The health and wellness bubble of privilege

I cannot say how relieved I am that winter is finally over. This one was particularly shit, and saw me get the flu twice, a chest infection, and then, a couple of weeks ago, end up in hospital with pneumonia. The kids didn’t come through unscathed either, with a resurgence of asthma and chest infections. As I’ve spent most of the last fortnight lying in bed recovering, I’ve considered throwing the towel in on this blog, and Instagram, largely because for me, feeling unwell = feeling down = low motivation = what’s the point?

But then an online post which suggested that people who complain that healthy eating is expensive just have their priorities wrong got me fired up again and reminded me why I started this in the first place: because I love food, and I also have things to say about food (and other stuff). I must be feeling better, because the urge to rant has returned.

This period of illness brought to a head something that has irked me about the health and wellness sector over the last few years, in particular a couple of ‘key messages’ that I see and hear regularly:

1. That food is medicine and prevents illness
2. That healthy eating isn’t expensive – it’s just a matter of personal choice and responsibility; and people just need to get their priorities in order!

Message 1: Food is medicine and prevents illness

Look, there’s truth to this, undoubtedly. I’ve written before about how changing the way we eat improved my physical and mental health, my children’s and husband’s health, even the health of my parents (both of whom have chronic health issues) and some of my friends. I have more energy, and I hope to be able to avoid some of the chronic health issues from my family history, in my later years. I also hope my kids will continue to develop healthy eating habits.

But while food can build better health and help to prevent illness, it doesn’t provide total immunity. I take issue with the “pay now (for organic food) or pay later (in medical bills)” message that I regularly hear, partly because it blindly ignores privilege, which I’ll discuss below, but also because it’s not true. I eat healthier than anyone in my household, but my husband has always had a stronger immune system (including in the ‘old days’ when he preferred Arnott’s biscuits over rolled oats). Both of my children have asthma. I don’t believe I could have done anything else, diet-wise or otherwise actually, to avoid getting the flu and pneumonia this year. All that messages like these do, is shame unwell people into thinking it’s somehow their own fault.

Message 2: Healthy eating isn’t expensive – it’s just about personal choice and responsibility

This one has sat uncomfortably with me for years. I generally have quite left-wing views, and I strongly believe that society and the government has a key role to play in reducing inequality and supporting people, particularly those who are more disadvantaged or vulnerable. The health/wellness sector seems to operate on a much more liberal premise, that it’s just about individuals needing to ‘get their priorities straight’, ‘get educated’ and simply make the choice to eat healthy food (or exercise, both are true); rather than also considering how social and structural barriers play a part in this.

Again, there’s some truth to this, and for some people more than others. But the ‘personal choice’ doesn’t sit in isolation away from the complicated lives that people live. People are complicated, are part of complicated families, in complicated communities, have complicated family histories and intergenerational baggage, all of which contribute to various enablers and barriers in their lifestyles.

I’m really fortunate and privileged to have been able to make diet changes over the last few years. Three years ago, I wrote that healthy eating IS expensive, and in order for it to be most affordable, requires a certain amount of privilege to begin with: a) financial capital, to be able to buy in bulk at reduced rates; b) time, to prepare and cook food from scratch; and c) space and facilities, such as a deep freezer, to store all those cheaper homemade stocks, bulk-buy meats, cooked beans and extra dinners. For example, I buy rolled oats in 15kg batches from Honest to Goodness. We go through HEAPS of oats (looking at you, cyclist husband), and I’ve found this is one of the cheapest ways to buy it. But it does mean forking out $60 to begin with, just for rolled oats, and having bags and bags of the stuff stacked up in my kitchen cupboards. This is do-able for me, but financial capital and space is not a privilege that everyone has.

Fresh produce can also be expensive, even when buying seasonally, especially when we are encouraged to eat a diverse range of fruits and vegetables, and seven serves a day. I’m aware it’s difficult to buy fresh produce in some regional areas of Australia, where it’s either rare to come by and/or extremely pricey. We spend between $70 and $100 a week on fruit and vegetables for a family of four (before meat, dairy, pantry items and other household products). When money’s tight for us and we need to rein in our grocery bill, we inevitably lean towards meals that are more reliant on pasta, rice, bread and noodles to fill tummies, over more nutrient-dense dinners. “Just grow your own!” I hear people saying. Come on… That’s not that easy either, unless you’ve got an established garden already. Growing your own produce also requires capital, time and space to set up (and then crossing your fingers and hoping the goods actually grow).

But these are only a few of the enablers and barriers. There are other enablers that help us make the choice to eat well. Such as having parents who love good food and teach their children how to grow, prepare and cook food, socioeconomic status, school education, mental health and other health issues, social values, social circles, and even the physical environments we live in.

Public health is experienced on a social gradient. That is, people who are more disadvantaged or vulnerable experience worse health, and those who are more affluent and advantaged experience better health, at a population level, both across countries and within countries. This isn’t a coincidence: it is shaped by social, economic and structural inequities. The World Health Organization describes the ‘social determinants of health’ as the ‘circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness’, like socioeconomic position, gender, ethnicity, social class, income, education, occupation, as well as living and working conditions, biological and psychosocial factors. These in turn are shaped by economics, social policies and politics; and they all influence the opportunities that are available to us and the decisions we make.

Sometimes all of these enablers are in place and it’s still not enough. I wasn’t even aware that my diet wasn’t particularly healthy, until there was a trigger: when my mother was diagnosed with diabetes in 2014. Through my own subsequent research, I started to realise that the information we are fed by the food industry is largely misinformation and manipulation. But even with this realisation, it can be hard to make sense of: there’s so much conflicting advice about fat, sugar, dairy, meat, grains, carbs, oils, and with even prominent nutritionists promoting mainstream chocolate brands, it can be confusing. While people who have already changed the way they eat can be quick to judge others for not making the same changes, it’s easy to see why it’s not as simple as ‘priorities’.

While a lot of this is big picture stuff, I do also wonder at times about how the health and wellness sector may also be exacerbating this divide, and whether we are alienating people with our quinoa, spelt flour and nut milks, smoothie bowls, chia puddings, and fermented veggies. I’m not excluding myself from any of these by the way. Except maybe smoothie bowls, I’ve always just found them cold and sloppy, but each to their own. 🙂

So what can we do? Well, in addition to broad social policy change (too big to go into here and covered elsewhere) I’d really love to see some of the big players in the online health and wellness sector look at the role they could play in helping to increase access to healthy eating. Such as through political advocacy, creating accessible and realistic programs, or even by providing concession discounts. But I also hope that we can all stop being so black and white about blaming individuals for illness and lifestyle, and start acknowledging the bigger picture of privilege.

I’m aware that in posting this I’m going against the grain of common thought… So I’m keen to hear your thoughts too. What do you think?

Erin xx

Post-script: Thank-you for reading to the end – you deserve a prize!