Poverty and poor health worldwide are inextricably linked. The causes of poor health for millions globally are rooted in political, social and economic injustices. Poverty is both a cause and a consequence of poor health. Poverty increases the chances of poor health. Poor health, in turn, traps communities in poverty. Infectious and neglected tropical diseases kill and weaken millions of the poorest and most vulnerable people each year.
HIV, diarrhoea, tuberculosis and malaria, as well as communicable respiratory diseases such as pneumonia kill the most people. Diarrhoea, pneumonia and malaria account for nearly half of all child deaths globally. Neglected tropical diseases affect over one billion people, almost all in the poorest and most marginalised communities.
You may not have heard of diseases such as leprosy, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma, but they can cause severe pain and life-long disabilities — and mean enormous productivity losses. However, efforts to tackle them have usually taken a back seat to the bigger killers. See for example:.
A standard recommendation Iestra et al. Engage in moderate intensive physical activity for 30 min on at least 5, but preferably all, days of the week ;.
If you use alcohol: do so in moderation maximum 2 alcoholic drinks per day for women and maximum 3 drinks per day for men ;. Get regular health screenings MayoClinic. All such recommendations are fine and practical ways to stay healthy.
Let us see what that means. Here we concentrate on the traits and attitudes that predominate in individuals who have lifestyle diseases.
If one continues to remain hostile, unduly dominant, constantly angry, forever nursing negative emotions, one can hardly follow or benefit from simple dietary and exercise schedules. Either they are abandoned or, worse, serve only to give a false sense of protection in the absence of attitudinal changes. Similarly, unless such attitudinal changes are brought about, the medical approach will have to be used indefinitely and its use escalated.
That may serve the interests of the medical establishment but it hardly serves the interests of the patient. To study and incorporate personality variables and psychosocial risk factors into disease prevention and treatment and focus intense research attention on these variables does not seem to be high on the list of priorities of the opinion makers today, although honest soul-searching cannot keep them immune to this realisation.
Moreover, such advice has hardly been scientifically validated by rigorous studies as opposed to the benefits of most so-called medical procedures, as also of diet and exercise, which have been validated over and over again ; and that's always a convenient handle.
How could they be validated, if they do not enter the consciousness of the prescribing physician or the researcher? Unless, of course, he himself suffers from a lifestyle disease; then he is likely to adopt all these for himself. He will not only take drugs and undergo procedures, not only diet and exercise, but also slow down, simplify his life, try to tune in to his inner self, control his anger and his greed, be compassionate to others, etc.
He will start Yoga, meditation, Vipassana, attempt therapies from alternative and complementary medicine, etc. Depending on his level of realisation, and the ability to convert it into actionable advice for his clientele, he may or may not advise them to act similarly. For, the clinic has to run as well. And over the realisation that it is the ubiquitous lifestyle stress that causes a pervasive sympathetic overload; an overload that results in such stress hormone outpourings as wrecks the otherwise robust internal organ systems and their homeostasis.
It is time this was realised and as much serious research attention given to the third approach as is given to the first and the second. It is thus obvious that morbidity, disability, and death assail all three, the ones with infectious diseases, the ones with diseases of poverty, and the ones with lifestyle diseases.
For those societies afflicted with diseases of poverty, of course, the prime concern is to wriggle out of the deadly grip of poverty-disease-helplessness. But, while so doing, be careful not to land in the lap of lifestyle diseases. This they can do only if, individually and collectively but especially individually , they realise the enormous potential of the human spirit and are ready to trudge the long way uphill against callousness, deprivation and exploitation.
They must do so without nursing anger, resentment, and hostility towards the haves. Simply because these emotions will never allow them inner peace; they will only make them more amenable to the lifestyle diseases waiting to take over. For the haves, the need is to seek inner rootedness, to seek the healthy pursuit of self-esteem DuBois and Flay, , to ask science not only to give them new pills for new ills but to define and study what is inner peace, what is the connection between spirituality and health, what is well-being, how negative emotions hamper health and how positive ones promote it, what is self-actualisation, what prevents disease, what leads to longevity, what attitudes help cope with chronic sicknesses, how can sicknesses be reversed and not just treated.
