Monthly archive for May 2014
Showing results 1 - 5 of 18 for the month of May, 2014.
30 May 2014
Is Transition good for a community’s health? Janet Richardson is Professor of Health Services Research at Plymouth University in the School of Health and Human Sciences and is the first person to do a Health Impact Assessment of a Transition initiative. In 2011 she did a “rapid” Assessment for Transition Town Totnes. What did it discover, and what can we learn from that?
What is a Health Impact Assessment?
A Health Impact Assessment is a framework which includes a number of tools to assess the potential health impact of something like a planning decision, it could be around the building of a major supermarket or a housing estate. It’s a mechanism for looking at the potential health and wellbeing impacts on the community who are likely to be directly affected by the changes.
You did one for Totnes in 2011 that looked at the health impacts particularly around the Transition Streets programme that was running at the time. Could you tell us a bit about that and what its findings were?
We looked at one of the major Transition Town projects, the Transition Streets initiative and we applied a Health Impact Assessment framework, but particularly looking at sustainability. Obviously the focus on the Transition Streets is around building resilience and looking at sustainability around peak oil and the effects of climate change.
We used that framework and allied that framework to a Health Impact Assessment decision making tool. It was a rapid Health Impact Assessment, so we looked at desk-based material and we also interviewed key informants in the community who would potentially give a different view, so they were purposely selected in order to provide a range of views about the project.
What we found was that on a range of health and wellbeing measures the initiative itself had enormous capacity to increase the health and wellbeing of the people who were participating in that particular project, the Transition Streets initiative. Primarily that health and wellbeing benefit was through community engagement and engaging with immediate neighbours.
The health and wellbeing benefits of increasing socialisation and increased capacity to engage with the local neighbours who the people involved in the project might not ordinarily have engaged with, because there was a focus to that engagement. Other benefits were around exercise, so increasingly the people involved with the project were spending more time outdoors, working in their gardens, sharing food, cycling, those kinds of benefits.
The potential health and wellbeing benefits were associated with the people who were engaged in the project. One of the issues that we raised was the need then to look at people who are not engaged in the project like that in the town, and how those benefits through engagement can filter out across the town to other people who are perhaps harder to reach groups. That’s one thing that’s quite a challenge to do anyway, in any kind of project – a Transition Town project but also a health promotion project or community engagement project. It’s really how you have a mechanism for engaging those hard to reach groups who potentially could have much more benefit than the ones who are likely to engage.
How big a piece of work would it be to do a Health Impact Assessment of the impact that Transition Town Totnes has had since it started?
That would be a really interesting piece of work because what you’d be looking at is not just the impact on the local community but the impact on the infrastructure as well. Health Impact Assessments do also look at the impact on the development of infrastructure so it could be small scale, large scale, but I think so many years on that would be an interesting retrospective. The thing with the impact assessment framework and the process is that often the process is done retrospectively. It’s much better, particularly for planning development if the process can be done prospectively, so what you can do in terms of benefits is look at potential mitigating factors.
If you see that the likelihood of changing traffic flow to accommodate a housing estate or a supermarket is going to potentially increase the risk of road traffic accidents, you can mitigate for that. So it’s a really good framework to develop mitigation strategies for developments. Also, retrospectively you can look at what benefits you might have had from the impact of the project as a whole.
If you look across what a group like Transition Town Totnes does, you could argue that pretty much everything it does benefits public health, like being involved with a community energy company, having a greater sense of agency as to where the future of your community is going – it’s hard to think of anything involved with Transition that doesn’t have a benefit. How do you see that overlap, that merging of the two?
There are overlaps at different levels. If you start with an end point such as a disaster: major flooding for an example that we’ve seen recently and are likely to see more of. There are obviously disaster management plans in place. Those could potentially overlap with the social capital in the town.
If you know where the social capital is in the town and the skills, particularly in a town like Totnes with such a range of diverse skills, if there’s the potential for at that point in time within your disaster planning to know what the social capital in the town is.
More broadly with the health service which is a huge consumer of energy, there’s lots of overlap there in terms of how we manage it. The NHS Sustainable Development Unit is doing sterling work on that, focusing on the estates management and being more energy efficient. But public health has a huge remit for health promotion and primary prevention and a lot of the work around Transition is capitalising on staying well.
The challenge is behaviour change. With behaviour change it’s harder to change behaviour for the benefit of some things that are going to happen in X number of years. Climate change is a bit like smoking. Obviously the long-term benefits of giving up smoking are phenomenal. The short-term benefits are good as well.
