"Me'ol nan smoked like a chimney all 'er life and lived till an'undred. Twinkletoes was dahn at the gym six nights a week and dropped dead of an'art attack at forty-three, din'ee?"
Health is an interesting phenomenon in the West, because here humans have turned the idea of being well into a sort of novelty. A lifestyle ..not for the faint of heart. An entire industry of supplimentary medication and behavioural regimes and dietary solutions to make you feel better. From all the 'feeling better' that the junk food, booze and sex industries first promised to comfort you with. And you say you're not high maintenance.
But when we get to issues connected with human wellbeing on the planet's grand future-building To Do list, the bullet points of goals can quickly run off the bottom of your page – not simply because there are so very many ways of Being Not Well, but because as hard as aid agencies and researchers are working to treat the basics of sickness and death in struggling parts of some nations, everyone in the countries with all the basics in place seem to be willfully making themselves sickness statistics. And this despite cumulatively spectacular progress in medicines, treatments and understandings of how the human vehicle works. So how well do we feel, as we consider the future of human fitness? And does all of it have rather less to do with our hairy paunches and more to do with another bit of us altogether; the flabby bit between the ears.
For humans on Earth in the early 21st century, you could say that the health of our species is under attack from two main sharp-ends at once – both forged in our own brains by the relentless hammers of habit: Toxic political cultures and sick consumptional cultures. As a health champion today, you’ll either be sparring war and corruption to get essential lifestyle infrastructure set up, to arrest some very basic issues of sanitation and nutrition, or you’ll be jabbing wearily at the apparent impossibility of not eating tons of debilitatingly terrible crap every day.What you’re least likely to be doing is having a spa treatment.
Health is hard. But let’s see if we can ingest some fortifying essentials to make it all around the hill of it before tea time. Think of this episode of Unsee The Future as the Kendle Mint Cake of your quick yomp around the challenge of being well. And yeah, if you hate the idea of a worthy sounding hike anywhere then, ah, we have even further to go, man.
Let’s push past the flab and try to take a truthful general look at what’s ailing us. Without having to mentally add units to your declared weekly intake like your GP does.
“Living so healthily was killing me.” So quipped writer AJ Jacobs after completing his wellness marathon to spend a couple of years living by all the health fads he could. But in his interview with Men’s Health not long after supposedly hurling himself off the health wagon with the completion of his book Drop Dead Healthy, he concieded that one of the things he learned was what you can’t squirm out of – the basics. Because it turns out the an awful lot of scientific consensus on that – despite the regular reports of regular red wine or blue cheese or extra-marital action doing away with the need to ever get out of your chair. You want the French lifestyle, but the truth is you can’t drive it.
“I was like, ‘Hey, maybe I can not exercise and be the healthiest man alive,’” Jacobs says. “But no, the basics are gonna stay the same—that you need to eat whole foods, you need a lot of sleep, you can’t stress out, and you do need to keep moving. The sedentary life is a killer. Those will always stay, I don’t see those being overturned in any way in our future.”
He discovered, of course, plenty of fads. And like all worthy causes, a lot of these fads and solutions have a quick knack of deploying passive agressive guilt if you don’t go all out on their view of purity. Yoga parties don’t appear to be much of a thing in popular culture. Being super-healthy often appears to mean bipassing your sense of humour, and often seems to involve embracing pain. Whether its the floor-strengthening ache of clenching in a veggie curry nifter as your class moves into a malasana pose, or the agony of relaxing your wallet.
Getting attention by horrified tabloids and others at the start of this year is the apparent new ‘craze’ for raw water. As Vox outlines, it’s a belief that all the accidental hormones and deliberate fluoride in your tap water is at best killing your gut’s natural biotic balance and is probably a brain-washing commie plot to boot – which you can neatly side-step for just thirty-five bucks a pop with products like Live Water – untreated natural H2O.
Now, if there’s one thing I’ve learned quite soberly since embarking on my own accidental quest to the future these past couple of years it is that my Western culture has kind of brainwashed me to laugh at hippies. To see the counter culture as not so much planting the seeds of modern organic wisdom in an honest cry of the human heart from the bowels of the soulless social machine but more like a bunch of work-shy, sock-eshewing scruffy bean eaters and hemp dealers. But I do know that there are an awful very lot of water-born bacteria that are not so much pro-biotic as prolapsing-botty in their health effects on humans that are a thing of the incomprehensible past in modern life because of all the treatment. And I suspect too that my very lovely dentist would echo the sentiments of a 2014 Public Health England report that simply said the fluoridation of public water services was: “a safe and effective way of preventing tooth decay” and she might even go as far as agreeing with the Centres for Desease Control and Prevention in the US that flatly states: “Because of its contribution to the dramatic decline in tooth decay over the past 70 years, CDC named community water fluoridation as 1 of 10 great public health achievements of the 20th century.”
Depends who you believe.
And belief is a massive thing in health.
As Professor Alia Crum explains in a 2016 TEDMED talk, the power of the placebo effect is so marked, it would be canny of medical science to start using it more consciously. She sites a wealth of evidence that the body’s digestive system, edocrine system, immune system, nervous system… like, basically all the systems can produce chemical reactions to things a person’s mind believes is happening. Often even when they also essentally know they’re taking a sugar pill or a pretend capsual or even undergoing a fake surgical procedure. Eric Mead, in his less authodox talk on the placebo effect, suggests its power has a hierarchy – capsuals work better than pills, and syringes work best of all. And you laugh at new age rituals.