To confront the man of science who keeps accusing the man of religion of talking without evidence, and instead forcing the former to collaborate with the latter to find ways of mitigating human distress by finding such evidence. To avoid restricting himself to the treatment of just the disease but, rather, to concentrate on its prevention; to help a person function at his optimum in spite of his disease.
For that, the physician will first have to realise that it is a person who has a disease, and it is not just a case of a disease afflicting a person. For this, it is man, and his development and welfare, which should be the measure of all things.
Scientific progress, economic development and social order are meant to promote human development, not the other way around. It is heartening to note that in the last few decades some scientific attention, though belated and grudgingly given, is getting focussed on the concept of well-being, the means to achieve longevity, and the need to make life simple.
Some attention to these areas may be pertinent here. The goal of all health-related measures is not just treatment of disease, but also its effective control, eventual cure, and prevention. More important, it is the promotion of well-being, an amorphous concept getting more standardized with scales like the Positive and Negative Affect Scale PANAS Watson and Clark, , which measures the presence of positive and absence of negative emotions; the Temperament and Character Inventory Cloninger, Svrakic and Przybeck, , which measures mature character traits, including self-directedness, cooperativeness and self-transcendence; the Satisfaction With Life Scale SWLS Pavot and Diener, , which measures life satisfaction or quality of life, and character strengths and virtues, such as hope, compassion, and courage Peterson and Seligman, What characterises well-being?
It is mainly positive emotions, character strengths, virtues, and life satisfaction, which is the result of growth in self-awareness Cloninger, It is also the result of letting go of all struggles, working in the service of others, and growing in awareness.
Self-transcendence-man's search for what is beyond individual human existence-is also crucial for the development of resilience and maintenance of well-being Cloninger, Self-transcendence has been shown to have a strong neurobiological basis in human evolution, with unique genetic determinants Gillespie et al.
Self-transcendence is also important for the preservation of grey matter for meta-cognition as people age Kaasinen, Augmentation of cognitive-behavioural therapy with increased awareness reduces relapses and recurrence rates in therapy for a wide range of disorders compared to cognitive-behavioural therapy alone Cloninger, ; D'Souza and Rodrigo, ; Fava et al. Positive psychology has been preoccupied with the cognitive and social aspects of well-being, neglecting both its neurobiological and its spiritual roots Cloninger, The foundation for personal well-being is the self-awareness that each being is an inseparable part of a universal unity of being Cloninger, Thinking beyond individual human existence, understanding and establishing transpersonal connections are essential to well-being.
Here thoughts of the essential unity of all existence, like for example the thoughts of Sri Aurobindo, assume importance Singh and Singh, ; forthcoming. This does not necessarily need religion, although religion facilitates such a realisation. Even agnostics and atheists have a spiritual perspective that helps them understand the purpose and meaning of their life Hay, In our quest for well-being, the connection between competition and territoriality on the one hand, and poverty, conflicts and war on the other also deserve our careful attention:.
What do deep primitive beliefs about the primacy of competition and territoriality have to do with poverty, conflicts and wars? All are rooted in ancient human fears-of scarcity, of attacks by wild animals or other fearful bands of humans. We must move beyond this economics of our early reptilian brains- to include the economics of our hearts and forebrains! These old fears underlie today's continuing cycles of oppression, poverty, violence, revenge and terrorism. Indeed, if we humans do not root out these now-dysfunctional old fears, we will destroy each other.
Politicians frequently use fear to manipulate consent. Yet fear can be counterproductive. Franklin D. Roosevelt during the Great Depression in the US proclaimed that we have nothing to fear but fear itself!
Henderson, How we move from competition and confrontation to cooperation and consensus, without blunting the entrepreneurial edge, is the great challenge before mankind today.
Closely connected with the concept of well-being is the search for longevity, which we may now briefly survey. Based on the life of centenarians, Maurice Ernest Ernest, , identified the following key factors to long life:. Care for physical self: eating frugally, and therefore not becoming overweight; exercising and getting plenty of fresh air; maintaining a high level of personal hygiene; drinking wholesome liquids; having a bowel movement once a day; getting proper medical attention in case of illness;.
The pattern that emerges is of an individual who cares for his physical health, does not push himself too far in competition and strife, is simple in tastes and easy-going by nature, and self-sufficient enough to survive the losses that are inevitable over one's life span: of loved ones, economic hardships, loss of power, prestige, etc. Simplicity is often the cornerstone of a life lived long, and it would be worth our while to concentrate on it here.
