When we talk about chronic conditions like Type 2 diabetes, heart disease, or high blood pressure (non-communicable diseases, or NCDs), it’s easy to blame the individual. Phrases like, “If that person just lost some weight,” or “If they just ate better,” are unfortunately common. However, this view is too simple. The truth is, preventing NCDs is made incredibly difficult by the systems, environments, and economies we live in.
The Complex Web of Health Behaviors
The decision to eat a certain meal or choose to be active is rarely simple. It’s affected by a complex list of factors, including:
- Cost: Is the healthy, unprocessed food more expensive than the highly-processed, quick meal?
- Access: Do you live in an area where you can easily walk to a grocery store that sells fresh vegetables, or only to a convenience store selling chips and soda?
- Transportation: Do you have a car to get to a good grocery store, or must you rely on public transit?
- Time: Do you have the time and energy to cook a healthy meal after working two jobs, or is it faster to rely on convenience food?
- Culture: Are the foods you grew up eating and sharing with family considered “unhealthy” by current guidelines?
When healthcare providers meet a person with diabetes, they need to be curious and non-judgmental about these factors. They must realize that a person’s diet isn’t just a matter of willpower; it’s a story shaped by their life, their environment, and their finances.
The Challenge of the Food Environment
Our current environment is set up to promote unhealthy living. The profit motive often drives this system:
- Profitable but Unhealthy: Many products that increase the risk of NCDs (foods high in sugar, salt, and unhealthy fats) are hugely profitable for companies.
- Ultra-Processed Foods: The food industry constantly develops more ultra-processed foods—products with many added ingredients, sugars, and preservatives. These are cheap, widely available, and heavily marketed, especially to children. This makes it difficult for people to choose the healthy, whole foods found at the start of the food processing chain.
- Inactivity Incentivized: Despite having many conveniences, our society often encourages sedentary lifestyles. We drive instead of walk, and our entertainment (TV, video games, phones) keeps us sitting down. This lack of activity is a major driver of NCDs.
Prevention and Cost: Who Pays?
The cost of this unhealthy environment is massive.
- Individual Financial Strain: Even in countries with publicly funded healthcare, people with diabetes still face thousands of dollars in annual out-of-pocket costs for essential items like continuous glucose monitors, insulin needles, and medication.
- Cost to the System: Treating NCDs strains the entire healthcare system, requiring the support of healthcare providers and hospital resources.
The ultimate takeaway from the discussion is that focusing only on individual choices ignores the bigger picture. To truly combat the rising rates of NCDs and Type 2 diabetes, there must be a global shift toward addressing the environmental and systemic barriers that make healthy eating expensive and physical activity difficult for the average person. It requires a curious mind, a non-judgmental approach, and policies that make the healthy choice the easy choice.
About the author
Paige Alliston
Paige is a dietitian and PhD student with an interest in chronic disease management. Her PhD work focuses on testing knowledge mobilization strategies for people with diabetes using an online platform.