Belief. Ritual. Fad – we embrace a very wide spectrum of comforts in our bid to feel good and fight death. And the list of worthy things you really must look into in 2018 if you’re serious about wellbeing yourself ranges from the fanciful to the sensible to the technical. According to Good Housekeeping, tumeric is the new avocado, jackfruit is the new kale, maca powder the new drinking from the holy grail and ‘lab-grade equipment’ the new fitbit. The Guardian pictures super-charged vitamin pills and streamed versions of your mum’s (or your dad’s) Jane Fonda workout videos but emphasises the growing demand to just blot out the noise. The ‘digital wellness escape’ is now a thing, you’d better believe. And are you surprised, they imply:
“Those passive-aggressive “Talk to people!” chalkboards in cafes with no free wifi? The thin end of the wedge. Expect social media fatigue to peak over the next 12 months, with more Trump-weary tweeters committing to digital detoxes, and more pubs and cafes actively discouraging mobile phones.”
If turning off your phone and adding kale to your Ginsters lunch still seems a bit edgy for you, then you might consider getting over your laughable greenertia by leaping right off the health fad high board. And if you’re looking for just the thing to jolt you into the hippest pre-dystopian high fashion food, be of good cheer because there are some super developments in the celebrity salubrity lifestyle world for 2018 – and surely it’s time you embraced the whole Mad Max chic and tried cricket. Not the crack of leather on willow, but of teeny tiny little dessicated legs snapping.
Entomophagy. Insects. Global nutritionists have been coughing the idea behind their hands for a few years, in the face of the looming food supply crises. But… wait, what? I’m not sure if we’re supposed to be eating invertibrates for fun, but Charlotte Payne of Cambridge University says boldly that she’s a particular fan of locust: “Lighter than meat and heavier than seafood, they’re delicious. Each one of these plant-loving insects absorbs the taste of your chosen seasoning and adds a satisfyingly crunchy texture.”
..Why. Why oh why. Well, many insects are high in calcium, zinc, iron and protein, she says, and farming them would create a fraction of the greenhouse gases of livestock. They’re already eaten in larval and adult form in many parts of the world anyway and there’s, y’know, a good supply of bugs.
If that doesn’t light your insense stick then The Art Of Healthy Living goes straight for fashion body-mass nirvana with wabi-sabi, stress pebbles, standing and kindfulness. Well, sure. Sign me up for a namastaycation.
There are some interesting themes infusing these stories, truth be. But ritual and belief alone has not healed the world so far. The global detox is going to have to go a bit deeper.
The UN’s Global Goal of Good Health & Wellbeing opens with a statement: “Over the last 15 years, the number of childhood deaths has been cut in half. This proves that it is possible to win the fight against almost every disease. Still, we are spending an astonishing amount of money and resources on treating illnesses that are surprisingly easy to prevent.
Its aims cover the spectrum of human wellbeing, from planning ever better responses to global health risks and fighting comunicable desease, to reducing deaths from lifestyle accidents in various ways, including addiction and simply tobacco use. It also advocates some kind of world-wide healthcare coverage by 2030. It’s a massive task, when put all together. But it shows a suitably rounded view of what we’re facing to give a whole planet of people a fighting chance to live to their potential.
The basic headlines of health are a mixed bag of remarkable progress and consequently even more appalling-seeming problems today, as we look forward. The reduction of disease in many countries is, if we stop to think about it for a second, astonishing. Life expectancy today is somewhere around seventy years globally on average, when for centuries until around the turn of the last century it was somewhere in the mid thirties. I’d be a grand pater by now. No, I’d be dead by now. From not being able to get any kind of job whatsoever in pre-AppleMac Merrie England. Africa’s life expectancy, meanwhile, always was and still is at the bottom of the pile according to Our World In Data with Europeans conversely these days living easily into their 80s. Japan seems to top the list always. Interestingly seeming to demonstrate that the Japanese commitment to playful environment, bonkers pop, zen gardening and merely-neatened fresh seafood outweighs the stresses of their cultural obsession with excellence and propriety. Life seems to sit well with being tidy. But everyone’s lives have gotten longer. Giving us more time to get ill.
But not any more with some diseases. One main human disease in history has been labelled actually eradicated – Smallpox holds the distinction, with, as The History of Vaccines says, the last case of wild smallpox occurring in Somalia in 1977. And thank goodness. A disfiguringly pustulous, highly contageous disease with humankind for thousands of years, it killed an estimated 300million people in the 20th century alone, and got everywhere nastily. It’s also said the Spanish took it as an accidental biological ally when conquering the Americas as the peoples of the new world had never had it before and it spread hideously. Now it’s gone. I’d call that progress.