It is heartening to note that in certain quarters vigorous steps are on to simplify life and increase awareness of the ill effects of:. Parenthesis added. Reducing debt, de-cluttering one's home and downsizing one's career ambitions WebMD, What is this simple living? It is also defined as:. Simple Living is a self-endorsed pattern of activities, possessions and values that is substantially free of detractions from fulfilment and sufficiency, fostered by conducive social policies Simple Living America, Simple living is not about living in poverty or self-inflicted deprivation.
Those who wish to live long, and well, have much to learn about lifestyle and personality modifications from writings and studies such as these. In the light of what we have discussed so far, it is possible to visualise the task ahead for each one of us. Physician: If you are a physician, you now know the task cut out for you. Ask for therapies that ensure well-being and adopt measures that ensure longevity in your patient population.
Be careful before you prescribe the costly new medicine to the poor, who may drain their meagre savings to somehow comply with your prescription. Be careful to look into the anger-greed-hostility-over-consumption-immorality angle that often complicates recovery from lifestyle diseases. Advise your patients to simplify their lives. Also, stop being impersonal in your treatment, without seeming to interfere needlessly in personal matters.
Be more humane, look to help the person behind the disease, even as you do not neglect being objective, for both these ensure comprehensive treatment of the disease. Know the boundaries not to be transgressed. Refuse to be taken for a ride by marketing techniques masquerading as scientific evidence.
Patient: If you are a patient, you now know the task cut out for you. Demand for definitive research to combat the diseases of poverty and those of lifestyle. Demand for research directed at the cure of diseases, not control of symptoms. Demand longevity with well-being, not just longevity alone. Simplify your life, declutter your home, downsize your ambitions, avoid excessive debts, over-consumption, and over-connectedness, and avoid over-exposure to negativity.
Ask for physicians and researchers to clean up their acts. Stop being satisfied with what an archaic physician dishes out to you. Ask for, and expect, uncompromising scientific evidence for the treatment offered. Remember, treatment administered should cure sometimes, comfort always, hurt the least, harm never Singh and Singh, Continue to have faith in your physician, expect him to do his best, expect him to be firm with you at times; but know your rights as well, so you do not get taken for a ride.
Expect informed consent to be exactly that, informed, and never get coerced into unsubstantiated research or treatment. Demand, and get, your right to be handled with care and compassion, and expect your physician to give of his time and expertise liberally, even as you do not take advantage of his gentleness. Give due credit to medicine and due cash to the medical person who makes it possible for you to enjoy its benefits. The physician is no God, true, but often treating him like one works in your favour.
Caregiver: If you are a caregiver relative, you now know the task cut out for you. Caregiving can be exhausting, can be extremely stressful, and result in burnout. Know and learn better ways of coping with caregiving, especially in chronic debilitating conditions.
The patient is suffering, and so are you. It hardly helps if you increase his suffering by nursing negative emotions, by passing caustic remarks, or by neglecting his genuine needs, for it only exacerbates his problem and, more importantly, compounds your own as a caregiver. Expect your physician to be competent, but caring too. Do not tolerate his lack of courtesy or any brusqueness. Do not accept that ethical standards are low everywhere, so how can medicine be spared.
Demand high ethical standards, even as you demand high professional standards, and be ready to pay for what you get. Biomedical researcher: If you are a researcher, you now know the task cut out for you. The patients, caregivers, and physicians have had enough of your dillydallying. Give them therapies that work.
Tell them the reason why they fall sick so they can prevent it. Give them clear-cut preventive measures. How does poverty interact with disease, how does lifestyle and stress affect body and mind? What roles can religion, spirituality, and alternative and complementary therapies play?
Do not sneer at them for their lack of robust evidence-subject them to searching critical scrutiny, but redefine and refine your parameters to understand them too.
Work towards giving therapies that cure, not just control. Study well-being, simplicity, and longevity systematically and comprehensively. Orient your researches to answer such questions. You can continue your intellectual arguments, your work for so-called scientific progress, and take care of your own career advancement with smart write-ups and speeches. But you cannot afford to neglect the hapless patient or the harassed caregiver and, thereby, the well-being of society in general, whose welfare alone is your raison d'etre.
