I was stunned when I was diagnosed with pre-diabetes at the age of 24.  Not as much with the fact that I have it—my family has a history of Type-2 diabetes—but that I got it so young.

In the next few years, as I struggled with weight gain, cystic acne, and polycystic ovarian syndrome (PCOS), I got to know several women my age were battling the same health issues—whether it was cardiovascular and hormonal issues or cholesterol and high blood pressure.

In fact, multiple women in my family who struggled with the same in their youth were either not taken seriously or were too caught up with raising a family to take care of themselves properly.

If this feels familiar, you’re not alone. Poor representation of South Asian women is a global norm.

When it comes to the reason why South Asian Indian women's health is different, global clinical health research reveals that they are rarely represented. This lack of medical awareness has led to terrible consequences, where instead of trying to understand differences, they were exploited with stories of their bodies being used for medical experiments.

There’s a global health crisis, and it is disproportionately impacting women, as highlighted in this report by the World Economic Forum. Women’s general health, in terms of preventative care, mental health, safety, and basic needs, is deteriorating as per a 2021 global survey conducted by medical technology company Hologic. But for South Asian women, things are a tad different and, as a result, complex. 

There are 1.9 billion South Asians worldwide,  making up 25.2% of the world population. South Asian women make up nearly half of that population, and their lives are at greater risk than everybody else.

A US team of researchers called Masala—Mediators of Atherosclerosis in South Asians Living in America—found that South Asians are more prone to developing higher blood pressure, high triglycerides, abnormal cholesterol, and Type-2 diabetes at lower body weights than other ethnic groups in the US.

Cultural and socioeconomic factors at play

Last year, a South Asian medical professional, Dr Mubin Syed, went viral on TikTok and Instagram for a video that linked South Asians’ predispositions towards health risks with British colonisation. In the 18th and 19th centuries, he says in the video, South Asians survived 31 famines, rendering them “starvation-adapted”.

So, much like generational trauma, the generational tendency to generate and store fat and not burn it off has resulted in the group’s health risks today. This research is backed by another published by Brown University that linked famine-afflicted China to an increased hyperglycemia risk among generations of Chinese people, even without a famine.

“In the modern era of abundance, it becomes an evolutionary mismatch. Our adaptation to scarce food availability is no longer suitable for our environment of food abundance,” he told Huffington Post.

Over time, South Asian genetics have developed ‘starvation adaptation’, which allows us to process food efficiently and store fat during times of abundance. Today, with our diet and nutrition having increased access to high-fat foods, this adaptation has been rendered, well, risky. 

For South Asian women, these factors are exacerbated by a combination of cultural and socioeconomic factors.  Endemic social issues continue to be prevalent, from neglect of sexual and reproductive health to poor maternity care and lack of awareness and access to healthcare in general for women and girls.

Culturally, South Asians love big family gatherings and high-carb food. At the same time, South Asian women have been found to do less physical activity than men because of conservatism and societal stigmas around women using public spaces or mixed-sex workout facilities.

Bridging the gap is a long road ahead

Despite significant steps in the right direction when it comes to workforce participation, cultural practices and traditions continue to bind most women to their homes. Most South Asian families prioritise men when food is served, leaving the leftovers for women, resulting in diminished chances of getting nutrition.

With these challenges, South Asian women have historically been misdiagnosed and medically gaslit. While the world has advanced substantially with medical breakthroughs, those obtained explicitly through the research of South Asian women’s experiences are extremely rare. Women from this region have the potential to find solutions to most of the world’s problems. It’s imperative that the world keeps them healthy while doing so.

Medically reviewed by:

Dr Sujata Chakravarti, Family Physician