Meanwhile, many other previously deadly killers are being effectively eliminated locally around the world. Polio, Rubella, Measles, even Malaria is being beaten back. Through effective combinations of biological research, systematic vaccination campaigns, and public awareness practice campaigns. And the scourge of medieval history in Europe, the plague? Well, Yersinia pestis has far from gone away, with outbreaks of plague popping up in various places this century. But while outbreaks of it recurred in Europe for five hundred years when it arrived on the continent in the 1300s from burgeoning Asian trade routes, killing tens of millions and decimating populations, it’s not the haunting terror of our imaginations it was to my ancestors, thanks to much improved hygiene and pest management. Lifestyle changes. As a new study suggests, the evidence is the real spreader of the Black Death was not rats and rodents but human body lice. Bad bathroom regimes. So yay for power showers, exfoliating mits and manscaping.
Even the modern disease of HIV/AIDS is showing decline in almost all parts of the world. While some 36million people today live with HIV, the numbers of new infections is dropping. West Africa still struggles the most with it and it is still a big problem, but it’s no longer the leading cause of death on the continent, and drug treatments are extending lifespans for carriers thankfully much beyond what they were.
Where disease spreads badly today is where sanitation, nutrition and practical social hygiene are more of a challenge. Recurring biological assailants include Hepatitis in its various forms, Cholera, Meningitis, and of course Influenza – something that plagued Europe again much more recently. Chikungunya, Dengue and the hideous Zika affect 50 to 100 million people each year and, as an ECDC report from the end of 2017 says: “in the past decade, all three diseases have been reported across an increasing number of countries.”
And I’ve not scared you with talk of birds. Chickens giving you flu. It’s the basis of many science fiction panics – viruses mutating across species. But while this looms in the mind of health bodies around the globe, it’s far from top of the list.
TB is the leading disease to deal with currently. The WHO says 0.4 million people fell ill with TB in 2016, and 1.7 million died from the disease then. Along with influenza, pneumonia and bronchitis, tuberculosis is part of what makes lower respiritory diseases the deadliest communicable disease challenge still on Earth.
But while great pandemic outbreaks may grab the chilling headlines, making you eye your parrot wearily, it’s not the biggest problem facing us. Not by a long chalk.
One study suggests causes of death today are topped by bad blood pressure. Followed very closely by “poor diet”, tobacco use and air polution. According to this particular global disease study published in The Lancett, one in five deaths worldwide are poor diet related, claiming as part of this statistic that 11% of the world’s population were undernourished in 2016. The World Health Organisation says overall our biggest health challenges are with heart disease and stroke, followed then by TB.
In the world of medical accademia, University College London has highlighted seven priorities in its own Grand Challenge on Global Health, and it puts ‘migration and health’ at the top, interestingly. With non-communicable diseases second and mental health third. It may be in no particular order, but its interesting. Following up for them are antimicrobial resistance, the health impacts of climate change, the growing challenges of an aging population and finally… actual communicable disease. Catching something nasty.
The World Health Organisation each year manages to pull together a handy single document on the working status of human wellbeing, outlining all the ongoing challenges all over Earth. Just in case some wealthy passing alien life fancied a quick survey report on their potential new real estate aquisition. Think we’d all be grateful if they took it on for us, it’s become a bit of a fixer-upper as we’ve really let the place go in recent centuries. The WHO 2017 report lays out six systemic endeavours the organisation believes can be chased down in order to really get some weight under any progress. Besides talking about encouraging innovation and research technically, they include trying to help healthcare systems gear up to provide universal health coverage, promoting more sustainable health financing and helping different sectors work together better to actually make progress on things. And they talk interestingly of health equity – “leave no one behind.”
The specifics on the WHO’s agenda are a sort of fascinating collective To Do list. It includes maternal deaths in Kazakhstan, viral hepatitis in Cambodia, early deaths due to alcohol in the Russian Federation, malaria in Papua New Guinea, suicide in the Republic of Korea, fighting the tobacco industry in Uruguay and many others. But the headlines this last year appear to be very organisational – trying to implement the understanding that solutions are never isolated. Things cross-affect – just as much for good as for bad. It’s almost hopeful in its cool-headed analysis of such a huge, unfinished task. But it bears out the global themes of our times.
In Davos, where all the big power-players of the world get together each year, to compare Bugatti Chiffons or whatever they are, presumably, health challenges are seen as economic challenges, understandably. But the theme circling global strategic grown-up conversations at the moment is how to widen out what ‘health’ even means and how to begin to bring together many structures, bodies and ideas that have traditionally been thought of more separately. Because bigger in the minds of people in these rooms than the key challenges of basic nutrition and sanitation seems to be the swelling pressure balloon of Non Communicable Disease – chronic conditions. IE: personal ailments that continue over lifetimes that need lots of ongoing treatment.And interestingly, of course, so many of these you could describe as symptoms of bad lifestyle.
At a panel discussion at the World Economic Forum 2016, entitled Shaping the future of health, Francis Collins, an amiable seeming chap moderating the forum who headed the National Institutes of Health in the US at the time, said: “I wish that we could say that all of us are rational actors in every space, but we know that doesn’t always apply. And even in situations where resources are fairly plentiful, people make bad decisions about their health.” While we don’t want turn into Big Brothers or nanny states, we do want to come up with ways that encourage good health decisions to be the easy decisions and not the hard ones.”
Long term suffering, non-communicable disease, is the largest burden on the human-planet system today. As the World Economic Forum puts it elsewhere, NCDs are: “the price we pay for economic development, prosperity and major achievements in healthcare, which bring us longer, less arduous, but perhaps more stressful lives.”
