It isn’t often someone says something that completely changes your opinion.
But this happened on Tuesday morning over a coffee with Sneh Khemka, president – international population health solutions at Aetna.
To date, I have been a keen believer in individual responsibility when it comes to healthcare (albeit with a healthy dose of socialism to support people when needed and admiration for the NHS).
However, Sneh talked passionately about the impact government policies, local infrastructure decisions and so on have on our lives.
If you live in a country where you are forced to drive everywhere because there are no pavements or public transport and the facilities you need to access are too far to walk to, you are likely to drive everywhere. Think of the US and how few people walk anywhere in most of the country (the likes of New York are an exception). That is having an impact on waistlines across the pond.
I think of my own home country of South Africa, where crime prevents people from walking as freely as they used to, across all socio-economic groups. For a variety of different socio-political reasons, it is now the fattest country in sub Saharan Africa, according to research from the Lancet in May.
Rules around food advertising are strict in the UK, but less so elsewhere. This level of influence impacts people’s eating decisions.
Poor wages limit food choices, and often steer people towards cheapness but not healthiness.
My eyes have been opened and I hope to be less sanctimonious about people who appear to be unhealthy through their own fault.
Governments have a great influence. And so do employers: from workplace design, activities organised, stress levels managed and healthy food encouraged.
Health is not a personal issue after all.