Ask for, and get, clear-cut evidence for therapies that work. Diseases of poverty and lifestyle grip major populations groups all over the world.
What is the purpose of massive research funding and elaborate seminars, conferences, and workshops, if we are to be satisfied with only minor improvements, and there is no great movement to ensure well-being and positive health? Where even health defined as absence of disease is a very distant goal? Be on the look out for studies on well-being, simplicity and longevity, and help create a lobby for such type of research to flourish. Expose research misconduct ruthlessly, reputations be damned; but see to it that you do not become a pawn manipulated by some nefarious individuals and groups, and do not try to fish in troubled waters yourself.
Science administrator: If you are a science administrator, you now know the task cut out for you. Science is meant to bring about human welfare, even as it perpetuates its own progress. There can be no respite from supporting rigorous research into the diseases of poverty in the have-nots, and diseases of lifestyle in the haves. This agenda must be firmly set, and no waylaying of this agenda should be pardoned in researchers who do flimsy work with research grants.
Stop playing God, or having blue-eyed boys. Only the most urgent research and the most competent researchers should get the research grant. Be especially aware of neglected diseases and research areas that may not be fashionable to work in, but are the real need of the people. Systematic and comprehensive study of well-being, burnout, simplicity and longevity must be promoted.
Lobby with science administrators worldwide to pressure governments and bureaucrats to make health planning and care a priority on their agenda, along with poverty eradication programmes, and the means to make lifestyle changes possible.
Policy maker: If you are in a position to plan policies or execute them in government, you now know the task cut out for you. Stop finding reasons to put health and education on the back burner. Just think of your own self: if diseases of poverty won't get you, diseases of lifestyle definitely will. Systematic and comprehensive study of well-being, burnout, simplicity and longevity is the need of the hour. Give citizens the right to health, increase budget allocation for health, and get competent, qualified people to head health departments and ministries.
More importantly, have efficient science administrators and stop interfering in their work by recommending research grants to sycophants and blue-eyed boys. Ethicist: If you are an ethicist, you now know the task cut out for you. Just carry out a relentless campaign so researchers, policy planners, governments, science administrators, and the biomedical industry cannot deviate from ferreting out the truth about diseases of poverty and lifestyle.
Accept no compromise to ethical conduct in researchers and industry. It's a perennial and unrelenting fight, and only those who have the guts and stamina to go on and on and on need to stick on here. Ethics is no part-time job, nor is it one that earns handsome perks. The work done well is often its only reward; and often the other reward is enemies all around who love to hate you, but know in their hearts that you are right after all.
Man of religion: If you are a man of religion, you now know the task cut out for you. You know what ensures well-being and leads to longevity. You know the benefits of simplicity. You need to get the man of science to listen to you and your insights. Stop pulling him down or his branch. He works under methodological constraints that you do not have to face. He needs your insights and he needs your patience to understand those insights; he needs time, and your persistence, to help him make experimental models out of your insights.
But collaborate you must, for science combined with religion offers the greatest chance for complete human development and well-being. Nothing, just nothing, can match or derail this combination of science and religion if and when it comes about.
Also, equally important, the followers of religion are driven by a strong faith, which is often blind. It becomes all the more important that such faith is never, ever manipulated. For then, religion cannot become the means for human development; it becomes, instead, the means for human exploitation; which, knowing the powerful hold it has on the human psyche, it can easily degrade into. You are aware of lifestyle problems and have many insightful remedies to offer, which the person of mainstream medicine is sceptical of at present, and not without reason.
Be more of complementary and less of alternate medicine. Mainstream medicine has a lot to offer, and it will serve the cause better if you complement their efforts rather than try to prove your alternative status. Moreover, stop going overboard with tall claims that only conceal an inner insecurity. Offer scientific proofs the way mainstream medicine demands and does, for they dictate the research agenda and procedures today—and not without justification. There are many therapies that promote well-being and longevity that you may have to offer, but they must stand the acid test of scientific verifiability and replication across geographical boundaries.
Conscientious citizen: If you are a conscientious citizen of your country, you now know the task cut out for you. To read what is written as a challenge to all the guys above and not relent till they have done it. For they subsist on you, and can survive only till you allow them to. Simplify your life and get researchers to study how simplicity impacts health. Stop being taken for a ride by the empty promises of callous regimes and bureaucrats and ask what action is being taken to promote health, reduce hunger, eliminate poverty, and ensure longevity with well-being.