As Prof John Newton, director of health improvement at Public Health England is quoted in a Guardian article: “I don’t think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view”.
At the same WEF panel discussion, Risa Lavizzo-Mourey, Chief Executive Officer of health culture leadership organisation, the Robert Wood-Johnson Foundation, said: “As has been said many times at this conference, health is essential to having a healthy, resilient economy and population.” Well, yeah. What she feels this means is making sense of our health challenges in as broad a context as possible: “At our foundation we like to say that health exists where we live, learn, work and play. And so to achieve health we have to think more broadly than the healthcare system or disease states”. Our social life and geographical home are significant factors in how well we are, in other words. Trying to build health equity for the whole planet will mean addressing the challenges facing people in these regards as much as getting access to the basics or to the right medicines.
Coronary heart disease, diabetes? They sit alongside mental wellbeing as symptoms of modern life. The stuff we’re putting into ourselves every day, as consequences of our culture. It comes out again. The real challenge to our living well is the consequences of how we’ve begun to live with more. And if you’re homeless in the west, you will have all possible health issues to deal with at once, surrounded by wealth. All of this the true cost of our economic life, you might say. Which includes the pan-emotional effect of globalisation – worlds colliding.
Racism is bad for your health. And not simply if you are a victim of a bodily attack. As David R Williams describes with calm conviction there is much evidence for the simply shortened lifespans and medical wellbeing of black Americans compared with whites. It’s quietly shocking, even though you’re kinda not surprised. And he suggests that the problem is not so much a mystifying epidemic of racist cops but an endemic outlook gently marinading minds growing up in the background culture of the States. All taking its toll on everyone, in the end.
And then there is the real silent killer. Lonliness.
Announced just this week as I speak, the UK has just appointed a Minister For Lonliness. ..That is now, people. Such is our modern life. Tracey Crouch aims to take up the batton of social campaigner the late Jo Cox and calls it a “generational challenge”. But it’s not simply because more of us are living longer and so spending more time at the end of our lives alone – half of us over seventy, it’s estimated. It’s the young as well. As The Day quotes 30-year-old Kylie from a 2016 BBC doc The Age of Lonliness: “Nobody puts on Facebook — I’ve just spent a week indoors eating Hobnobs’. But they do. I have a significant number of dear friends across age ranges who separately try not to feel crushed by the sheer emotional weight of lonliness every day.
Mind estimates one in four people in the UK are suffering with mental health issues. And as we are coming to know, it’s been the hardest to get taken seriously. Especially because we don’t even want to talk about it, let alone find treatment, such has been the social stigma. Even getting diagnosed with dyslexia has taken many people half a lifetime, with the burden of ‘stupidity’ clinging to them for far too long, just because their brain is a bit chancey with pattern recognition. And that’s possibly one in ten of us. For others of us with Asperger’s and forms of attention disorder, getting recognition is like coming out. Being told you’re essentially normal, as a human dealing with your condition.
But issues to do with lonliness, anxiety, depression and learning challenges seem to be talked about today more than ever swirling around and between us all, all of us honestly able to testify to something of it. This too feels soberly like a kind of progress.
The comforts we seek to cope with everything rather easily become part of the problem. When we talk about sexual health in 2018, we’re not simply talking about avoiding STIs or worse, we’re much more talking too of mental and social health here – behaviours. What is acceptible? What is good for us? Me. You. As we have rolled open new social, sexual freedoms, we’re all trying to shake down how most healthily to enjoy them. The digital tidal wave of easy-access porn, for example, is damaging some of our real-world sex lives and relationships. As the BBC reports, psychosexual therapist Angela Gregory says she has far more young men, not just older chaps, referred to her with problems connecting with their partners, because on-screen action has eroded their normal sense of connection with flesh and blood. An affect that is quickly not English cheeky seaside postcard at the lido so much as cheerless broken libido. Comforts quietly taking us away from each other.
Then there is simply the ultimate mental health statistic. Suicide. And the significant social health metric that in the UK in 2016, three-quarters of all cases were men. Talking and connecting is still a big cultural problem for too many of us, it seems. The largest percentage of men taking their own life in this time were in their early forties. The largest percentage of women doing so were in their early fifties.
In a time of unprecidented prosperity and scientific improvement of health outcomes, we are unwell. All over the world. Collectively getting over our bacterial challenges, we are now trying to deal with our perceptions of the world. That’s a heavy challenge. Something many in my country, the UK, wish the greatest public healthcare system in the world could do much more to cope with. But the NHS is by many accounts woefully underfunded and fragmented in its approach to mental health support. And just when more British people are waking up to their mental health needs, their national health service looks like it’s on its knees.
This is because the NHS was set up wrongly from the start.
If you live in my country, you’ll have heard many stories this winter of the crisis in healthcare. Again. Of A&E departments looking like refugee departure points, spilling over with patients on trolleys in coridors while nurses flee from the whole public profession. Again. Still. Yet the NHS is one of the most resonnant rallying cries of identity across modern Brittons. To such an extent that Danny Boyle made a huge feature of it in the most genuinely patriotic experience I may have personally experienced – the 2012 Olympic Games opening ceremony. Ah, the days when London became a haven of goodwill and peace on Earth. Rumour has it, Cameron’s Conservative government really wanted Boyle to take it out.
