If New Zealanders undertook four basic public health measures they would not only live longer, they would significantly reduce the pressure on their badly politically driven overstretched health system.
Three of these measures involve doing moderate exercise, consuming little alcohol (an addiction when misused), and not smoking (an addiction when used or in the presence of).
Aotearoa New Zealand has a proud record of a small country punching above its weight in many areas. This includes being initially and then more recently momentarily, a world-leader in moves for the country to be smokefree.
At least we were world-leading until the new National-led coalition government announced its intention to repeal recently adopted smokefree legislation under the former Labour government.
This legislation would have led to a generation of New Zealanders becoming smokefree for the first time.
The biggest winner of the repeal decision is ‘Big Tobacco’. I discussed this in my health systems blog Otaihanga Second Opinion (12 December): Perversity is the outcome when smoke gets in your eyes.
Punching above a country’s weight
The fourth public health measure is low sugar consumption. Now we have a country much smaller than New Zealand punching even more above its weight in leading the fightback against a ‘blood relative’ of ‘Big Tobacco’ – ‘Big Sugar’.
The country is the small Caribbean island of Barbados with a population of around 280,000 on 440 square kilometres. Compare this with New Zealand’s just over 5 million population and over 267,700 square kilometres.
It has punched well above its weight in the fight against climate change injustice. I discussed this in an earlier Political Bytes post (11 January 2023): Barbados fights climate injustice.
Now Barbados is also fighting well above its weight against ‘Big Sugar’. This is reported in The Guardian by its former health editor, Barbados based journalist Sarah Boseley (8 June): Barbados fights ‘Big Sugar’ for survival of its people.
The introduction to the article cuts to the chase:
The legacy of colonialism, modern-day conveniences and a diet high in fat and sugar have bequeathed the island a diabetes and high-blood pressure pandemic. But can health plans win out over corporate interests?
After describing the visual paradise that is Barbados, Bosley refer to its “major trouble forcing it to fight for “its people’s survival”:
You could call it obesity, you could call it heart disease, diabetes and high blood pressure. Or you could call it the postcolonial predations of Big Food and Big Sugar.
Regardless (in my view you can legitimately call it both but the latter is at the core), the wider food industry is considered responsible for the island’s sugar consumption-driven crisis.
Barbados is one of the 57 small island developing countries which “…have particular vulnerabilities…” to non-communicable diseases. In Boseley’s words:
They cannot grow enough fresh food for their populations and, as the climate crisis worsens, water is scarcer and storms wipe out entire fields of crops every year. So they are reliant on importing their food: for some islands as much as 90% of it. And much of what they import is ultra-processed food. high in calories with very little nutritional value.
Boseley covers how these problems in Barbados are “…rooted in colonialism and slavery…” which ensured a diet of heavily salted and sugared fatty foods.
British colonialism bequeathed to the small island a “pandemic of chronic illnesses” like diabetes.
Post-slavery to modern industrialism
Post-slavery Barbadians health improved as they were both physically active in agriculture and eating a healthier diet.
But, with industrialism camouflaged as modernism arriving and bringing with it the powerful marketing influence of ‘Big Sugar’, things changed dramatically and detrimentally for the worse, particularly in the 1960s.
Its diabetes rate has made it one of the “amputation capitals of the world.”
When writing about the impressive approach of Barbados to fighting climate injustice (see above), I commended the leadership of its prime minister Mia Mottley.
She is now leading the fight against the health and wellbeing destruction imposed on the island’s population by ‘Big Sugar’.
The fightback began with the introduction of a 10% tax on sugary drinks in 2015. This led to a drop in weekly sales by an estimated 4.3%. In 2022 the tax was increased to 20%. Now Mottley’s government is exploring a salt tax.
By way of disappointing both past National and Labour led governments have spurned health professional advice to introduce a sugar tax.
‘Big Sugar’ is inevitably ‘Big Tobacco’s’ soulmate. In New Zealand the latter strongly opposed, including through advertising, successive and successful smokefree initiatives.
Success for ‘Big Tobacco’, however, came with its influence in the new government’s decision to repeal the legislation creating a first-time smokefree generation.
In Barbados ‘Big Sugar’ (with Cola-Cola at the forefront) is retaliating. Through advertising it is attempting to reduce diet to a personal only responsibility.
A major battlefield is now food labelling. ‘Big Sugar’, along with the wider food industry, opposing prominent bold warnings on the package of food high in sugar, salt or fats. New Zealand’s labelling is weak by comparison.
Another battlefield is children’s diets through a new school nutrition plan. Sugary drinks are banned, there are lists of acceptable smacks, and school lunches are being overhauled.
Until the last term, 85% of Queens College students ate fries daily supplemented by sugary drinks. Now the drinks have gone and fries are replaced by grilled potatoes and salads.
Wealth accumulation and contrasting responses
It is an ongoing struggle. Like ‘Big Tobacco’ in New Zealand and elsewhere, ‘Big Sugar’ isn’t giving up without a well-funded marketing fight.
In June the World Health Organisation held a ministerial meeting in Barbados on what to do about non-communicable diseases globally. The focus was on what was aptly called commercial determinants of health.
The gathering wasn’t confined to just sugar and food. Alcohol, tobacco and extractive industries were also considered. A global report from WHO is expected next year.
There is a critical root cause commonality characterising ‘Big Sugar’ in Barbados and ‘Big Tobacco’ in New Zealand. In both countries, along with most of the globe, the biggest driver is the unwavering accumulation of wealth. More than anything else this is what ultimately calls the shots.
This driver is so powerful that even seriously harmful and deadly addiction is considered to be a justified profitable commodity. Contemporary Dickensian one might rightly observe.
Fighting this powerful driver is an ongoing struggle. But, in this respect, there is a fundamental difference between the responses of New Zealand and the much smaller Barbados.
The importance of struggle is that it is from this that consciousness comes which, in turn, strengthens the struggle. Barbados struggles hard and with some impressive success against the powerful ‘Big Sugar’.
In contrast, which once New Zealand did struggle hard and with some impressive success, it has now degenerated to accepting ‘Big Tobacco’ soundbites.