“I don’t want to achieve immortality through my work; I want to achieve immortality through not dying”.
In 1919, right after the horrors of World War 1, William Butler Yeats wrote, in his powerful poem, The Second Coming:
“Things fall apart; the centre cannot hold…
…The best lack all conviction, while the worst
Are full of passionate intensity”.
And so it seems to be with us a century later.
While uncharted political change is in the forefront, demographic and behavioural changes may be where we also need to focus, if our behaviour, much of which is potentially changeable, is not to bankrupt our economies in the decades ahead.
In the years after the second world war Britain was struggling with the challenges of a rising birth rate and how to provide for all those new children, the baby boomers, needing schools. 2017 is the year of the 70th birthday as more of that cohort than ever before hit three score years and ten. Me included.
A recent excellent radio programme, It’s the Demography Stupid with David Willets explored the way such changes in demographic profoundly impact our politics. Best current data suggests that life expectancy has, for most of the last couple of hundred years, been increasing at a rate of three months for every year. That is two to three years of life added for every decade. A ten-year old child in Britain today has a 50% probability of living to 104. Think about that for a moment. If this life extension continues as it has done, half the population will live to be 100. Half. This increase in life expectancy has been achieved as Gratton and Scott point out in their important new book The 100 year Life through three phases.
The first substantial increase in life expectancy came with the successful decrease in infant mortality from the 1920’s onward.
The second phase came in the latter part of the twentieth century as the fatal diseases that were commonly killing most of us moved ‘out of the bowels and chests of infants into the arteries of the middle aged and elderly’, particularly cardiovascular disease and cancer.
Now in the 21st century it is clear that the next substantial increase in life expectancy will come from tackling the diseases of old age. However this, like the other increasing inequalities of advanced modern capitalism, is in danger of dividing nations between those who can establish a healthy and sustainable life-style in middle age, and those, mostly the poorer, less advantaged and educated in society, who cannot. For unlike earlier times, where infectious deseases pounced and killed from one day to the next, many of the primary ills of later life are silently incubated over decades through the choices we make.
While it is certainly true that our National Health Service always needs more money, beds and an effective, integrated social care service, one thing nearly all of us could do to help it function better would be to take charge of our own health.
Eight our of ten middle-aged people in the UK are either overweight, drink too much or do not get enough exercise according to analysis from Public Health England (PHE)
PHE’s One You campaign is reaching out to the 83% of 40 to 60 year olds (87% of men and 79% of women) who are either overweight or obese, exceed the Chief Medical Officer’s alcohol guidelines or are physically inactive, to provide free support and tools to help them live more healthily in 2017 and beyond. Why not be part of the 1.1 million who have already taken the One You quiz so far?
It is estimated that habits such as poor diet, excessive alcohol, smoking and lack of activity are responsible for around 40% of all deaths in England and cost the NHS more than £11 billion a year. A worrying 25% of women and 20% of men in Britain fail to get even half an hour of exercise a week! This plague of stasis is driving the three D’s of Disease, Disability and Dementia, which in turn is driving the Health Service into an endless spiral of rising costs and declining services.
Oxford’s Professor Sir Muir Gray, famous both for his long work in Public Health as well as his book, Sod 70 is a great advocate for getting people walking. As he says,
“Over 15 million Britons are living with a long-term health condition, and busy lives and desk jobs make it difficult to live healthily. But just making a few small changes will have significant benefits to people’s health now and in later life”.
Two thirds of deaths of the under 75’s are avoidable, such as heart disease, diabetes, cancer, obesity, dementia and depression. Modern life-styles and working practices leads us to an over-eating-under-moving life with well-known dire consequences for our health. Perhaps we need to reclassify obesity, as Professor Gray suggests, as a walking-deficiency-condition or hyper-sitting syndrome.
For those of us who have to sit so much getting to, and doing, our work, Gray suggests we should try to measure our enforced sitting in half hour blocks dividing each one up with 20 minutes sitting, 8 minutes of standing and 2 minutes of walking to the printer etc. Better still try having all your meetings standing up or walking, often we can talk better together while walking side by side.
Perhaps a good start would be free pedometers for all. While 10,000 steps a day may be desirable even 3000 would be a great achievement for many to aim for.
Whatever we do we need to change the trajectory that is leading so many of us to be in danger of failing to enjoy long and useful lives that most of us can now, thankfully, otherwise expect.
To live a long life that is enjoyable we need to do the things throughout our lives we know will push back the onset of chronic diseases that lead to both morbidity, frailty and permature mortality. In this way far more of our lives can be productive, fun and joyful, rather than clouded by incapacity. We can have a chance to do the work of our later years, free from too much pain and disability, truly see into our own nature and better realise our true selves.
There are still too many health unknowns that can strike us down, but by far the majority of those ills that can impact on our activities of daily living (ADL) such as walking, bathing, continence, dressing and eating, are heavily influenced by choices we make decades before about what we eat how much we drink, the drugs and tobacco we consume and when and how we move. Too often it is less, in Yeats’s words, that the centre cannot hold, but rather how much the centre of our body does hold. For most of us the answer is, too much dangerous visceral fat!
Change these and we can all have a profound impact on our National Health Service. The same NHS that spends 10% of its overall budget already on one preventable disease, type 2 diabetes, could in decades to come, be free to deal with those challenging diseases that seem still to strike out of the blue, as well as look after the very old in the short time of their compressed decline towards death, while we can deal as much as we can with all those drivers of premature frailty and death that we know we can change with quite small adaptations to how we work and lead our lives.
The fourth industrial revolution is already upon us. As Klaus Schwab Founder and Executive Chairman, World Economic Forum says,
“We stand on the brink of a technological revolution that will fundamentally alter the way we live, work, and relate to one another. In its scale, scope, and complexity, the transformation will be unlike anything humankind has experienced before. We do not yet know just how it will unfold, but one thing is clear: the response to it must be integrated and comprehensive, involving all stakeholders of the global polity, from the public and private sectors to academia and civil society”.
We will surely have enough to cope with without dealing with the problems we already know how to change and solve if only we can get ourselves to change our behaviour.
So take the One You quiz, and act now to reduce that 40% of deaths we know we could reduce substantially and see how you can help change all our futures. http://www.nhs.uk/oneyou