I personally owe the NHS unrepayable debts. And that’s me as an almost offensively lucky person in health. But while my lolling frame has carried me around with very little fuss for forty-seven years to date, those I love have had their lives transformed by it’s essentially ‘free’ world-class expertise. Which means my life has been. From the various new joints and years of care and drug support my father and mother have had, to the essential fact that I would be pushing the lovely first lady of Momo along Bournemouth prom in a bath chair with a tartan blanky over her knees today if they hadn’t replaced both her failing hip joints in the last three years. A person who is otherwise strong and fit and committed to the wellbeing of activity would be old and invalid by her mid forties in another age. And living with horrible pain. She would be suffering with depression.
And come to think of it, I’d have a dicky eye without the NHS too. I had a squiffy one as a kid and they turned it straight again. Much as Marty Feldman made an asset out of his, er, look, I’m not sure I’d have liked to be sporting two cheeky stares at once.
Yet, while everyone half knows the NHS is being despatched in pieces to private firms because it is creaking under its own weight, public debate here is very stalled on the matter. Full of heat, but like a car in a ditch still revving loudly and going nowhere. But something that sounds borderline offensive were I to call in and ‘reckon’ it on LBC, comes from a boss of the BMA. The NHS was set up wrongly in the first place.
Dr Kailash Chand is honorary vice president of the British Medical Association and recalls that before the NHS’s establishment in 1948 by Clement Attlee’s Labour government, “the have-nots feared ill health.” Because they had no way to pay for treatment.
But writing in The Guardian, Dr Chand says this:
He goes on to suggest that there is a big over-reliance on drug presciption and surgery that, added to wider social infrastructural problems adds up to an NHS annual bill of: “billions that it does not have”.
With social care in the UK “in a state of paralysis” as he puts it, ‘lifestyle’ illnesses like type 2 Diabetes and obesity looking like an epidemic in 2018, economic worries and pressures bearing down on families in multiple ways and mental health services alone cut dramatically from something arguably inadequate in the first place, GPs are overloaded and A&E’s in “a permanent state of chaos”. Concluding simply: “The fear of getting ill that gripped Britain in the past has returned.”
Target culture. Many would say it is the real tyrant of our education system as well as our public healthcare in the modern UK – the demand for accountability that promotes higher standards of delivery turns into something more desperate – competition, won by numbers. Not emotional outcomes. Anything but accountable, ironically. It’s simply massive encourager of ill health – driven by a healthcare system that’s trying to kill its staff, some of them feel. From the stress it puts people under, promoting not just rushed decisions and inadequate time responses at work but poor cooking, quick food fixes and increasing comfort eating and drinking in private life, to the sheer fact that many NHS workers believe managers are hired more than clinicians and carers – to be seen to be responding to government drives. Politics kills.
“The NHS must move from a treatment model of care to one of prevention” says Dr Chand. “Decisions made at the health service’s inception created the problems we see today. Social care was never integrated with the NHS, and domiciliary care has always been left to a mixture of private companies and local councils. The NHS’s unique strength has always been that its large purchasing power and economy of scale make it more economically efficient than its international comparisons. But a lack of joined-up thinking fails to make the link between people aged over 75 presenting at A&E departments and cuts to social care funding. Our political discourse has not helped. Pressurising councils to freeze council tax at the height of austerity has compounded problems.”
Prevension. And personal ownership of the health challenges we all face. While existing healthcare systems might need to return to some basics of how to organise the effective delivery human care, the principle that everyone on Earth should have access to healthcare without fear is a constant theme in global health strategies today. And perhaps no sector has proven more than the health sector the principle that smarter, more connected thinking saves lives.
Thankfully, there’s never been a better time to equip ordinary shmos like you and me with the tools and the awareness to build a healthy life.
Pulchritudo et Salubritas. Do you know what this means? It’s the motto of my home town, Bournemouth. “Health and beauty.” It’s an interesting combination of words to describe wellbeing.
The Victorians, who founded my home town, loved a bit of lifestyle. And cooking. And technology. If they’d not built their whole outlook on hogging all the pie, and skewering whomever’s pie it was in the first place, such thinking might have helped a lot more people. As it was, they did help me, as they built their seaside retreat on the principle of its restorative airs, mixing sea air with pine, building a remarkable perambulatory ornamental gardens in its town centre, where the affluently ill could convalesce agreeably. A sort of sauntering wellbeing I still try to channel while living here to this day.
Of course today, we live in an age of incredible medical advances over the early medical industry market of the Victorians. And there’s a lot more coming.
From growing organs for transplant to order in labs, to simple exoskeletal support for the paralysed or more sophisticated mechanical limb replacement tapped into the patient’s neurocontrol centres, life is getting more and more of a helping hand from human health development. Robotic surgery is now a thing and 3D printing of not just infrastructural equipment in medical challenge zones but technical componentry and even biological elements for surgical procedures is going to become some kind of normal. Attempts to restore sight, hearing and nerve activity in paralysed limbs continue on multiple fronts, and even simple medical procedures will be made much easier, such as VeinVeiwer Vision2, which “uses near-infrared light to generate real-time imagery of patient’s veins”. Helping your med student not pincushion you while trying to get a line into your arm. Liquid biopses, meanwhile, could significantly improve the treatment of cancer with non-invasive analyses of progress and just as I write a whole new cancer blood test that can look for eight types of the disease at once, including the tricky pancreatic kind, has been unveiled by scientists at Johns Hopkins University.