But it’s about educating and supporting people to change their behaviour in a way that is going to be good ultimately for the planet and for our children but also will have immediate impacts on health and I think those are the kinds of messages around Transition and working alongside public health that can be quite positive.
There is huge potential and particularly with the ageing population and the need to look at loneliness and how we support people with long term conditions. Building social capital and community resilience can really be mobilised to support some key public health issues.
[This is an abridged version of the full interview, which you can hear below]
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29 May 2014
Here is the latest blog I have written for The Guardian’s Live Better Challenge section:
EcoBricks and education: how plastic bottle rubbish is helping build schools
It began in Guatemala, and now a South African town is using recycling bottles as building material as part of an inspirational and regenerative campaign against rubbish
Take a two-litre plastic drinks bottle, a heap of plastic bags, crisp packets and other non-biodegradable waste (roughly one week’s worth of plastic waste), and a stick. Pack the bottle full of the waste materials, packing it as tightly as you can, using the stick. That’s it. You have an EcoBrick.
Next time you hold a plastic bottle in your hand, try thinking of it not as rubbish to be disposed of, but as the building block for something extraordinary. The story of EcoBricks starts in Guatemala, and takes us, via the Philippines, to South Africa. Susanna Heisse, horrified at the level of plastic waste around Lake Atitlán in Guatemala, first came up with the EcoBrick idea. She built a wall out of them, which became an inspiration to others around the world.
There are now 38 EcoBrick schools in Guatemala built by an organisation called Hug It Forward, Vida Atitlan (Susanna’s organisation) and others, with many more planned. In the northern Philippines, ecobricks.org created an open source manual, distributed to local schools. As part of the curriculum, students are asked to bring in a completed EcoBrick each week, having written their homework on the side of it.
EcoBricks represent a different approach to waste management. Plastics recycling is an energy intensive, polluting business, often involving long transportation distances. How might it be to find alternative uses for them at the local scale? Construction is one obvious approach. EcoBricks turn waste into a highly insulating, robust, affordable, building material, which simultaneously tackles problems of unemployment, waste and lack of housing. They can be used vertically as infill in timber-frame building systems, or horizontally, where they are mortared together with clay or cement.
Greyton in South Africa is the first Transition initiative in the country. Greyton is a town, like many in the country, struggling to deal with the legacy of apartheid, wide social inequalities, lack of affordable housing, and a waste management system that is virtually non-existent.
Nicola Vernon, one of the initiative’s founders, found the Transition model adapted beautifully to the setting and challenges of Greyton. “As a driver for social integration it’s the best I’ve encountered in 30 years of working in social welfare,” she told me. A whole raft of projects are underway: community gardens, working with local schools, and Greyton is set to become South Africa’s first plastic bag-free town this July. A new eco-village settlement is being designed, and 18 jobs have been created already through the group’s activities.
Joseph Stodgel, a US artist, musician and entrepreneur, who heard of what was underway in Greyton and went there to see how he could help. A trip to the town’s dump provided the inspiration. “The dump is the first area you come to if you are walking from town,” he told me. “It is really a beautiful place, that has such a striking contrast between the pristine nature and man-made pollution. Pristine sites are usually host to festivals, but sadly enough are often degraded and polluted as a result of them. I wondered – could we reverse this process and actually use the medium of celebration to drive rehabilitation? Could we use a festival to turn dumping sites into pristine gathering spaces?”
The Trash to Treasure Festival was born, hosted in Green Park, the first part of the dump cleared by the festival, and the part closest to Greyton. Bands play on a stage built from reclaimed tyres. Every year (the third festival just took place in April), EcoBricks are made and exchanged for prizes donated by local stores, and new buildings are created with them. Already a composting toilet block has been built, and future plans include a kitchen, shower stalls and even on-site accommodation. An outdoor classroom is currently nearing completion, with each wall having been built by a different local school.
How does he feel launching these ideas in the context of a town-wide Transition initiative helped? “Greyton Transition Town has been instrumental in uplifting the local community, launching and sustaining a several wonderful initiatives and bringing great attention to wastefulness. Altogether they have been a truly positive force in the area in a number of ways. So many people across the community are into the journey to zero waste. It has been a hugely positive force”.
One of those who caught the EcoBrick bug in Greyton is Ian Domisse, an architect based in Port Elizabeth. He was so inspired by the potential and possibilities they offer that he quit his job and set himself up as an EcoBrick architect. While he waits for planning approval for his first building, an EcoBrick classroom for the Penguins Play and Learn nursery, he has started an EcoBrick Exchange in order to generate his building materials.
