By: Dr Syathirah Hanim Azhar Hilmy
THE health of an individual is deeply influenced by what we call social determinants of health (SDH)—the factors around us that shape our well-being. These factors can be grouped into biological, individual lifestyles, social networks, and broader socioeconomic, cultural, and environmental conditions. In Malaysia, nearly 98% of the population is grappling with at least one risk factor linked to systemic issues like rapid urbanization, poorly designed living environments, income disparities, lax nutrition regulations, and low health literacy.
A significant concern is the rise in lifestyle-related risk factors, particularly unhealthy diets dominated by sugary foods and drinks. This unfortunate trend has led to a surge in non-communicable diseases (NCDs) such as diabetes, hypertension, cardiovascular diseases, and dental issues. The common denominator? Sugar. While it provides a quick energy burst, it lacks essential nutrients like vitamins and minerals.
The phenomenon of hipster cafés popping up in urban areas is equally alarming. These trendy spots serve up colorful desserts and sweet drinks at wallet-friendly prices, enticing people with ‘Instagrammable’ treats. One look at a drizzling caramel latte or a rainbow of cake slices, and it’s hard to resist—especially in a world driven by social media validation. But how swiftly can we curb this enticing temptation?
Grocery stores play their part by placing unhealthy snacks at checkout lines or eye level, coupled with enticing offers like ‘buy one, get one free.’ This tactic tempts shoppers into impulsive buying—not out of necessity, but because these products are strategically positioned to lure them in. How can we challenge the notion that these tricks are simply clever marketing strategies aimed at boosting sales?
The creativity of food vendors is another layer in this complex issue, presenting traditional Malaysian treats with unhealthy twists. Picture this: banana fritters topped with an overload of sweets, apam balik slathered in Nutella, and toast featuring a generous scoop of vanilla ice cream drizzled in syrup. When food looks so good, it’s often a case of & “the eyes eat before the mouth tastes”. How do we resist such delicious temptations?
Malaysia’s struggle with ‘lifestyle diseases’ is not isolated—it reflects a regional epidemic. However, it’s currently the most affected country in Southeast Asia, a trend that’s as alarming as it is heartbreaking. With low health literacy, we can’t simply expect Malaysians to self-regulate their health. Insights from the National Health and Morbidity Survey (NHMS) 2019 revealed that many cases of serious health issues, like diabetes, go undiagnosed in their early stages; shockingly, nearly half the population is unaware they have it.
The unchecked intake of sugary foods has led to rampant obesity levels, soaring from over 20% to nearly half the population between 2006 and 2015. Malaysia has achieved the dubious title of Asia’s fattest nation, with over half of its people classified as overweight or worse. Diabetes rates have skyrocketed as well, jumping from 11.6% to 17.5%, landing Malaysia among the highest globally. If current trends persist, nearly a third of all Malaysians could be living
with diabetes by 2025.
This public health crisis doesn’t just threaten individual well-being—it impacts overall quality of life (QOL), contributing to heightened feelings of anxiety, depression, and social isolation. Oral health deteriorates too, leading to productivity losses for those affected by dental pain or untreated cavities, as social interactions become intertwined with our appearance.
The burden of NCDs extends to economic consequences, crippling personal finances and stunting national economic growth. These diseases often strike during people's prime working years, leading to exorbitant healthcare costs and diminished productivity, particularly in low- and middle-income nations like Malaysia.
The result? Households face increased financial strain while economies struggle to grow. Moreover, the rising prevalence of chronic NCDs incurs escalating care costs due to long-term treatment and management, equating to an estimated 1% loss in gross domestic product (GDP) due to decreased productivity.
Creating a healthier population, community, and society hinges on collaboration among all stakeholders—from government ministries and health service providers to educators, community organizations and media. While the Malaysian government has initiated a sugary beverage tax, it only targets pre-packaged sugar-sweetened drinks, overlooking the numerous other sugary products consumed daily. Therefore, the question remains: are these efforts sufficient to tackle the overarching issue?
At the heart of our communities, mass media education and promotions play a vital role in raising awareness and empowering individuals. By launching targeted media campaigns, we can combat misinformation and strengthen our communities, making them more resilient in the face of health challenges. Collaboration is key! By partnering with academic institutions and research organizations, we can translate evidence-based public health practices into effective policies and regulations at the national level. This united approach ensures that our actions are grounded in solid research, leading to better health outcomes for everyone.
On a more personal level, while medical and dental teams have taken strides in promoting health education, many of these initiatives lack a foundation in psychological theory. To truly motivate individuals to reduce sugar intake and adopt healthier behaviors, we need to integrate behavior change models that spark inner motivation and foster ownership of one’s health.
Creating a supportive environment is essential for encouraging healthy behaviors. Imagine workplaces where junk food is banned, healthier options are clearly labeled and affordable, and local communities implement programs aimed at improving health outcomes. These initiatives can transform daily lives and promote a culture of well-being.
It’s crucial for health providers to work together, breaking down silos and enhancing collaboration across sectors. By addressing the multifaceted factors that influence health outcomes—many of which extend beyond traditional healthcare—we can create a more holistic approach to well-being.
Innovative promotive and preventive health strategies grounded in local needs will emerge when we combine diverse expertise and perspectives. This means our communities will receive comprehensive support to lead healthier lives. Ultimately, embracing a comprehensive public health approach that targets common risks can effectively tackle multiple health challenges.
Not only is this strategy sustainable in the long run, but it also maximizes our resources. Together, let’s champion a holistic view of health that touches every aspect of our lives, ensuring that everyone has the opportunity to thrive!
The writer is a Dental Public Health Lecturer, Faculty of Dentistry, Universiti Sains Islam Malaysia.