Of course, we’re already blurring the lines between technology and human today. Pacemakers and permanent defib units and replacement joints are generationally normal now, living inside our bodies with out us thinking about them. But as humans move on in their expectations of longevity, we will inevitably want to keep ‘upgrading’ ourselves – and we’ll manage it.
The biggest gamechanger of our age may be the mapping of the human genome. Actually being able to edit the genetic information that grows you into you and me into me has brought us much closer to the chilling Gataca future of designer babies and a perfectly symetrical genetic overclass, no doubt, but with the latest CRISPR developments of this, we really could be seeing genetic diseases rolled back. As The Medical Futurist puts it: “CRISPR now seems to be re-imagining everything in genomics. It could cut non-desired elements out of our DNA, add new features to the DNA of animals, plants and even humans, and cure previously incurable diseases such as Huntington’s disease.”
Perfect tomatoes and perfect blonde children. If that’s what you want.
Alongside the more hands-on human tools of VR and computer modeling, ours will increasingly not be the only intelligences involved in our treatments, fo course. The Medical Futurist suggests, though, that if we are to integrate AI into our healthcare systems, we might need to tighten up some of our procedures to cope with it. Machine and deep learning algorithms can still be fed medical biases and how legally culpable is HAL when he misdiagnoses your meningitis?
One of the medical trends to reach us sooner in the home, however, will be diagnostics and body sensors in daily personal life. We’re already addicted to Fitbit metrics, counting steps obsessively and there are plenty of apps in use by billions of us to monitor heartrate and sleep cycles. It’s normal. But shrinking sensors will mean ever more accurate, detailed data for your daily fitness targets and the array of medi-wearables on show at this year’s Consumer Electronics Show was bigger than ever. As CNET rounds up, there were sleep devices and heart monitoring watches a-plenty at CES2018, alongside electromagnetic pulse emitters like the Oska Pulse to ease chronic muscle pain – presumably fitted with a limiter so you can’t blackout your whole neighbourhood – and smart mirror’s like the HiMirror Mini which tells you how saggy and ill you look while you stare at yourself in it. But the kind of future I envisage definitely has Foreo’s sonic Luna Face Brush in it, the first “smart mask treatment.” The device offers 90-second facial treatments that combine LED light therapy, thermo-therapy and “T-Sonic” pulsations.” Yeah. Space-cleansed.
But what all this really paves the way for is something key to a better global health report. And it’s not technical. A more connected outlook. As much as digi-tech guff loves to gadget-trap us into imagining the word ‘connected’ is just part of some mobile comms iStock advertising eu/dys-topia, it’s a principle that the tech can really help us practice into a wider experience. A more helpfully human one.
That 2017 report by the WHO makes clear it sees the connectedness of all the sustainability goals – and how they pretty much all affect health.
“It is clear that responsibility and accountability for health in the context of sustainable development extend well beyond the health sector. [There is] a real opportunity to place health in all domains of policy-making, to break down barriers and build new partnerships, and to bring coherence to policies and actions.” Health, in other words, gets positively affected by putting other things right in our human-planet system right. As they site: “health stands on common ground with social inclusion and poverty alleviation, and efforts to move towards universal health care contribute directly to public security. In addition, ending hunger and achieving food security and improved food safety and nutrition are vital for health and development, while the provision of clean water and sanitation could substantially reduce the hundreds of thousands of deaths each year caused by diarrhoeal diseases.” Yup.
You and I can pick up the slack from national health services by joining our devices to our bodies and becoming more consicous of what our bodies are doing, if this helps us do so. Facing how we’re living. Something getting easier to do than before, if we didn’t fancy going to the quack’s. But the aim must be prevention. Right in line with the view at the high strategic level. Taking responsibility for ourselves a little more, bit by informed bit. And as with every other element of Unsee The Future’s exploration of the components of a complete, sustainable human-planet tomorrow, being aware of how this bit of our little lives fits into the greater whole is, I think, empowering. Emboldening. Helpful to us making little appreciable differences to, well, how we live.
And there’s one aspect of our health across the planet that might focus our thinking effectively.
Paul Bulcke, Chief Executive Officer of Nestlé, quoted something at a Davos panel that he attributed to a Chinese saying: “The best medicine is food.”
Now, you old cycnic, if you’d spotted that he or anyone else from his company also appeared on a panel that year entitled Health is wealth you might quickly say: “It bloody is for Nestlé, mate”managing as the largest global food & bev maker does to be “one of the most hated companies in the world” thanks to a list of accusations against various parts of its production practices around the world over the last decade or more, as ZME Science summarises interestingly, if you want a grim catch-up on the history of that one.
But Paul Bulcke’s quote here might quietly remind us that amid corporate global human culture, the personal human story is never so simple. Because his point is still valid – nutrition is a central, vital part to our wellbeing.
Dr Gunhild Stordalen of EAT spells this out in a TEDMED talk, and suggests that while just about everything going on around us affects our health, in fact, the way to pull many of our sustainability endeavours to heel at once is to properly tackle something else – our world of food.
