes of chronic illness in this country in general, but especially the health problems that have plagued the South Asian community such as low levels of physical activity, obesity, alcohol misuse and smoking.

The health secretary Andrew Lansley has ruled out legislation on junk food, a minimum alcohol price and he has severed the £75 million marketing budget for Whitehall’s Change 4 Life anti-obesity programme.

It is disappointing that the white paper has failed to address fast-food advertising, glamorous alcohol marketing and tobacco displays in large supermarkets.

Our sedentary habits, ie, less walking, little cycling, lack of interest in PE at school, overprotection of children and not allowing them to play outdoors, have all played a major role in causing obesity and heart disease in Asians.

A lack of exercise, obesity and smoking are the reasons why Asians will die five years younger than the national average. Addressing these lifestyle issues should, therefore, be at the core of any decent health strategy.

It is far too simplistic to suggest that obesity is caused purely by moral failure of individuals. It is, in fact, an unintended consequence of modern culture and powerful advertising.

I have had patients lose weight and stop smoking, and the changes in their quality of life can be dramatic. The issue of life expectancy can seem unimportant in youth and middle age, but immediate health benefits can be felt by those who succeed in giving up smoking and/or losing weight. But we can still only really help those who want to help themselves.

There is an urgent, major need for education within the South Asian communities on the causes and prevention of heart disease and diabetes.

To make greater inroads into public health, more action is needed at central and local government levels.

Setting a minimum price level per unit of alcohol and increasing taxation in relation to the alcohol strength of particular products would help reduce alcohol misuse, and the taxes would provide revenue toward the immense cost of the health problems caused by these products.

Other steps include making it mandatory for restaurants and takeaways to display meals on a traffic-light system where red is high caloric value, amber is medium and green is low; opening school playgrounds and athletic fields to the local communities; realigning bus routes or other transportation to increase access to supermarkets and grocery stores; developing walking and cycling networks; and increasing access to free, safe drinking water in public places as an alternative to sugar-sweetened drinks.Such steps may be seen as radical, and in some cases may be unpopular, but legislation against smoking was once seen in the same way.

Our society has major problems, and we need drastic measures. Without such prevention, the NHS expenditure for treatment of acute and chronic illnesses will keep on soaring and our society will be the poorer for it – both in financial and health terms.

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