I’ve been reading about social determinants of health for some years now, but I had to see this phenomenon in practice before I truly ‘got it’.
It’s one thing to understand an issue or fact intellectually, another to experience it first-hand. That’s been made clear to me twice recently concerning health care here in Nepal and what are sometimes called ‘social determinants of health.’
One of my current projects is reporting about malnutrition during Covid-19. I contacted the Nutrition Home close to Kathmandu hoping to speak to the guardian of a child who had been admitted because they were malnourished.
A study finding that infants in Kathmandu are getting 25% of their calories from junk foods was a major talking point in Nepal last week.
Looking at the article in The Journal of Nutrition, it is also surprising that among the 700 or so kids studied, the group who ate the most junk food were shorter than the average, not fatter as might be expected.
Shorter than average is a description of stunting, a major marker of childhood malnutrition. Decades ago Nepal had extremely high rates of stunting, which is also an indicator of a country’s development, but managed to reduce it greatly. Still, the country is not on track to meet the 2030 target of the Sustainable Development Goals: 15% of children under 5 stunted.
Below is my article published today in Nepali Times, online.
A municipality in Bara district, 60 km south of Nepal’s capital Kathmandu, is distributing chickens to new mothers and pregnant women. The local initiative to add protein to families’ diets is part of the national Multi-Sector Nutrition Plan, which I’ve written about previously.
The news itself is shocking: in 2017 poor diets worldwide caused 11 million deaths, concludes the report, published in The Lancet journal. Eating too much salt and not enough whole grains and fruits were the major culprits.
Obstacles to healthy eating
But what Crowe also highlights are those factors that are beyond the control of individuals and are known as ‘environmental determinants of health’. These range from absent or misleading labels on food packages to prominent placement of junk food in supermarkets to the unaffordability of the fruits, vegetables and other healthy food that we’re supposed to be eating more of to prevent those 11 million deaths. Continue reading “To fix unhealthy diets: activism before ‘an apple a day’”