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[Music]
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for the past ten years or so I've been
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working with National Geographic to
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identify geographically defined
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demographically confirmed parts of the
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area where people live measurably longer
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these are populations not just
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individual experience tens of thousands
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of people in most examples and then
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working with other experts to find their
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common denominators I wrote this up in a
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book called Blue Zones you don't have to
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buy the book because in the next 90
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seconds I'm going to tell you all the
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essential secrets no matter where you go
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in the world whether it's Okinawa Japan
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certainiy Italy the highlands Nicoya
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Peninsula Costa Rica the Katya Greece
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I'm on the seventh-day adventists you
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see the same nine things happening over
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and over and over among the longest live
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people a lot of these things are very
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intuitive eating a plant-based diet lo
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and simple carbohydrates high in things
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like beans and nuts the ever-popular
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prescriptive to have a couple glasses of
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wine a day and no you can't save up all
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week long and have 14 on the weekends
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people actually ask me that but the
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really cool findings come from the
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counterintuitive things you do you know
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that people who have a strong sense of
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purpose and can articulate it live about
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seven years longer than people who don't
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people who belong to a faith-based
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community and actually show up four
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times a month lift four to 14 years
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longer than people who don't and none of
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the longest-lived
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people in the world and I interviewed
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253 of them ever exercise in the way we
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think of exercise they did however live
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in environments that constantly nudge
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them into physical activity they burnt
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about five times as many calories as we
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do in non exercise physical activity
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they lived anywhere from 7 to 11 years
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longer than we did with a fraction of
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the rate of chronic disease these are
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populations one of them is even an
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American population that was a decade
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longer than the rest of us but as you
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know you can tell people all day long
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the things they ought to do to live
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longer and to be healthier but how do
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you actually get a population to do them
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we spend almost a
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trillion dollars a year and largely
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preventable diseases cancer diabetes
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heart disease largely preventable
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diseases but I assert we not only are
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spending too much but we're aiming at
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the wrong target if you look at what
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really drives disease and costs in this
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country about 80% of it is lifestyle and
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environment only about 10% is genes this
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is on a population as a whole and
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healthcare accounts for another 10% of
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it but now look at the way we spend our
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money this incidentally comes from the
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CDC we spend only about 4% of our our
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healthcare dollars on on prevention and
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then we spend 88 percent of them on
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cleaning up the problem if the problem
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has happened we're aiming at the wrong
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target instead of the downstream
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problems we should be aiming at what to
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do before they happen I think most of us
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know that we do spend over a hundred
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billion dollars a year on prevention so
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you may say Dan you know we're are an
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overweight population here in America we
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don't move enough we nudists we should
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be focusing on diets and exercise and
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supplements the problem is by and large
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they don't work when you think of things
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that are going to truly add to longevity
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to truly lower your chances of getting a
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chronic disease you cannot think in
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months or in years you have to think in
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decades or a lifetime so you say well
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diets a pretty good idea but no diet in
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the history of the world has ever worked
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for a significant proportion of people
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who started we could come up right now
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we could spend the next three days and
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come up with the TEDMED diet the best
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minds on the planet when it comes to
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medicine come down and come to Ted come
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up with a TEDMED diet we get mark up
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here and J up here and we do a man hug
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and we get people all pumped up about it
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but the reality of diets if a hundred
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people start a diet 'day within seven to
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ten months you'll lose 90 of them and
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within the next two years you'll lose
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all but about
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percent of them so when it comes to a
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long-term strategy diets don't work no
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diet in the history of the world
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exercise has a similar recidivism curve
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we were able to find data on gym
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memberships on out of a hundred people
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who start a gym membership today in
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three years you'll learn lose about 90
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percent of them this is a bit of a
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heresy I know but when it comes to
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public health exercise just isn't
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working the average American only burns
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100 calories per day engaged in willful
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physical activity exercise supplements
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whether they're medicinal or
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nutraceutical about the same thing we
