**6. Conditions in which we are conceived, born, grow, live and work affect our health**

24 years since independence apartheid in South Africa has persisted in an economic form [18]. Many families live in airless hovels constructed using splintered boards and metal sheets [18]. Post-apartheid, land is still largely in the hands of the white elites with most black South Africans still living in the townships [18] and one needs political ties to survive and thrive in business [18], closing this door to many.

Health is determined by the conditions in which we are born, grow, live and work [19]. We take this a step further and say health is determined by the conditions in which we are **conceived**, born, grow, live, work etc. One South African domestic worker said;

*"Our children are being born in the same situation I was born" [18] - Credit Jao Silvia, New York Times.*

In rural settings, people often have land, are surrounded with friends and neighbours, have time, have spiritual groups usually and the environment is less crowded and less filthy. Many have access to seasonally available fruit and vegetables. In the urban setting, many blacks have no access to land, live in crowded unsanitary, unsafe environments and neighbourhoods, isolated and often cannot practice spirituality, and many live from hand to mouth-informal sector. The usual diets are high in carbohydrates and saturated fats.
