Ghanaian adults just keep getting unhealthier

Ghanaian adults continue to put on more kilos. In the 1980s, just about 2 percent of Ghanaians were obese. Today, Ghana’s obesity rates have surged to about 15 percent. Like obesity, many Ghanaian adults are becoming overweight. The number of Ghanaian adults with high blood pressure (also called hypertension) is also on the rise. Recent data shows one in three Ghanaian adults has high blood pressure.

Being obese or having high blood pressure increases your chances of developing many disabling or life-threatening medical conditions including diabetes, strokes, and heart disease. Together, these diseases which are not passed from person to person, are called non-communicable diseases  (NCDs for short).

NCDs also include cancers and respiratory diseases like asthma. It was previously thought that NCDs mostly affected people living in rich or high-income countries. On the contrary, new data shows that NCDs disproportionately affect people living in low- and middle-income countries including Ghana. The majority (more than three-quarters) of global deaths from NCDs occur in low- and middle-income countries including Ghana.

According to the Institute for Health Metrics and Evaluation, an independent research center at the University of Washington, deaths attributed to NCDs in Ghana have risen very sharply over the past decade. For example, from 2009 to 2019, stroke moved from being the fifth to the second most common cause of death in Ghana. In that same period, heart disease moved from being the seventh to the fifth most common cause of death in Ghana.

In the same decade, the death rate associated with high body mass index has increased by nearly 50 percent while the death rate associated with high blood pressure has increased by nearly 30 percent, according to the Institute for Health Metrics and Evaluation. These statistics show that factors that increase a person's risk of developing NCDs as well as deaths from NCDs are on a sharp upward trend.

These are not merely statistics. I am sure you know a family member or friend who has suffered from diabetes, stroke, or heart disease. As a country, we have lost some of our best talents and productive young individuals to NCDs - Designer Kofi Ansah, Journalist Komla Dumor, Footballer Uriah Asante, and many more.

The reasons why people develop NCDs are many including changing lifestyles, genetics, and, very importantly, poor eating habits, including eating processed foods high in salt, sugar, and fat. Charles Agyemang, a Ghanaian professor at the University of Amsterdam and the John Hopkins University often says that “You are what you eat”. He is right. There is overwhelming evidence showing that people who eat more processed foods high in salt, sugar, and fat are more likely to gain weight and become obese or develop hypertension.

The increasing number of people developing NCDs in Ghana is a deep concern considering the country’s limited medical resources including healthcare professionals and infrastructure. Our nation lacks enough doctors and nurses, let alone those specializing in the management of NCDs. Further complicating the situation in Ghana, medication for high blood pressure and management of NCDs is expensive and affected patients may either ration to save money or seek alternative forms of treatment which are most often ineffective.

While there is a National Health Insurance Scheme, it doesn’t cover some medications for treating NCDs. Further, it doesn’t cover devices for monitoring important health measures including blood sugar or blood pressure.

Given the above, many doctors and public health experts have expressed their fear of the consequences of the continuing rise in NCDs among Ghanaian adults. Equally worrying is the fact that efforts to educate Ghanaians about the health risks associated with these conditions, including avoiding poor diet do not seem to be working. Lessons from many regions of the world show that telling people that there is a problem often does not change their poor health-seeking behaviors.

Very often, such health education should be supported by a national policy or regulatory framework. At a time when the nation is heading towards an NCDs crisis, the food/beverage industry is pushing harder against stronger public health measures aimed at dealing with the very cause of this impending NCDs crisis. To safeguard the health of our citizens, we need to implement policies that will augment the efforts of our doctors and public health experts in building a healthier Ghana.

Currently, the Advocating for Health Coalition which comprises as team of academics, civil society organizations, public health associations and nutrition professionals is advocating for the creation of a favourable environment and stakeholder buy-in for food-related fiscal policies in Ghana through evidence-informed advocacy and scholar activism.

It’s not all bad news. As a country, we are making good progress in some health areas including reducing the death rates in under-5 under-1 age children and meeting targets for maternal, infant, and young child nutrition. However, we have a lot to do when it comes to preventing NCDs.

According to the 2022 Global Nutrition Report, Ghana has shown limited progress toward achieving the NCDs targets. For example, Ghana has not met the targets for reducing obesity and high blood pressure. Lessons from policy and regulatory changes that inspired improvements in successful areas may be valuable in curbing the high rates of NCDs in Ghana.

Footnotes to readers

Overweight is when your body mass index (BMI) is 25.0 to less than 30 kg/m2. Obesity is when your BMI is equal to or exceeds 30 kg/m2.

Diabetes is diagnosed by your doctor when your blood sugar is more than the normal value. Similarly, hypertension is when your blood pressure is greater than the normal value.

By: Charles Hayfron-Benjamin MD PhD

Charles Hayfron-Benjamin is a senior lecturer at the University of Ghana Medical School and an expert in noncommunicable disease prevention including heart and lung diseases.