Eat mostly plants, eat real food, and eat just enough, while aiming to waste none. These three approaches combined, just to begin with, would eat into our culture of waste and bad nutrition. We’d begin to shift the market emphasis away from unconscious bad eating to more mindful, aware, healthier eating, if these were our conscious consumer aims. But the food system as it stands has failed us, she suggests.
“We’re not dumber, lazier or less considerate than our parents,” she says. “But in just a few generations our food environment has changed dramatically. The modern food system has succeeded in giving us more to eat but it has failed us in three significant ways.” Accessibility, affordability and convenience. It’s simply too hard to find good food, too often, never mind afford it – so often outpriced is it by junk food, frankensteinly designed to outlive healthy food by significant factors too. And because of this, it’s a lot easier to get unnutritious artificial foods into remote truckstops and motorway filling stations than it is handmade quinoa salads. Crap is convenient virtually everywhere.
“Why? Why did the food system fail us so badly?” she asks. She suggests it is how un-joined up are all the players in the food chain. All working to their own ends rather than one big end. She calls it a “massive systemic failure” of departments and companies working against each other with very different goals. What Dr Stordalen is implying is that the whole circle of our ingestion and activity should work together. Do we have nutrient balance habitually? How much comfort are we reaching for, and in what forms? There is, she suggests, a growing movement asking and exploring this. “But,” she says, “just imagine what would happen if we could connect the dots – the speed and the scale of this movement if we could connect the facts, the players, the money and the great ideas?”
Putting the science together with the policy makers together with the business models… together with our individual food minfulness.
When it comes to considering the future of health, Dr Stordalen says: “If we look too far out on the horizon, we may miss the solution that’s right in front of us – food. Because food can fix it. Even small changes can make you healthier and happeier, protect the planet and help make a better future not just for millions but for billions of us.”
I think of Singapore’s water supply reinvention, where they put together the utterly linked but mysteriously separated departments of sanitation and drinking water management with a holistic, socially-mobilised vision of how the whole could work. And applying this to the food industry could propel many of the goals of the health sector.
How do we value our wellbeing? If water is life, what’s it worth, for example? And when good ol’ Nestlé talk about putting more value on it to dissuade wastage, what is their mechanism of value? If it’s only money, we’re still missing the point of how we build a healthy tomorrow for us all.
The separation of Britain’s care system from both the rest of the health system and human goals of emotional outcomes, in favour of financial ones, is leaving a generation of sick, elderly and lonely people adrift. One practical systemic truth that illustrates the wider one – disconnection breeds unwellness.
I’d suggest our context is crucial to our wellbeing. Those Victorians didn’t need telling that beauty was part of health. Ask Oscar Wilde. If you have hours to spare. And a time machine. But they knew that our physical environment is an important factor in our wellbeing – which is why I bang on often about the despairing nature of the UK’s current housing stock, devoid of wellbeing thinking in the building sector’s design of new homes as it is. Public realm, like private home, changes how we feel. And how we feel always changes what we do. Our behaviours.
It’s nothing new in architecture or urban design of course – or any design. But these days, it sounds niftier if we can wang some sciencey metrics in there. The Future Laboratory reports, among its other trends of 2018, on the splendid idea of Wellness Architecture: “In the past few years a lot of research has been done into the relationship between spatial design and its effect on the human brain” they say.
They quote Eve Edelstein, research director of the Perkins+Will Human Experience Lab: “Our studies of light, colour and intensity showed that heart rate variability, a sensitive indicator of mental engagement and health risk, changed with only 15 minutes of different electrical light conditions in a controlled space”. The point being, I suppose, that the good scientific principle is: prove it. It’s one thing to kinda know it feels cool, yeah but it’s more useful to know why.
Where we live affects how we feel about ourselves, our health, the things that have happened to us. Many of us work hard to afford a nice home to come home to after a stressful day, earning all that money to afford the home. A circle of living that constantly reinforces the kind of health issues facing most of us today.
“Burnout is the disease of civilisation” says Ariana Huffington. And she should know. As Becker’s ASC review reports, the founder of the Huffington Post once collapsed with exhaustion and fractured a cheekbone. “Is this is what success looks like? By the conventional definition of success I was, but by any sane definition I was not” she apparently said. “Defining success in just terms of money and power is like sitting on a two-legged stool – sooner or later you will fall off.”
Personal wellbeing and health is the third metric of success, she decided, and now reportedly embeds this in her businesses, opening much-used staff nap rooms in her offices, banning devices at meetings and committing to make vacations a proper self-restoring experience.
I’ve said often, through the experiences leading me to begin Unsee The Future, that what’s going on around the planet is a product of our shared mental outlooks. And at the moment, so much of this is not well at all. We live in a pandemic of mental health challenges. But what if this itself needs a new perspective? Not simply that of opening up about how we feel, unlocking more relief with more honesty. I mean on what it is we are really dealing with.
In an extract from his new book, Johann Hari talks about his experiences taking anti-depressants.
“I was a teenager when I swallowed my first antidepressant” he says. “I was standing in the weak English sunshine, outside a pharmacy in a shopping centre in London. The tablet was white and small, and as I swallowed, it felt like a chemical kiss. That morning I had gone to see my doctor and I had told him – crouched, embarrassed – that pain was leaking out of me uncontrollably, like a bad smell, and I had felt this way for several years.”
