Ronald Eporu: Here’s Why Monitor’s ‘Poor living longer, rich dying younger’ report was insightful

By Ronald Eporu

The Daily Monitor report of October 08, 2024, titled ‘poor living longer, rich dying younger’, was creatively assembled and truly insightful. I hope researchers across Uganda took keen interest in this report and sought to address unanswered question(s) raised in it. However, none of the researchers or health experts who were consulted for this report gave a convincing science-backed explanation.

The Daily Monitor analyzed two separate reports from the Uganda Bureau of Statistics (Ubos) including the 2022 Multidimensional Poverty Index report and the 2024 National Population and Housing Census report, and a report from the World Bank, which showed that people in regions with high poverty rates lived longer than those in areas with lower poverty rates and better access to social services.

In eastern and northern regions, which have poverty rates of 40 percent and above, people on average live 70 years and above. But in central and western regions, which have lower poverty rates of between 15 and 26 percent, the life expectancy is 63 and 64.7, respectively, according to the census and World Bank reports.

The 2024 census report attributed the increase in life expectancy at birth between 2014 and 2024 to improvement in childhood mortality rates, which are core in determining life expectancy at birth. The Ubos report postulated that an increase in life expectancy could be attributed to improvements in healthcare.

However, people in regions with poor coverage of health facilities and poor water and sanitation indicators had better life expectancy. Consider the fact that our national referral hospital and most private health care facilities are located in the central region, which had a lower life expectancy than eastern and northern regions; thus, these findings contradict the proposition made by Ubos attributing increase in life expectancy to improvements in health care.

Following my extensive review of science literature on longevity, with a view to slow down ageing or delay onset of chronic diseases, I found a study conducted by Anne-Julie Tessier and colleagues (2025) revealing that eating high-quality carbohydrates from whole grains, fruits, non-starchy vegetables and legumes in midlife was linked to healthier aging.

Their finding is consistent with our national finding of the poor in northern and eastern regions, who commonly eat whole-grain bread made of millet and sorghum, living longer than their affluent counterparts in central and western Uganda, who commonly eat matooke, white rice, refined wheat, Irish potatoes and white posho. Fiber-rich whole-grain carbohydrates rank better at maintaining stable blood sugar, for prevention and control of non-communicable diseases, than highly refined carbohydrates.

Secondly, calorie restriction, which refers to a 20-40% reduction in calorie intake, was associated with longevity in various studies conducted on species like fruit flies, nematodes, yeasts, hamsters and several strains of mice. It is obvious that most affluent people in Uganda consume highly processed high-calorie foods whereas the rural poor in eastern and northern regions with limited access to processed food tend to eat minimally processed nutrient-dense foods.

I spent one week in Karamoja in December 2008 where I joined a team of charity workers for a medical outreach in rural areas and sorghum bread is commonly consumed. It was not unusual for local residents that I met to live on only one meal in a day or utmost 2 meals, which is associated with a slower rate of ageing. I found it unusual for a woman in her early fifties to be carrying a toddler whom she claimed was her child whereas I thought she was carrying her grandchild.

Genetics and access to health care facilities pale in comparison to diet when ranking determinants of human longevity for prevention and control of non-communicable diseases. That said, we still need to improve access to health care. Ronald Eporu is a Medical Researcher. (For comments on this story, get back to us on 0705579994 [WhatsApp line], 0779411734 & 041 4674611 or email us at mulengeranews@gmail.com).