Let Them Eat Cake: Can South Africans Live Healthy Lives If They Have Empty Bellies?


Let Them Eat Cake: Can South Africans Live Healthy Lives If They Have Empty Bellies?

by Dr Anja Smith*

The deeply enlightening brief series on the impact and nature of non-communicable diseases by Percept has just been published. It considers topics on non-communicable diseases in South Africa in 14 briefs.

The first brief refers to, among other things, what the World Health Organization (WHO) calls “modifiable risk factors”. Modifiable risk factors are aspects/parts of our lives that can be changed to prevent diseases from developing – or improve them once they’ve developed.

I often wonder about what South Africans eat now and whether it is possible to improve people’s diets. How do people who live from grants and who do odd jobs manage to provide food for themselves and their families? It is already difficult to do this within the constraints of a salary, never mind the limits of a child support grant (R480) and small payments here and there. In 2022, it will get even more difficult.

The first impact of the very high inflation we are expecting in 2022 became evident in April this year when inflation data for March was released. In March, annual consumer price inflation (CPI) increased from 5.7% in February to 5.9%. This means that, on average, the prices of goods in the basket of items used to calculate CPI increased by 5.9% in March 2021 to March 2022, with the items that contributed the most to this increase being transport (a big expense item for low-income South Africans), housing, utilities, food and non-alcoholic beverages.

The increase can be seen as a signal of what is to come, and we are bracing ourselves for far higher increases later this year. South Africans are facing an expensive year when most are already living off little money.

How much do South Africans need to live? The Pietermaritzburg Economic Justice and Dignity (PEJD) Group calculates what a monthly basket of food for a household costs. They do this using data from five different national locations: Johannesburg, Durban, Cape Town, Springbok and Pietermaritzburg.

The components of the basket are insightful. There are no luxury items, just basic items like maize, rice, tinned pilchards, basic meats and some fruits and vegetables. The basket is not linked to an ideal food basket to ensure health and wellbeing – in fact, the PEJD describes it as “not being nutritionally complete”. Rather, it is based on the most common items that low-income women in the five locations buy for their families, given their limited budgets[1].

The average cost of a household food basket (for a family of seven) was R4,542.92 in April – 8.2% higher than a year ago. In addition, the increase in the cost of the basket is 2.3 percentage points higher than the increase in general consumer prices.

How does this compare to the ideal food expenditure: the amount of money required for buying a basket of healthy food? If we wanted the same household of seven people to buy food to meet basic nutrition (or what PEJD calls “a basic nutritional food basket”) it would cost R942.69 more at a total cost of R5,485.62. In addition, the PEJD reports that in April, the child support grant was 40% lower than the average cost to secure a basic nutritious diet for a child.

We are still a very long way off from ensuring that the majority of South Africans have access to full bellies, never mind nutritious food required to ensure health and wellness.

We are confronted by stark inequalities in the food space. Newspapers write articles about the food wastage of supermarkets and wealthy South Africans, alongside reports of children dying from starvation. Technology can help to bridge some of the gaps between food abundance and extreme food shortages: initiatives like the Farmlink Project, which connect abundant food locations (farms and supermarkets) to places that need food (like shelters) are springing up across the world. But these are piecemeal solutions that don’t solve systemic problems.

There are no easy solutions to first ensuring that all South Africans have enough to eat, and second, that what they do have to eat is nutritious and able to ensure good health. We need food systems (including transport and logistics) that take good, nutritious food to where people work, commute and live. But more fundamentally, South Africans need a level of income that enables them to buy the food that can fuel health on an ongoing basis.

Sustained health and wellness from food can only be experienced when people are able to buy daily what they need in an easy, convenient way. For that, we need more than just higher grants. We need jobs and economic opportunities. We need people who spend less time travelling to and from work and have more time for food preparation. We need a more equal society, in all respects.

More on this will be written and shared as this blog series progresses and we reflect on health, wellness, and wellbeing in multi-dimensional ways.

[1] Once the list of items that people buy is finalised (it’s never final, though, as it continues to be updated), monthly information on food prices is collected at 44 supermarkets and 30 butcheries.

* Dr Anja Smith is a development economist and part-time academic. After spending eight years consulting in access to financial services and financial inclusion, Anja changed her research focus to health and health systems through a PhD focused on various health system questions. She has since deepened her consulting and academic work in health. Anja works as an independent economic expert and has a part-time position as researcher at the Economics Department of Stellenbosch University. Her work requires her to write extensively about socio-economic topics across various sectors. She enjoys sharing ideas and stories with people, and finding ways in which life can be made better for more South Africans. The article above reflect Dr Smith’s views.

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