His doctor told him this was essentially a chemical imbalance. And a pill would rebalance it. And it did. For a few weeks.
“A few months into my drugging, something odd happened. The pain started to seep through again. Before long, I felt as bad as I had at the start. I went back to my doctor, and he told me that I was clearly on too low a dose. And so, 20 milligrams became 30 milligrams; the white pill became blue. I felt better for several months. And then the pain came back through once more. My dose kept being jacked up, until I was on 80mg, where it stayed for many years, with only a few short breaks. And still the pain broke back through.”
He began to look into it as the years went on. And discovered a drug-prescription culture that had grown in the GPs’ surgeries dealing with depression because of pharma studies evidence, backing up the efficatious nature of the chemical support. Except it wasn’t. Some of them were, he says, but the much greater majority of studies on antidepressant drug effects showed no improvement. Studies that were, he claims, hidden by the pharma companies.
Today he suggests, there is a huge number of people on regular antidepressants not effectively enough benefitting from them. Hari is at pains to make clear he doesn’t think they have no place at all, or that everyone should come off them. But something else is at work in the mental mix here, surely, he says.
“So, what is really going on? When I interviewed social scientists all over the world – from São Paulo to Sydney, from Los Angeles to London – I started to see an unexpected picture emerge. We all know that every human being has basic physical needs: for food, for water, for shelter, for clean air. It turns out that, in the same way, all humans have certain basic psychological needs. We need to feel we belong. We need to feel valued. We need to feel we’re good at something. We need to feel we have a secure future. And there is growing evidence that our culture isn’t meeting those psychological needs for many – perhaps most – people. I kept learning that, in very different ways, we have become disconnected from things we really need, and this deep disconnection is driving this epidemic of depression and anxiety all around us.”
Meaning. We are wired to need it. And if the Gallup pole Hari quotes is correct, this most exhaustive survey of life at work supposedly carried out to date, between 2011 and 2012 found that only 13% of us love our work. The rest of us, to varying degrees, are ‘disengaged’. With this activity that fills our waking ours and our worries, that keeps us from loved ones and from fun and from beloved hobbies and so many instances of “what we really want to do” and upon which the global economy depends.
Freedom. Feeling like we have some control over our lives, and the work we’re doing matters. It’s like magic to our minds. And most of us don’t have it.
Perhaps it’s something I’m wired to notice, or value more. I have clearly put a cash value on freedom and creativity over career influence and money. Don’t get me wrong, I’ve tried hard to have some savvy balance to it all, personally, and most of my earning life as a creative has been around topics I wouldn’t normally have any interest in. But working for myself, as I felt circumstancially forced to do fifteen years ago, began the healing process of cracking apart with a lack of meaning. One I’d been kind of faithfully adhering to while doing the day jobs, ironically. The crisis of getting nowhere ate into my mind over a period of time. And it wasn’t pretty. I knew what I wanted to spend my time doing, but I couldn’t work out how to be able to get on and do it. Getting out of where I felt trapped was like a weight leaving me. And while it took some years to leave the shadows behind, I eventually really did. And the new freedom let all kinds of empowering new experiences quietly fortify me.
All of which means, I don’t know about chronic and recurring mental health issues. Not across a short wavelength at least. I recognise. But across the measure of my life, I carry my vulnerability with me everywhere now and it is maybe my most meaningful qualification.
For me, finding the beginnings of new purpose did it. And Johann Har’s findings suggest that we should look upon depression not simply as faulty wiring to compensate for – even though this very diagnosis was meant to help you feel normal. Like a simple brain disfunction. Actually, he suggests, for millions of us it may be more of a context malfunction.
He says he wished he could go back to his young self and say: “This pain you are feeling is not a pathology. It’s not crazy. It is a signal that your natural psychological needs are not being met. It is a form of grief – for yourself, and for the culture you live in going so wrong. I know how much it hurts. I know how deeply it cuts you. But you need to listen to this signal. We all need to listen to the people around us sending out this signal. It is telling you what is going wrong. It is telling you that you need to be connected in so many deep and stirring ways that you aren’t yet – but you can be, one day.”
How can we encourage the more hopeful, healthy, human tomorrow? It’s by putting together our world view. And including each other in it. Recognising that so much of our unhealthiness is symptom – symptoms of something wrong that our mind is simply resonnating against. There can be nothing simple about dealing with this possibility, but we should learn to listen to it. In ourselves and each other.
In his book, Drop Dead Healthy, AJ Jacobs says his two biggest conclusions of living two years on health regimes were these – noise and joy. Lose much of the former, and invest in the latter.
Acceptance. The central tenet of mindfulness. Plus something more that is perhaps released by it – finding beauty in everything. How can we help each other find more beauty in life? Because it’s worth knowing, apparently studies have shown that the placebo effect works by far the best in the nice social context.
Pulchritudo and salubritas. It’s no fad. It’s the healthy full life of the future.
SIX LESSONS FOR ACHIEVING THE GLOBAL GOALS ON HEALTH >
Read the World Economic Forum’s headlines for making cultural differences to wellbeing aims.
IS EVERYTHING YOU KNOW ABOUT DEPRESSION WRONG? >
Read Johann Hari’s moving and insightful introduction to his book