Poor People Don T Just Get Poor They Get Sick Too

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They used to say that diabetes was a “Datuk disease”. The buncit, golf buggy, teh tarik kurang manis ordering elderly “Datuk”, or that “Tan Sri” who eats steak every night and sees his doctor more often than his grandchildren.
For the longest time, non-communicable diseases (NCDs) like diabetes, high blood pressure and cholesterol were thought to be the success story of the rich and privileged because they’re the ones with the money to indulge.
However, this has long been proven to be a misconception. These days, NCDs are hitting the poor harder than anyone else.
A recent report done by Protecthealth, the Peka B40 2024 Report, stated that 70 percent of their participants in their screening had at least one NCD, and the reason isn’t because the poor suddenly developed expensive taste buds.
It’s because poverty itself has become a disease.
High costs of healthy food
Let’s start with food. Eating healthy in Malaysia can bankrupt you faster than parking your car in a car park in the middle of Kuala Lumpur for a day.
A small pack of apples or pears can set you back RM15, while a plate of nasi lemak with ayam goreng costs half that and still leaves enough for teh o ais limau.
Sure, grapes are an imported fruit and are subject to our new high tariffs, but you have to admit that junk food is way cheaper than healthy food.
So when people say, “Just eat more vegetables lah,” I just laugh because you think a B40 family doesn’t want to?
Go to a sundry shop and see what’s available. Instant noodles, processed meat like burger patties and sausages, and packet drinks are all way cheaper than fresh chicken and Cameron Highland vegetables.
That’s not even mentioning the convenience that these instant and processed food provides.
Remember when the government tried implementing the sugar tax back in 2019 (it’s still in effect now)? Well, it’s actually a good idea to make sugary drinks more expensive because the logic is that it will reduce consumption.
Unfortunately, Malaysians didn’t stop drinking soft drinks. Some companies absorbed the tax, others just shrank their bottles and kept the same price. Many switched to even cheaper sugary drinks or liquid cordials with enough sugar to fuel a five-year-old kid to the moon.
So, although the sugar tax was a good start, without making healthier options affordable, it just didn’t serve the purpose or achieve the objective.
Time is a luxury
There are also those who say: “Just exercise lah! Go jogging or join a gym!”.
Most B40 workers don’t have the luxury of free evenings. They work long hours, sometimes multiple jobs, spend hours in traffic, and live in apartments or flats the size of those expensive parking lots in the middle of Kuala Lumpur.
By the time they reach home, it’s midnight. As for gyms, a couple hundred ringgit a month is a week’s worth of groceries. So who are we kidding? We have to realise that it’s not laziness, it’s life.
And then there’s stress, which isn’t just mental, it’s physical too. Worrying about bills, rent, kids’ multiple fees, and surprise hospital bills keeps your mind spinning and spiralling.
Over time, this raises blood pressure, spikes your sugar levels, and basically destroys your health. Being poor is toxic.
We also like to say that Malaysian food is unhealthy, but I refuse to believe that. Traditional Malaysian cuisine is actually packed with nutrition: ulam, ikan bakar, sayur lemak, tempeh, and dhal.
The problem isn’t our food, it’s what we’ve done to it. Everything is now fried, oily and eaten in excess.
Nasi lemak on its own is not evil. It’s coconut rice, anchovies, cucumber, and sambal. It’s pretty balanced. But then we add fried chicken, sotong goreng, kerang sambal, greasy fried eggs and then we top it off with teh tarik, and suddenly it’s a gigantic plate of heart attack.
Reactive policies go nowhere
Meanwhile, the government spends millions of ringgit a year treating NCDs. That’s enough to build schools, hospitals, or maybe even another MRT line.
Instead, we’re paying for dialysis machines, insulin, and heart surgeries, all the expensive consequences of a problem we could have prevented with smarter policies.
Imagine if just a fraction of that money went into making fresh food cheaper, removing tariffs on imported fruits and vegetables, or creating safe parks and community spaces for exercise in every housing area. Prevention could actually be better than cure.
Catchy slogans like “Sihat Malaysia” are nice, but posters don’t lower cholesterol, rousing speeches don’t reduce blood sugar and motivational hashtags on Instagram definitely don’t make instant noodles less accessible.
What we need are actual policies - subsidies for vegetables and fruits, closing sugar tax loopholes, removing tariffs that make apples cost as much as gold and reforming school canteens so kids don’t grow up eating fried nuggets and sausages every day.
Here’s the honest truth: being poor is the first illness. It shapes what you eat, how you move, how you cope, even how long you live.
Until we admit this, we’ll keep blaming people for their “bad choices” when really, many never had a real choice to begin with.
The idea that NCDs are only for the rich is a relic of the past. Today, the poor are the ones carrying the heaviest burden. I believe that the government needs to help protect the vulnerable, like the B40, and do something to help them.
Health should not be a privilege. It should be a right, and if nothing changes, the only thing that will stay truly healthy in Malaysia is the instant noodles and processed food industry. And trust me, no amount of running can save us from that. - Mkini
ZAN AZLEE is a writer, documentary filmmaker, journalist and academic. Visit fatbidin.com to view his work.
The views expressed here are those of the author/contributor and do not necessarily represent the views of MMKtT.

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