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may say Stanton's and aspirin are really
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good for people to take but you don't
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get a critical mass you don't get enough
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people taking them over time so based on
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these findings I went back to National
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Geographic and I proposed another blue
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zone type worldwide search but this time
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I wanted to find communities that were
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unhealthy and got themselves healthier
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and God blessed that rectangular yellow
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heart of National Geographic they funded
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me one all over the world and found out
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two remarkable things number one of the
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tens of millions of dollars we spend on
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public health and different initiatives
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for that Amed chronic disease none of
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them have worked there's one in
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Minnesota the heart healthy there's the
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one in Stanford Connecticut another one
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in California what happens is more or
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less the health care equivalent of the
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Hawthorne effect as long as the experts
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are there paying attention and the TV
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cameras are rolling people will do what
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they ought to do but as soon as they
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leave people revert back to their
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baseline so as a long-term strategy it
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just the simply don't have them worked
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here in America there are two places in
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the world where projects have started
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out with unhealthy people and made their
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populations healthier one in France
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northern France the e-poll project
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brought down the rates of childhood
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obesity and maintain them for eight
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years and the
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second place was in Scandinavia they
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brought down the rate of cardiovascular
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disease by 90 percent and maintained it
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for decades and I was able to spend
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several months with these projects and
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really take a look at how they executed
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them how they made them work and I
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realized that the essence of their
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success hinged on a tenant that's very
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different than that attendant many of us
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subscribe to these projects did not rely
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on individual responsibilities to be
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successful they didn't look at you and
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say it is up to you to get yourself
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healthier they realized that we're all
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part of a system and you need to address
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the system so based on that I used some
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of the money of that grant to hire who I
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think are the greatest experts in
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America when it comes to optimizing an
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American system this by the way is not a
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program it's not a template it's an
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operating system it's a way of thinking
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and I pulled together six people from
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various different disciplines to help me
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think about how do you optimize an
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American community for health and our
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first finding was that we all live in a
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life radius we most of us spend about
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80% of our lives within about 20 miles
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of our homes and works so that's the
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area that we're trying to make better
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now what sorts of things influence a
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life radius well number one you have
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policy is it easy to smoke in this
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community
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can i smoke indoors and out is soda pop
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and salty snacks are they cheap do day
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care centers allow the licensed daycare
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centers allow little kids to watch TV
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before age - is there an opt-in or
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opt-out policy when it comes to organ
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donation state these things make a huge
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difference on a statewide level the
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built environment is it easy to walk
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downtown our parks neat and alluring is
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it safe you know the number one
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inhibitor to old people going out and
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getting extra
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the perception of safety doesn't even
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have to be safe just cleaning up
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cleaning up graffiti will get more older
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people out Robert Wood Johnson
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Foundation found that if you can just
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make the after active option the easy
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option in communities you raise the
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physical activity level of that
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community by thirty to forty percent no
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gym memberships no yoga classes no AB
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master just make the active option the
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easy option social networks another
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thing that you can modify at an
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environment if your three best friends
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are obese is a hundred and fifty percent
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better chance that you'll be overweight
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how do you help people optimize their
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social networks or expanded if necessary
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then there's structures we spend our
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daily life's in schools restaurants you
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know we eat out a hundred and ten times
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a year you could have a perfect kitchen
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but if if you're eating out a third of
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the time in places where they're over
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serving you it for every meal there's a
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problem there schools workplaces and
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then sense of purpose how do you in view
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people with a clear idea of what their
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values are and what they're good at and
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give them an outlet so this was a nice
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theoretical construct this is where we
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got the name silver buckshot
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evidence-based ways unleash him on an
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environment well thanks to AARP and the
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University of Minnesota School of Public
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Health we got another big grant to
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actually audition five cities and come
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into the city most ready to adopt this
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blueprint Albert Lee Minnesota one and
