Health and Me

Ishita Roy

How Colonialism Continues To Bear An Impact On The South Asian Health Crisis

More than 75 years after independence, the shadow of colonialism continues to loom large over South Asia’s health landscape. While rapid urban development and modern medical advances have redefined healthcare access in India, its fractured system and persistent disparities are deeply rooted in the legacy of British rule.

Before colonization, India’s approach to health was grounded in prevention, traditional medicine like Ayurveda, and community care. However, during British occupation (1757–1947), there was a seismic shift. Colonial policies devalued indigenous medical systems and replaced them with Western biomedical models that prioritized intervention over prevention. But these innovations were reserved for Europeans, leaving native Indians with limited and poor-quality care. The structural inequities didn’t end with the British exit.

Post-independence India’s healthcare policies mirrored its colonial past. Urban centers developed first, benefiting the elite, while rural and marginalized communities remained underserved. The wave of privatization in the 1980s worsened these disparities, pushing nearly 800 million Indians toward inadequate public healthcare, long waits, and low-quality services.

<h4>A Century of Starvation and its Genetic Toll</h4>

Colonial rule also plunged India into repeated famines. Unlike the Deccan famine of the 1600s, under the Mughals, which was a rare anomaly, British colonial policies, marked by grain exports, brutal taxation, and delayed relief, resulted in at least 31 major famines during the 18th and 19th centuries. From the 1770 Bengal Famine to the devastating 1943 famine under Churchill’s wartime policies, tens of millions perished, even as India exported food.

Dr. Mubin Syed, who has studied the generational impact of these famines, explains, as <em>Medium </em>also reports: “Exposure to even one famine has a multi-generational effect of causing metabolic disorders including diabetes, hyperglycemia, and cardiovascular diseases.” South Asians, he notes, are biologically “starvation-adapted”, our bodies are conditioned to store fat and limit muscle growth to conserve energy.

<h4>Health Consequences That Still Haunt Us</h4>

This biological inheritance has led to stark disparities in modern health outcomes. Studies show that South Asians are six times more likely to develop diabetes than Europeans, and 40% more likely to die from heart attacks. Even responses to exercise and strength training are lower in South Asians compared to other ethnicities, a result of generations surviving famine and undernourishment.

Height data from ancient Harappan burial sites (3300–1300 BCE) places average stature at 5'6", higher than most colonized populations under British rule until 1870. Famine and poor nutrition during colonial rule caused regression in health indicators until well after independence.

Colonialism may have formally ended, but its effects are far from over. The multigenerational toll is not just physical, but mental and systemic, ranging from mistrust in health institutions to an inequitable healthcare system. Most of us weren’t taught how historical oppression impacts our biology, and that lack of awareness holds us back.

But as Dr. Syed reminds us, “It’s not a doom and gloom scenario.” With awareness, lifestyle changes, and systemic reform, focused on diet, fitness, sleep, stress, and substance use, much of this inherited burden can be reduced. South Asians must reclaim their narratives, advocate for equity in healthcare, and educate future generations on how to heal from a history we didn’t choose, but continue to live with.

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More than 75 years after independence, the shadow of colonialism continues to loom large over South Asia’s health landscape. While rapid urban development and modern medical advances have redefined healthcare access in India, its fractured system and persistent disparities are deeply rooted in the legacy of British rule.From Ayurveda to InequalityBefore colonization, India’s approach to health was grounded in prevention, traditional medicine like Ayurveda, and community care. However, during British occupation (1757–1947), there was a seismic shift. Colonial policies devalued indigenous medical systems and replaced them with Western biomedical models that prioritized intervention over prevention. But these innovations were reserved for Europeans, leaving native Indians with limited and poor-quality care. The structural inequities didn’t end with the British exit.Post-independence India’s healthcare policies mirrored its colonial past. Urban centers developed first, benefiting the elite, while rural and marginalized communities remained underserved. The wave of privatization in the 1980s worsened these disparities, pushing nearly 800 million Indians toward inadequate public healthcare, long waits, and low-quality services.A Century of Starvation and its Genetic TollColonial rule also plunged India into repeated famines. Unlike the Deccan famine of the 1600s, under the Mughals, which was a rare anomaly, British colonial policies, marked by grain exports, brutal taxation, and delayed relief, resulted in at least 31 major famines during the 18th and 19th centuries. From the 1770 Bengal Famine to the devastating 1943 famine under Churchill’s wartime policies, tens of millions perished, even as India exported food.Dr. Mubin Syed, who has studied the generational impact of these famines, explains, as Medium also reports: “Exposure to even one famine has a multi-generational effect of causing metabolic disorders including diabetes, hyperglycemia, and cardiovascular diseases.” South Asians, he notes, are biologically “starvation-adapted”, our bodies are conditioned to store fat and limit muscle growth to conserve energy.Health Consequences That Still Haunt UsThis biological inheritance has led to stark disparities in modern health outcomes. Studies show that South Asians are six times more likely to develop diabetes than Europeans, and 40% more likely to die from heart attacks. Even responses to exercise and strength training are lower in South Asians compared to other ethnicities, a result of generations surviving famine and undernourishment.Height data from ancient Harappan burial sites (3300–1300 BCE) places average stature at 5'6", higher than most colonized populations under British rule until 1870. Famine and poor nutrition during colonial rule caused regression in health indicators until well after independence.A Call to Remember, and ReformColonialism may have formally ended, but its effects are far from over. The multigenerational toll is not just physical, but mental and systemic, ranging from mistrust in health institutions to an inequitable healthcare system. Most of us weren’t taught how historical oppression impacts our biology, and that lack of awareness holds us back.But as Dr. Syed reminds us, “It’s not a doom and gloom scenario.” With awareness, lifestyle changes, and systemic reform, focused on diet, fitness, sleep, stress, and substance use, much of this inherited burden can be reduced. South Asians must reclaim their narratives, advocate for equity in healthcare, and educate future generations on how to heal from a history we didn’t choose, but continue to live with.