“As long as poverty, injustice and gross inequality exist in our world, none of us can truly rest.” — Nelson Mandela.
Malaysia, often celebrated as a food haven, is increasingly grappling with the health consequences of unhealthy lifestyles, notably obesity and diabetes. Malaysia is the top country in Southeast Asia in terms of diabetes incidence, mostly attributed to unhealthy dietary habits such as excessive intake of refined carbohydrates and inadequate physical exercise. Predictions indicate that around 7 million Malaysians adults aged 18 and older will be affected by diabetes by 2025. Meanwhile, obesity is viewed as a ‘ticking time bomb.’ In conjunction with the month of “Malaysia Sihat,” the Malaysian prime minister urged Malaysians to maintain a healthy lifestyle through a healthy diet and by allocating time for exercise and leisure, implying work-life balance.
In a commendable move, the Malaysian government proposed a 20% tax increase on sugary drinks to foster a healthier nation. Additionally, the non-compulsory legislation of flexible working arrangements (FWAs) indicates a positive shift in ensuring the goal of work-life balance. If these two are effectively combined, they may benefit the cause. However, the crux remains: how can we ensure that economically and socially marginalised or vulnerable groups can lead a healthier lifestyle in a society that often sidelines them?
Poverty in the nation of plenty
While Malaysia has experienced remarkable economic progress over the past decades, this economic prosperity has yet to translate into improved wages for the country’s lowest-income earners. The World Bank reports that the cost of living in Malaysia has outstripped wage growth, leading to a decline in real incomes, especially among the bottom 40% (B40) and middle 40% (M40). The current minimum wage in Malaysia, which is RM1,500 and is scheduled to be reassessed in the upcoming parliament session, falls dramatically short of the living wage proposed by Bank Negara Malaysia (BNM) of RM2,700 and the RM2,100 suggested by UNICEF Malaysia. Forbes, in parallel, approximates that the collective wealth of Malaysia’s top 50 families and individuals amounts to around US$81.6 billion. This widening gap between the rich and the poor means that many low-income workers, predominantly in the B40 bracket, struggle to afford even basic necessities, let alone healthier food options.
Limited by economic constraints and demanding work schedules, the working class frequently has limited choices, forcing them to select cheaper and less nutritious food. Khazanah Research Institute’s (2024) discussion paper revealed a correlation between income, lack of time and poor eating habits, highlighting Malaysia’s dual issues of ‘undernutrition’ and ‘overnutrition.’ A separate study conducted on the urban poor showed a notable prevalence of unhealthy food intake and inadequate healthy lifestyles among the B40 demographic. Specifically, 89.5% of adults fail to consume sufficient quantities of fruits and vegetables, while 68.1% consume sugar-sweetened beverages on a weekly basis. Low-cost housing communities demonstrate unhealthy eating habits characterised by excessive consumption of intensely processed and high-calorie local foods. A UNICEF study highlighted that over 10% of children in low-cost flats in Kuala Lumpur had fewer than three meals daily, with urban adolescents in food-insecure households showing poorer health status and diet quality.
Overall, the underprivileged segments of society experience food insecurity, leading to nutrient deficiencies and increased risk of chronic diseases. It is perplexing that this phenomenon occurs in a country renowned for its abundant variety of cuisine, particularly in a country that asserts to have a robust economy and is conducive for billionaires to amass more riches. Is this a multiverse of realities determined by individual possession of wealth?
The Cost of Healthy Eating
Healthy diets are becoming increasingly unaffordable for low-income Malaysians. Fruits and vegetables, essential for a healthy diet, are among the most expensive food items, making them inaccessible for those not within the living wage standards. Increasing food costs and static wages compels low-income households to prioritise more affordable protein choices that provide energy and satisfy their taste buds, rather than nourishing foods such as fruits and vegetables. Consequently, this compromises the quality of their diet and increases the likelihood of health problems. Suppose the food options are affordable, such as raw vegetable supplies and fruits—what then hinders healthier food consumption?