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they mainly one because the mayor the
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city manager the head of public health
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the superintendent of schools had a
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Chamber of Commerce signed a pledge
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saying we're on board for changing the
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environment our experts came in and we
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just listened we found out for example
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that they wanted to widen Main Street
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and raise the speed limit something that
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we believe would tear the social fabric
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in half instead we convinced them to use
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some of that money to create one walking
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vector from every neighborhood downtown
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there was a beautiful place to
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recreative on this beautiful lake but
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you couldn't get around it so we took
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some of the street Wyatt E money and we
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created a path which is now full
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all the time optimizing the built
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environment we built for community
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gardens this is a city of only 19,000
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people dr. Brian Watson came in and
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helped us optimize food environments do
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you know the one adjectives that most
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assures that you will not order an
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entree on a menu the healthy choice
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nobody wants a damn healthy choice they
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want something good adjectives like
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crispy and fresh will get people eating
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the same food that was otherwise
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mislabeled we have dozen tweaks we can
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do to restaurants when in all the
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grocery stores got them to flag healthy
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foods and even create checkout lanes
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where the impulse buys were all healthy
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we went in all seven schools and got
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them to adopt nine policies the most
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powerful one of which a simple policy
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that prohibits kids from eating in
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classrooms and hallways that one policy
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alone much more impactful than whatever
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you put in the school lunch that one
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policy alone will lower the BMI of that
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school by about 11% and it's permanent
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we went into about half the workplaces
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appeal to individuals and got them to
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sign a pledge to make permanent changes
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to their homes everybody took a risk a
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risk assessment longevity compass we
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call the vitality compass so we could
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get a baseline we got them to do
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permanent things like grow gardens let
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our experts come into their kitchens and
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trade out the 14 inch blades for 10 inch
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plates and do things like put signs on
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the counter reminding people to pre
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plate their food those two habits alone
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equate to about a twenty to thirty
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percent fewer calories in any given
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sitting and then we went and helped
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people optimize their social environment
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we took the people or ready to change
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their behaviors and fostered long-term
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friendships with them over the course of
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18 months we got phenomenal media
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coverage USA Today Good Morning America
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Nightline
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Walter Willett the Dean of Harvard
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School of Public Health came in and
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wrote a two-page story on our on our
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little experiment and found the results
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stunning
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US News and World Report's came in a
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year and a half later and found out that
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everything we put in place was still
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working and then our numbers I think
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mirrored the success of the idea
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people's life expectancy went up
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people's weight went down and there was
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a 40% drop in city workers health care
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cost that ladies and gentlemen is where
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the rubber hits the road I don't have to
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tell this audience that we have a
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healthcare problem in our country 68% of
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us our beefs are overweight and that
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numbers going up along with cost
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diabetes is on the way up and for the
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first time in living history life
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expectancy of our children is supposed
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to go down is that because we're stupid
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or if somehow undergone a degradation of
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our moral character or we have less
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discipline or love our children less
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than our grandparents or kids did now we
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live in an environment of ease and
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abundance we are evolutionarily
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hardwired to crave fat and to crave
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sweetness and to crave rest when we can
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get it but we cannot go to a pharmacy to
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fill up our car with gas to rent a DVD
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without being routed through a gauntlet
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of salty snacks or sugar sweetened
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beverages every single day 278 images
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rinse over our brain telling us to buy
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it stuff we largely don't need and to
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eat food that isn't all that good for us
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raise your hand if you walk to school
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when you're a kid go ahead rage and look
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around almost every hand is up now raise
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your hand if your children walk to
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school 1970 50% of American children
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walk to school we're now down to about
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10% just engineered three miles of free
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physical activity out of kids is daily a
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weekly life when it comes to making this
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country healthier and getting health
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care cost under control there is no
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silver bullet
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it's silver buckshot its unleashing
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evidence-based long-term ways to change
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people's environments and it's doing it
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one ready community at a time thank you
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[Applause]
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[Music]