Stop feeling lost when scientists give long-winded explanations, which are often only a substitute for action, and urge them to find mechanisms to reduce stress and the related lifestyle diseases. Do not get exploited by smart researchers and their henchmen who may use you like a guinea pig to try out unsubstantiated therapies without your informed consent. Stop feeling helpless when your call for action elicits no response from the powers that be.
Knowledge is power, and when you know what you need to get done and why, these people have no option but to do it; you must rid yourself of the shackles that poverty in the developing and lifestyle stress in the developed place on your psyche. Unite and carry out concerted efforts with NGOs, national and international, to make your voice heard. With the help of the knowledge that organisations like the WHO and its related agencies now place at your disposal and with the explosion of knowledge that the WWW supplies, if only you know how to use it to further your cause , there is no way that the lethargy and complacency of the powers that be will not be shaken.
Thus aroused, the slow wheels of change will gather momentum. For the government and power machinery are like sleeping giants. Once awakened, they can do wonders. You must leave the indolent giants with no alternative but to work that wonder. Thus, you take the first firm steps to achieve the glory of human development, which is at once both your journey and your destination. Citizens of a world community: As citizens of a world community, know that the world has indeed shrunk; peoples and cultures are closer.
So much that is good in far off geographical areas is now available to us because the world has coalesced and people and societies have opened up. Along with this comes the realisation that mankind exists at various stages of development. Those in the developed world have the means to make life meaningful but have often lost the meaning of life itself, while those in the developing world are fighting for life but often have the recipes to make life meaningful.
This is especially true of a society like India, which is rapidly growing out of its underdeveloped status to become a developed society; it boasts of an ancient civilization and a philosophical outlook based on a robust mix of the temporal and the spiritual. There is a vibrant indigenous biomedicine and related disciplines for example, Ayurveda, Yoga, etc.
In fact, a rediscovery and careful sifting of such values to determine those relevant to the modern times is an important task before the thinking Indian of today.
In so doing, he may be doing a signal service both to Indian society and, by extension, to most other societies that are escaping, or have escaped, the vicious grip of the diseases of poverty but are about to land, or have already landed, in the lap of lifestyle diseases. How the means that the developed world has combines with the recipes to make them meaningful that the developing world has-that is the challenge ahead for mankind as it gropes its way out of poverty, disease, despair, alienation, anomie, and the ubiquitous all-devouring lifestyle stresses, and marches with halting steps towards well-being and the glory of human development.
Diseases of poverty afflict populations in the developing world, while lifestyle diseases grip those in the developed sections of society. At present, positive health and well-being appear a distant goal for both. Poverty is not just income deprivation but capability deprivation as well; poverty also means optimism deprivation.
While life expectancy may have increased in the haves, and infant and maternal mortality reduced, it does not necessarily ensure that well-being results. For those societies afflicted with diseases of poverty, of course, the prime concern is to escape the deadly grip of poverty-disease-helplessness. But, while so doing, they must be careful not to land in the lap of lifestyle diseases. For the haves, the need is to seek inner rootedness, to combat lifestyle diseases, to reduce professional burnouts, to ensure longevity with well-being, to simplify life, declutter homes, downsize ambitions, avoid excessive debts, over-consumption, over-connectedness, and over-exposure to negativity.
Studies on well-being, longevity and simplicity need the concerted attention of researchers and science administrators. How the means that the developed have combine with the recipes to make them meaningful that the developing have-that is the challenge ahead for mankind. This is especially true of a society like India, which is rapidly growing out of its underdeveloped status to become a developed society of the near future.
It is an ancient civilization with a philosophical outlook based on a robust mix of the temporal and the spiritual, with vibrant indigenous biomedical and related disciplines, for example, Ayurveda, Yoga etc, as well as a burgeoning modern biomedical knowledge corpus in active conversation with the rest of the world.
Increasing health in a region can significantly reduce global poverty , in effective and unexpected ways. People in developing countries face challenges due to diseases that those in developed nations do not. For instance, in a developing country, someone who gets sick may have to sell their possessions to pay for medicine.
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