Prevention
There’s an image of really good health that’s abnormal, almost uncomfortable – smugly distant from the way that most people live their lives. From Jamie Oliver’s school dinners campaign to recent calls for us to abandon the bacon butty, there’s a resentment of public interventions to control our health - even if, in the long term, we reluctantly admit they’ve done us good.
Perhaps it’s partly because so many of these campaigns are framed with appeals to workforce effectiveness. Ten million working days lost each year from depression, billions of hours lost because of back pain – or allergy – or nights on the booze. If the sole purpose of our health is to turn us into more-efficient work machines - well then, a few days off with that recurring back pain might have something to be said for it after all. It’s no surprise that stress is a compounding factor in many chronic illnesses.
Nortin M Hadler - The Last Well PersonThere are examples in large companies with multiple facilities of epidemics of disabling back or arm pain in a single facility. The physical demands of tasks are uniform across the facilities and are therefore not the culprit…. Usually, this situation is a reproach to management style in that facility.
Why get up in the morning?
To truly want health, people need something to feel healthy for. The philosopher A C Grayling has written a series of books about what makes a good and worthwhile life. In his own life, the answer is partly very fulfilling work: he describes leaping out of bed in the morning and rushing to his desk filled with enthusiasm for the task in hand.
Grayling’s an exception – not everyone can have a job they really enjoy. But everyone should have something to centre their lives around because they love it and think it’s worthwhile for them – not for the country’s GDP. The irony is that a nation of Graylings would be excellent for the economy.
Public health messaging is all true. You are more likely to die from cancer if you smoke, you will be healthier and may well live longer if you eat less salt and eat more fruit and vegetables. But these calls to health have comparatively shallow roots if we don’t consider the wider causes of wellbeing. These may range from the view outside the window, to friends and support, to a human-sized built environment. Cut off from these things, you can see how people might imagine that the best way to short-term happiness is a daily diet of chips followed by a few Marlboro Lights and a bottle of wine.
How can we live in the environment we want?
However, it’s not quite that simple. Public health messages assume that in the end healthy choices devolve to each person. But sometimes the surrounding environment makes it difficult or impossible for an individual to make such choices.
The asthmatic whose condition is made worse by ambient pollution, the would-be jogger who is scared to run on dangerous streets at night, the rurally isolated pensioner with no bus service, the child whose parents only buy processed food or a teenager living in a food desert - all these people may be forced into unhealthy ‘choices’ they can do little to avoid.
So the second strand of prevention is making the sorts of changes that only governments, communities, town planners and local authorities can bring about.
How can we reach a point where satisfied people find healthy choices easy to make? How can we shift the big picture so that people who want to live healthy lives have an opportunity to do so? In the coming months these pages will gather examples of many solutions that can contribute to the blueprint of a healthier society.