Time Poverty
The KRI’s study noted long working hours and managing other household responsibilities leave little time for planning and preparing healthier meals. Many Malaysians, especially the working class, face severe time limitations due to the demands of paid and unpaid work. The working class in question predominantly comprises individuals from the B40 income bracket, earning minimum wage or below the living wage threshold. Preparing nutritious foods frequently necessitates time that individuals lack, resulting in a reliance on convenient, processed meals. Employed spouses and single-parent families are among the most adversely affected demographics due to this issue. Gender plays a significant role in this regard, as women typically assume the majority of household and caregiving responsibilities. About 62% of women have cited household chores as a significant obstacle to participating in economically rewarding activities. In contrast, workers’ retention and attraction initiatives, such as tax relief propounded by institutions like TalentCorp, exclude low-income earners from its thoughtfulness.
Back to the issue of healthy eating, the time necessary to purchase groceries and allocate the time to cook meals is highly constrained due to the increasing labour demand at workplaces. The essential care workforce, which is also predominantly female, in healthcare and social care exhibits burnout levels that have been documented in various studies but remain inadequately addressed. Moreover, the need for more public transportation and the absence of flexible work arrangements result in working people spending more time on the road (166 hours of time spent driving and 81 hours due to congestion) instead of engaging in meaningful activities. In simpler words, they just do not have the energy and time to have leisure and family time or to cook for another hour or so when they get home.
Policy Interventions
Ultimately, the complex interplay between poverty, time constraints, and the high cost of healthy eating has resulted in a concerning state of nutritional and health challenges for many Malaysians. Addressing this issue requires a multifaceted approach that tackles the underlying economic and social determinants of health.
While the tax on sugary beverages is a step in the right direction, it is not a standalone solution. To truly address the health crisis, Malaysia must implement comprehensive measures.
Increased Wages
The government must show serious intentions to raise the minimum wage to meet or exceed the living wage proposed by BNM and UNICEF, either RM 2,700 or RM 2,100, which is crucial. This increase will provide low-income families with the financial capacity to afford healthier food options. At the same time, make fruits, vegetables, and other nutrient-rich foods more accessible and affordable through cost subsidies or direct cash transfers, specifically to lift their economic burden.
Widened Public Education & Healthy Options in Schools
If class affiliation does inform and influence dietary preferences, Malaysians should be educated by public health campaigns on the significance of a well-balanced diet and the hazards linked to inadequate nutrition, perhaps through school, as the Malay proverb suggests: “melentur buluh biarlah dari rebungnya.” It is recommended to broaden the Rancangan Makanan Tambahan (RMT) program to guarantee universal access to nutritious meal choices for all schoolchildren. From my recollection of my school days, the food options in school canteens included nasi lemak, sugary beverages, and burgers, which do not qualify as nutritious meals. I presume the state of school canteen food has not radically changed.
Flexible Working Arrangement
Despite the current legislation being optional and lacking clear guidelines on the eligibility for FWA recipients, it is imperative for the government to take the lead in making FWAs mandatory. This will also allow workers the necessary time to prepare nutritious meals and participate in physical exercise, enhancing their general health. Similar to the intentions expressed by our prime minister, Anwar Ibrahim. This also reduces the hours and costs spent commuting from work to home and vice versa.
Improving Social Care
As mentioned earlier, household duties such as cooking, grocery shopping, and caregiving fall disproportionately on women. Therefore, policies that address this unequal distribution of unpaid care work are crucial. One way to move forward is to increase and improve access to affordable and quality childcare and eldercare services. This reduces the time and effort required for these essential household tasks and allows families to spend their income on healthy food options rather than expensive care services. Studies have shown that low-income earners are forced to spend a significant portion of their income on food. If it continues to be so, possibly it could hinder their access to care services as their wages are allocated to basic necessities. By providing subsidised care centers or high-quality public institution-owned care centers, this imbalance can be addressed effectively.
In conclusion, while Malaysia’s tax on sugary drinks is a laudable effort towards cultivating a healthier nation, it must be part of a broader strategy that addresses economic disparities, food affordability, and time constraints. By tackling these issues comprehensively, Malaysia can ensure that all its citizens, regardless of socio-economic status, have the opportunity to lead healthier lives.
Ilaiya Barathi Panneerselvam
References:
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