Exploring transitions towards a healthy society

It’s time to fundamentally change and rethink the way society fulfills the need for health. Modern societies are confronted with persistent health problems, that cannot be solved by ‘end of pipe solutions’. Inspired by twenty years of studying and researching sustainability transitions, and driven by personal experiences, I have founded HEALTi to explore ‘health transitions’:

A health transition could be defined as a “radical transformation towards a healthy society, as a response to a number of persistent problems confronting contemporary modern societies” (Based on the definition of ‘sustainability transitions’ by Grin et al., 2010).

Persistent health problems

Health transitions are needed because we are confronted with persistent problems such as: non-communicable diseases (cancer, diabetes, cardiovascular diseases, etc.), increasing mental health problems (depression, burnout), air pollution (NO2, PM10, PM2,5), microplastics pollution (in food, water and air), increasing obesity (62% of the Dutch population is over weighted in 2040) and ‘socioeconomic health inequalities’.

“All over the world, people with a less advantaged socioeconomic position (SEP), are less healthy, die earlier and live shorter in good health” (Simon-Op het Veld, 2018) For example in the Netherlands, people with a ‘low-SEP’ die 7 years earlier and their life expectancy in good perceived health is almost 20 years shorter.

Though our ‘average life expectancy’ is still increasing, this doesn’t say anything about the health of individuals, your family or the next generation. My mother died 20 years earlier than her ‘life expectancy’ despite of her good socioeconomic position and ‘healthy lifestyle’ (e.g. daily exercise, no smoking, no alcohol, ‘normal’ food, 8 hours of sleep, a positive mindset, a meaningful life, etc.). Because of this personal experience, I am very much aware of the complexity of health problems and the relation between health and our environment. We still have limited awareness and knowledge about how our modern living environment and related problems are impacting health. An example is our ‘unintentional’ plastic consumption, because of micro-plastics in food, water and air: 

“People consume 5 gram plastics a week, which is equivalent to the size of one credit card”  (source: NRC, 27 juni 2019)

These problems are complex, because they are embedded in our modern lifestyles and societies (which have been developed in several decades and will not change overnight!).

Another example is our ‘unintentional’ sedentary behavior. In the Netherlands it is very normal to sit more than 7.5 hours a day, while sedentary behavior is increasingly recognized as an important health risk (linked to type 2 diabetes, cardiovascular diseases and mortality).

This figure shows that the Netherlands and Denmark are European champions in self-reported sitting time (source: Loyen et al., 2016)

Though we have a high quality healthcare system in the Netherlands, this system is limited in it’s ability to prevent or reverse diseases that are related to lifestyle and environment.

“Medical sciences in the Netherlands helps you with slowly dying.” (Prof. Jim van Os, NRC Science 8 & 9 June, 2019).

Limits to health?!

It is clear that our modern society is confronted with many persistent problems that are impacting our health. To address these problems, we need to look beyond the limits of the healthcare system.

Our modern healthcare system is based on ‘end of pipe solutions’… The dominant problem solving paradigm is helping people who are sick (instead of helping people to stay healthy). 

We need to contribute to a much broader ‘health system’, which includes all actors that undertake health actions.

For example actions aimed at:

– healthy behavior (eating, exercising, relaxing, sleeping, living a meaningful life etc.)

– healthy water and food (full of nutrients and free of micro-plastics, EDC’s, etc)

– healthy air (free of NO2, SO2, O3 and particulate matter)

– healthy houses and working places (for example environments that enable healthy choices; Westendorp & van Bodegom, 2015)

– healthy communities (for example Blue zones)

– healthy cities and regions (for example nature-based solutions)

– a healthy planet (Planetary Health)

“We need to look at the bigger picture to understand the influence of environment and lifestyle on health (…) and reconnect with nature and ourselves” (Anna M. Kruyswijk, 2014)

Our health is inevitably depended on the health of our planet, and vice versa. “Damaging the planet, damages human health” (Source: The Lancet). To live on this planet in a healthy way, we will need to address big sustainability challenges. For example, we can tackle the climate crisis, and increase biodiversity, by planting more trees (source: The Guardian, July 4, 2019). A healthier, greener planet contributes to a healthier living environment, since trees and plants have an effect on air quality ánd reduce stress.

Unfortunately, it will take several decades before the planet has become greener, the ocean is cleaned up, the air contains less particulate matter, and our food and water is free of micro-plastics… We might speed up these sustainability transitions if we create more awareness and knowledge about the related health impact. For example, accelerating the transition to sustainable mobility will reduce particulate matter near our roads, which will have a significant* impact on our health.

*If the Netherlands would comply with the WHO guidelines for particulate matter: our life expectancy increases with 3 months, 800 people wouldn’t die earlier, 800 babies wouldn’t be born with low birth weight, during 175.000 days children would suffer less from asthma etc. source: RIVM

To fundamentally improve the health of present and next generations, we will need to look at health from a long-term, complex system perspective and take action now for sustainability AND health transitions.

Let’s rethink health from a ‘transition perspective’ and look beyond limits! – HEALTi

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