High blood pressure, diabetes and other "lifestyle diseases" are no longer just for the rich and are wreaking havoc among South Africa's poor.
"Lifestyle diseases" refers to illnesses we can prevent by changing the way we live, like eating better, drinking less alcohol and quitting smoking. Hypertension or high blood pressure, diabetes and heart diseases are some examples of lifestyle diseases, which are often also called non-communicable diseases (NCDs).
For many years, NCDs like these were associated with the wealthy but not any more in a trend that is likely to get worse, according to Bob Mash, professor of family medicine and primary care at Stellenbosch University's Faculty of Medicine and Health Sciences.
"NCDs are emerging among all South Africans, particularly those coming from low socio-economic and poor communities," Mash says. "Hypertension, diabetes and asthma are among the top conditions currently seen in primary care, and we expect (cases) are going to mushroom even further."
About one in ten people living in Cape Town is estimated to be diabetic, however recent research in Cape Town's low-income Bellville-South area found rates of diabetes three times that.
Good food out of reach
According to Mash, poorer communities may struggle to not only find safe places to exercise but also to afford healthy food.
"If you go to Khayelitsha, people will tell you they can't afford to buy healthy food," he adds. "The food industry doesn't make healthy food accessible - if you go to a supermarket in Khayelitsha you'll find all the fattiest cuts (of meat)."
And NCDs are affecting South Africans at younger ages than one would think.
"A lot of people die from NCDs in old age, but here a lot of these deaths are in the working age population," he tells Health-e. "People in their 40s, 50s and 60s are developing and dying from these diseases."
He believes that the solution to the NCD epidemic lies in prevention. He suggests that health authorities draw on lessons learned from the HIV epidemic, such as awareness campaigns and patient management programmes, to curb the problem.
South Africa will also need to get to the root of risk factors. In 2013, Health Minister Dr. Aaron Motsoaledi amended the Foodstuffs, Cosmetics and Disinfectants Act to set a maximum salt content for an array of food. New restrictions would require most bread producers to reduce the salt content of loaves by one percent by 2019.
According to Mash, bread is the biggest contributor of salt to South Africans' diets. Reducing salt content in bread may lead to massive reductions in the number of people who die of stroke and heart disease each year, he added.