Epidemic, part 2

I started to comment, but it grew much too long
So decided to post again, to say "I'm not wrong!"

In response to the comment to my post yesterday:

Yeah, you can prevent HIV/AIDS. It's called a condom. But that's not 100%, of course, and additionally there are situations when people contract HIV in a "monogamous" relationship, through IV drug use, or through non-sexual non-drug means. And I'm okay with calling that an epidemic (and I used it as an example because it is called an epidemic, and I think it works with the public's perception of the meaning of "epidemic"). Because while there are some preventive measures that can be taken, socially (like the woman in Africa who has unprotected sex with her Positive husband who has been stepping out on her), it's not always possible. But back to the matter at hand.

Problem is, Ray Ray, that obesity is associated with wealth. As a sweeping generalization, poor countries have infectious disease problems, and rich ones have obesity, cardiovascular, etc. problems.

Diabetes (a major sequela of obesity) is related to lifestyle choices like driving (instead of walking or transit), and has even been shown to be associated with the suburbs, rather than the downtown core, at least in Toronto.

And yes, I absolutely agree that health is tied to socioeconomic status -- it's a problem, and the fact is that poorer people get sicker more often, and have worse outcomes than richer people.

But I feel like the tie between socioeconomic status and obesity is much less cut and dry, than say, hypertension, cardiovascular disease and psychological disorders. While it may be a precipitating factor to certain diseases associated with obesity (such as diabetes, CV disease, hypertension), not having access to good quality food or a car generally does not make one obese. They tend to deal with other problems due to poor nutrition, stress, and infection.

Definitely, there need to be supports in place to help people of lower SE status in gaining access to proper health care, treatment options, and basic living standards.

And I've tried to steer clear of these sweeping generalizations for the most part, because the cause-effect relationships are not clear.

But the whole point of the post is about empowerment, not finger pointing, and I'm sorry if that wasn't clear. Assigning blame is useless, especially if we're at the point where someone is already suffering from an illness. But what does make a difference is in empowering someone to feel that they indeed, as the patient, are also part of their medical care, treatment, and management. That they are not merely the pokees, but can poke, prod, and take care of themselves as well. And in making some take responsibility for their health, we'll see much better outcomes.

And the fact is that empowerment is, well, powerful, especially in terms of a population health standpoint. We can't monitor everyone all the time (and no one wants a big brother society anyhow), but we can encourage people to take ownership of their own health by promoting healthy lifestyle choices, hand in hand with social supports that are already in place.