They have sold you a giant myth when it comes to improving their health

According Devi SridharWe have our bad health priorities. In fact, they have sold us a giant myth. We are obsessed with what we can do personally: diet, exercise and the rest) and we largely ignore the most important determinant of our health. This magical bullet: government.

Public health measures such as universal medical care, drinking water, clean air and safe roads have a much higher impact on our possibilities to reach 100 than any number of gym sessions or collty hobbies. Sridhar, professor of global public health at the University of Edinburgh, the United Kingdom, has called a new book called How not to die (too soon)What makes a robust case that public health, not only individual effort, is key to living a long and healthy life.

She spoke with New scientist On why we swallow the myth of purely individual health, how we can make public health more attractive and what would do if they were in charge.

Graham Lawton: Are you saying that assuming the responsibility of our own health is a waste of time?

Devi Sridhar: No, no! It is super effective if you can do it. You can make the decision to be healthy if you have resources, time and education. But I think the idea that people are totally responsible for their health, which is what they are projecting us, does not reflect the realities of people’s lives. Where he lives and the circumstances in which he lives affects how long he lives. That is so easily forgotten with health problems, that their responsibility is considered. You need people to have agency during their lives and feel they can make a change. But in reality, when we see the change at the population level, where does it come from? In general, it comes from governments.

Why do we fall in love with the myth that it depends on us?

It makes us feel empowered. People say: “What can I do today?” And “I can do it if I’m hard enough!” But it is difficult to get people to think about broader structural problems and how to change them. And we are not exposed to that so much. We are exposed to self -help books, well -being literature, which are excellent if you have time and resources. But there is less about structural factors because people cannot see it directly applicable to their lives. And there is a lot of cynicism about politicians, thinking that they are all the same and nothing changes.

What is the correct balance between personal interventions and public health interventions?

I think it depends on the problem. With diet and physical state, you can assume a lot of responsibility. But with things like air pollution and clean water, what can you do individually? You are at the mercy of where you live and your government.

Do things like celebrities and influential people of Tiktok also biased balance?

Yes. It is marketing. It seems that thinking that the things that are marketed and sell us in the right way are better. I think there is a real marketing problem in public health. The last years have probably not helped. Public health is seen as draconian and dominant, eliminating freedoms instead of giving freedoms.

How do we change public health perceptions?

It’s about how we talk about public health. Instead of saying that it is good for the planet or that it is good for society, we could talk about it in terms of how it makes life easier and better. I think people want to know, why is it good for me? It makes me sound cynical, but that is the world we live in.

Even then, it can be difficult to transmit the message when there is so much erroneous information about things like vaccination. Why do so many people believe in nonsense?

I think that part of this has to do with social networks and the fact that it does not matter if you are accurate or not: popularity determines the truth. For example, you have Joe Rogan in his podcast talking about measles, saying that They all had measles When I was a child and everything was normal. It is surprising. He is not a doctor. He is not a public health expert. He is just giving his opinion. But he will be more influential than any health agency. If it came out and said: “Do you know what the secret for the longest life is? Gin and Tonic!”, He would get a million clicks. I think that is the challenge.

And there is also the challenge of implementing sensible public health policies, right?

There is always resistance to change. Think about the prohibition of smoking in pubs, there was resistance. When the seat belts entered, there was resistance. But in general, resistance comes in the first six months or year, then people get used to and that becomes the norm. The norms are changable.

His book contains many successful government intervention stories around the world. What is your favorite?

Because I’m in Scotland, I have to say Dunblane. Weapons Legislation [put in place after a school shooting in 1996 using legal firearms] It was a very close battle, there was real resistance, but the reward is not decades of massive shots in British schools. Many lives have been saved. And we have seen that template used worldwide.

In high -income countries, it is estimated that 20 percent of deaths are due to preventable causes. What can we learn from countries with lower prevented deaths?

