Many health complaints, such as cardiovascular disease, diabetes or joint problems seem inescapable diseases of old-age, but originate mostly from our lifestyle. A lifestyle that is largely dictated by our environment. The mismatch between our 'old' genes - our evolutionary heritage - and the 'modern' environment is the reason that we cannot resist the constant stimuli that seduce us to make unhealthy choices. Do's and don'ts cannot help us.
This health course will take a radically different approach to showing you how to secure a lifestyle, which will keep you healthy throughout the lifespan. We have to let the environment do the work for us. By making small changes at our home, work, school or neighbourhood, healthier choices can become easier and automated.
Practical assignments will give you the skills to re-design your daily environments to promote healthy, longer lives for you and your family, colleagues and neighbours with whom you share your re-designed environments. You will learn how to create your own healthy living zone!
We will take you on excursions to Copenhagen, Denmark and to Ghent, Belgium to show you hands-on how the environment can help you live longer, healthier and happier lives!
Week 1. Old genes in a new environment
In this week we will first look at how people used to age in the past. We will share the insights of our 9 years of field work in rural Africa, in the upper east region in Northern Ghana. Next we will look at how different people age in our modern environment, characterised by low levels of physical activity and high levels of calorie-rich food, by chronic stress from our 24-hour economy, and the changed rhythm of wake and sleep that accompanies that. Our modern environment makes us ill.
Week 2. The medical reflex and the alternative
And when we become ill, we visit the medical doctor. In what we call the medical reflex, he or she treats the symptoms of our unhealthy lifestyle with medication. This seems like putting the cart before the horse. Why wait till our lifestyle makes us sick and then correct the symptoms with pills instead of fixing the problem, our lifestyle? We will view ageing and age-related diseases as emergencies in slowmotion: Just as deadly, but they take twenty years instead of twenty seconds from the first symptoms to death. This means there is a window of opportunity to steer away. But not by telling people what to do
Week 3. From conscious to unconscious health behaviours
For over thirty years we have been told for thirty years that what we should and should not do to remain healthy up to higher ages. The trick is to maintain the healthy behaviour in the long term by integrating it into daily routine. We have been told what to do, but our bodies don’t want to and never will. We can try to control our body with our brain, by telling it not to eat too much chocolate every day. But this is neither great fun nor very effective, especially in the long run. In this module we consider an alternative: what if these healthy options become easier, maybe even automatic and unconscious? We will review how many of our choices are heavily influenced by the environment even though we like to think of ourselves as rational individuals making conscious decisions.
Week 4. Hacking everyday environments
In this module we look at some common environments. We will start with the home environment and review how redesigning our kitchen can change the way we eat. We will study how changes in the bedroom can make us sleep better. Next, we will look at working environments. How can you convert your office into a place from which you gain health instead of one that increases your risk of cardiovascular disease and diabetes? And how can the school canteen and office cafeteria be arranged as a place to promote a healthy diet?
Week 5. In the neighbourhood, public environments and transits: the case of Copenhagen
In this module, we will look at the neighbourhood and the public environment and transits. How can small changes in the neighbourhood promote social interaction with neighbours? How can a city seduce its inhabitants to use the bike more often than the car? We will take an in depth look into Copenhagen, a city that has dedicated itself to become to cycling capital of the world. They have not told anyone that they should bike more often. Instead they have created an environment in which biking is the most accessible, fun, easiest, cheapest, fun, accessible and fastest way to get from A to B in town.
Week 6. A new public health
In the previous module we studied the case of Copenhagen. When promoting health in a radically different way (i.e.not by building hospitals and employing doctors but by converting a city into a cycling city), large investments have to be made in infrastructure. This requires a holistic view on public health. Health that is not only promoted by doctors and hospitals, which are financed by the ministry of health. Health can also be promoted, for example, the train company that facilitates commuting. Train companies can promote healthy behaviour by providing easy bike-access to platforms and facilities for taking bikes on trains. Although such investments do not pay themselves back directly through increased revenues from train tickets, their substantial health benefits and reduced sick leave benefits create a net positive return on these investments. In this module we consider a new public health, one that emphasizes healthy populations instead of sick individuals.
David van Bodegom MA, MD, PhD, Remon Rooij Ir, PhD and Rudi Westendorp MD, PhD