More similar than different...

I was speaking to a group of seventh graders today about the United States and South Africa. We compared populations, units of measurement, identified our capitals and learned how to read time zones on the map. I highlighted parts of their culture that they should be proud of like their Ubuntu way of life, being bilingual and their traditional music and dance. In a gentle manner I also squashed some of their ideas of the United States for it is only fair for them and us. We are not all rich, beautiful and thin. We have HIV/AIDS, teen pregnancy and single-parent households. When I asked them what is the biggest health concern and number one killer of people in South Africa every hand in the room went up. It is no secret. In some populations 30% are infected. So why does it continue to spread at the rate that it is? It comes down to two reasons: education and choice. People either don’t know how to protect themselves or they choose not to. Poverty will always play a part but it’s an indirect reason: too poor to go to school, women choosing unprotected prostitution to feed their children, husbands paying for unprotected sex while away from home for months at a time working to support their families. Culture plays another indirect role: young women and girls think that having sex is what they are supposed to do, prostitution is legal, it is socially acceptable for a man to have extra-marital relations. So where am I going with this you might ask? Well, the biggest health concern and number one killer in America right now is obesity. 30% of our population is overweight and another 30% is obese. Like HIV/AIDS and it’s many opportunistic infections (TB, pneumonia, thrush, meningitis and cancers), it is the complications from obesity that are killing Americans everyday. Type 2 diabetes, stroke, cardiovascular disease, high blood pressure, liver disease and many kinds of cancers are what take their toll and eventually lead to the death of our obese population. Why are we so fat? Is it poverty? It is true that much of our more affordable foods like pasta, hot dogs, boxed macaroni and cheese, and Ramen noodles are not good for you. Is our culture making it more socially acceptable? Cars have bigger drink holders for the “Big Gulp,” schools prepare meals from cardboard boxes straight from the freezer and our very own government subsidizes corn which directly aids in the low prices of pre-made, hyper-processed, frozen foods which are loaded with high fructose corn syrup. Can we blame it on education? Maybe we are not spending enough time in schools exploring mypyramid.gov. or requiring teachers to live by example. Would it make a difference? If you ask any obese American what they need to do to drop the weight they probably know the answer, diet and exercise. But there are nutritional details that can make or break the numbers on the scale that many adults aren’t even aware of. And there are lots of infected South African who know that HIV/AIDS is spread through unprotected sex with an infected partner but they also think that sex with a virgin will cure them. For those fully educated and aware of all the risks associated with obesity and HIV/AIDS there is a choice to be made. In the heat of the moment, whether it’s sexual or a food craving how many people will choose to abstain from the burger and fries and test the salad?