**8. Access to land**

No land no collateral [18], is another glaring issue in South Africa. Many South Africans have no access to land. Investment in ensuring that people have access to land, ensuring safe water supplies through digging more wells, boreholes and improving sanitation- the very conditions that promote people to be and stay healthy is fundamental. Land ownership is one instrument that is pivotal in addressing both rural and urban poverty [16]. In good health people can then access education, employment etc.

*"We never dismantled apartheid. The patterns of enrichment and impoverishment are still the same." Ayabonga Cawe, former economist Oxfam [18].*

**7**

*Poverty Is Not Poverty: The Reality on the Ground Including the Rural-Urban Divide…*

Causes of cardio vascular diseases (CVDs) in SA are high BP, smoking, drinking, poor eating habits, obesity and lack of physical activity [22, 23] and psychosocial stress (depression, anxiety, hostility) [24]. Cardiovascular risk factors disproportionately affect the socio-economically disadvantaged [25] and we can speculate

People use fire for cooking, breathing in fumes, barefoot they walk on ground littered with broken glass, needles, tins and daily they exchange armed robbery updates [18]. Is this conducive for health? Police frequently descend on these informal settlements tearing down these shacks without warning [18]. In some settlements human waste forms puddles [18]. While in some predominantly white areas toilets are stocked with soap, toilt paper, staffed with janitors and security guards [18], many townships are ghettos of isolation [18]. Diet, sedentary life, loneliness and stress and how people deal with it e.g., drinking and smoking are prevalent issues in townships. People often do not know where to get the next meal and the insecure environments prevents physical activities like walking forcing people to take taxis home or to school (no safe places to walk). Attending worship is also affected by these unsafe places. Some services are in the evening. Spirituality has been proven to give meaning and purpose to stressful life events leading to more positive emotions like well-being, happiness, optimism and fewer negative emotions. The psychological benefits of spirituality affect immune, inflammatory, endocrine and even autonomic functions. These unsafe contexts further deprive people of these benefits further affecting

*DOI: http://dx.doi.org/10.5772/intechopen.95901*

how this comes about.

heart health [24].

• Lack of food

and sanitation

caused disease.

**9. Fossil fuel, sedentary life unsafe places**

**9.1 How do people get diseases in theses contexts?**

• Lack of knowledge- leading to exposures

**9.2 How are the sick further affected in these contexts?**

personnel that do not take context into account

• Living in filthy overcrowded and unsanitary conditions

• Having knowledge but no options e.g., forced to scavenge from dump sites

• Lack of financial means to buy drugs, pay for transport, lack of knowledge to eat healthy (ongoing care and regular checks) and the condition gets worse.

• Living conditions, not safe to exercise, or walk, limited access to clean water

• No means to follow recommendations made by medical staff (medical education to change) e.g., Eat broccoli when you cannot afford this or live-in rural areas where such foods do not exist-unrealistic recommendations by medical

• People get medicine and are sent back to the very environment that caused the disease, leaving the stressors unaddressed e.g. the crime ridden township that

*Poverty Is Not Poverty: The Reality on the Ground Including the Rural-Urban Divide… DOI: http://dx.doi.org/10.5772/intechopen.95901*
