the hot mess that was @rcgp labelling COVID-19 a lifestyle disease: a thread from an (incredibly disappointed) medical student who used to be a social worker

before coming to medicine, i worked for almost 5 years as a youth/social worker. all the people I worked with were incredibly poor, food insecure & a majority had 1 type of “lifestyle disease” or another

the most important thing I learned in those 5 years is that poverty makes you sick. the violence of destitution & exclusion is brutal & it wreaks havoc on both the mental & physical health of individuals, families, and communities

i came to med from a “non traditional “ background (humanities grad, first in my family, ethnic minority) and have been shocked by the way socioeconomics of health is taught. especially worrying when you consider that the majority of med students are *very* upper/middle class

to be clear: in a country as unequal as the UK, there is no such thing as a “lifestyle disease”. that label is null & void in the face of a society that violently shapes the parameters of its citizens lifestyles from the day they’re born. these are diseases of poverty

the whole idea of a lifestyle disease ignores the structural forces shaping our patients lives & swallows wholesale the logic of capitalism by placing the onus on individual behaviours. it ignores all of the very complex factors that affect many low-income people

medicine claims to be evidence based, yet we continue to ignore lots of v good research that says, for example, that calories are a flawed concept. we ignore that obesity is a disease of exclusion &
a result of the sad fact that modern food companies exist to make money, not food

“lifestyle medicine” has taken off in tandem with the instagramification of our lives & it’s dangerous. should we be encouraging our patients to make healthier choices that will improve their quality of life? of course! but we do it badly

what we’re taught in this regard is very poor (all calories/keto/crossfit) when actually, just telling patients to put one spoon of sugar instead of two in their tea would make a bigger (& more achievable) difference. less glamorous, more effective

every single time we talk about “lifestyle diseases”, we need to be discussing the top-down changes that are the only real cure. we need to be talking about the underfunding of social services, the lack of food regulation, the drastic effects of poor housing, the gig economy

as a medical student who is considering GP, I was very disheartened by RCGP labelling COVID a lifestyle disease, and then claiming it had been a gimmick to promote their conference. the lived realities of our most vulnerable patients are not a “controversial” tag line

thank you to @Kitdempsey @HosniehMarbini @Dr2NisreenAlwan @AmeenKam @drjoshuawolrich and everyone else who spoke up against this!