The places to look are what we call the best performance countries, places like Japan, which has one of the lowest rates of chronic diseases and the highest rates of cancer survival. Then, he is looking at the best artists and saying that if each country looks like this, what could the numbers come? Japan is remarkably low, estimated at approximately 10 percent.

Our goal should be a greater life expectancy for all: reach 80, 90, possibly 100. If you can die of old age, you are going quite well, right? Because it means that there are no identifiable diseases or organic insufficiency.

But success would mean that we end up with a larger population. How would we deal with that?

I think we have to see aging as a positive force instead of a negative. We should talk about healthy aging, not reaching 100 to get there, but with complete mental and physical skills, without chronic diseases such as diabetes or hypertension, which are a burden for the health system and with the ability to live independently, which takes away social pressure.

How long would it take this idealized situation in which the preventable mortality rate is comparable to that of Japan?

Being realistic, it is probably a time scale of 10 to 20 years. Things such as reverse childhood obesity and the change in city design are not possible overnight. But they have great payments over time. One of the problems is that our current government model is the news cycle for the news cycle. It is not even year after year. He is headed to holder, and is incessant. So, there is no bandwidth so that people think 10 or 15 years ahead because they are trapped in it.

Ok, so if I were in charge of the National Health Service (NHS) in the United Kingdom, what changes would it make?

I am sure they have thought about this, but for me, prevention. We spend much less on prevention and much more on acute care. At this time, the focus in the United Kingdom is in hospitals and the waiting times of the ambulance, and will only get worse with a population that ages. So, I think I would go directly to prevention. What are the cheap forms in which we can invest in prevention to detect things before? Choose three or four problems that are the main reasons for hospital income and ask, how do we approach ourselves?

For example, we know that hypertension is a silent murderer. Could we have a program in which people enter and check the blood pressure once a year? It can cost more in the first year, but five or 10 years later, it is saving money. We could also take regular measures of things such as the circumference of the waist, the levels of abdominal fat, sugar and blood cholesterol, or even grip resistance.

Us The last time he interviewed you During Covid, when you said that pandemic was an opportunity to address some long -standing public health problems. Did that happen?

No. I think, in any case, there has been a reaction against public health and a reaction against state intervention because it was so draconian, in the sense of confinements and with masks. So, I don’t think we have taken that moment. It is quite fascinating what has emerged from the pandemic. Now there is even more emphasis on individual responsibility instead of acting collectively.

Did we learn the lessons of the pandemic itself? Is the world better prepared? For the next?

It depends on what you see. In public health, I would say no, we are going back. Public health infrastructure, such as the test infrastructure in the United Kingdom, has been completely dismantled. But in scientific progress, I would say yes. We are better to design vaccines. We have better vaccine platforms, more simplified research. The scientific community has become faster and more expert. I am quite sure that if the avian flu begins to spread [among humans]The United Kingdom government will have a vaccine, they will take it to clinics. They will be ready to leave.

An appointment near the end of his book jumped me: “We don’t need more research.” Actually?

Yes. We know a lot. We can probably obtain 90 percent of the way there with existing knowledge about how to improve public health at the population level. Of course, there is always room for more research, but do we need another study that shows that exercise reduces its risk of heart attacks? Probably not. It can almost be a distraction say: “Let’s do more research.” Because you can delay a decision. That was what I was trying to arrive.

Worldwide, are we in the right direction on public health?

I think, in general, yes. Life is getting longer. We live better today than 100 years ago. Maybe we are not progressing as quickly as we could, and there are some places where things are restarting. But the biggest trajectory is that we have made so much progress.

What do you expect people to remove the book?

That politicians can make a difference. Think about the NHS. A deliberate decision was made to create it. Not only did it happen randomly. I am trying to demonstrate that, in the world in which we live, all we have is a set of policy options that were made before, sometimes decades ago, that we are benefiting today. What we do today, we may not see improvements, but future generations will. What I have tried to do is give some hope.