The Exchange is a network of local business partners who are happy to offer storage space and discounts in exchange for EcoBricks, as well as community swap shops, where second hand items of value are exchanged for EcoBricks. This idea of EcoBricks as a form of local currency is one of its more intriguing recent developments. Ian gave a series of talks at local schools, inviting them to make EcoBricks for the Exchange. For four months he heard nothing, then suddenly 900 completed EcoBricks turned up.
As the world groans beneath the growing mountains of plastic waste and its toxic legacy, perhaps the solutions lie closer to home than the recycling plant. Perhaps the seeds being planted in Greyton, and the potential, as spotted by Domisse, of EcoBricks to catalyse a local economic renaissance, is an idea that could go to scale quickly. By keeping waste local, it is perhaps the creativity and imagination that it stimulates that could turn out to be its longest lasting and durable legacy.
Interested in finding out more about how you can live better? Take a look at this month’s Live Better Challenge here.
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29 May 2014
“What is the change we want to see in the world, and how will that change happen?” These were the two rather intimidating questions we posed ourselves at the recent Transition Network Awaydays – our twice-yearly retreat for staff and board members. This post shares one piece of the our wide ranging exploration of theories of change, which looks at what it is about human beings that enables us to create healthy, sustainable, pleasurable ways of living – and why we often don’t.
We started with a very big map of change – and the understanding that the change Transition seeks is towards more “health” in every part of our system. We used the word health not just for our physical state of wellness, but applied to all the different parts of the huge system of which we’re a part. So it includes our mental or emotional as well as physical health, but also applies to larger scales – community or societal health, ecological health, planetary health, and so on.
We went on to look at a number of “Theories of Change”, including the one below – which looks at how we can get stuck in an emergency state, and continually recreate stressful, unequal systems at all levels of scale.
Exploring Doing and Being
What follows is a really simplified version of a model which focuses on two aspects of human existence, Doing and Being. The model has lots of layers and facets. My intention isn’t to present something definitive or watertight, but to give an overview of something which I – and many I’ve shared it with – have found helpful. (See here for a video of me explaining this and another model of health / un-health at the Change Day in 2013)
Health = Balance and Flow
The first proposition of this model is that health for humans is a flow between two contrasting (not opposite) qualities of life. Some might call them archetypal qualities. Here are some words that describe them:
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Outer, Doing, Active, Will, Yang, Task-oriented
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Inner, Being, Receptive, Love, Yin, Relationship-oriented
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So we might draw health as something like this:
You can see this natural rhythm resulting from our evolution in a world which has similar cycles – night and day, winter and summer. In fact we have nervous systems which regulate our bodies for both parts of the cycle – parasympathetic for the relaxing, digesting, inward part; the sympathetic nervous system for the active outer phase.
Resilience = Ability to bounce back to health
When we are resilient we can be stressed in this system and bounce back to health. A lot of neuroscience research recently has shown that there are a number of ways we can respond to stress. The sympathetic nervous system often goes into fight or flight response – the most well known. Peter Levine’s work with trauma shows animals and also humans can freeze when threatened. Our evolved response is to take action, and then to release the tension from the body – either through the running away or fighting, or by shaking out after the freeze response. We can then come back to the healthy flow between relaxation and action.
Out of balance = Unhealthy
However there are circumstances where we don’t come back naturally to that flow. One is where our stress response is overwhelmed by a major event – such as a physical attack, or being shamed in front of others (we respond to emotional attack as if it were physical – we don’t have a distinction in these parts of the brain).
The other is if we endure some kind of stress over long periods, where there isn’t time or space to recover and bounce back. It’s been shown that this kind of long term activation of the stress system can damage the immune system, leading to illness.
One of the areas of research is into early development of the stress response, showing that the brain wires up differently depending on genes as well as our early holding and relational field. Some people have an overactive stress response, triggering easily into highly active attack or withdrawal; others handle stress by feeling numb, having a low emotional tone.
When our capacity for coping with stress is overloaded over time we can get stuck in the physical, mental and emotional survival state. For some this is a driven need to keep going, for others this may be a place of collapse. It’s helpful to see that these two positions are the extremity or the distortion of the healthy qualities of activity and stillness, and the healthy emergency responses of fight / flight and freeze.
Recognising an unhealthy system
There are a number of features of a system – whether an individual or a group – that has reached this state of distorted polarity:
- Both polarised states become an identity, not just a response to circumstances. “We’re hard-working”, “I’m powerless”.
- The people in the active state will tend to run the system – because they have capacity to act and do things. The beliefs of this state become the cultural norm.
- The overactive state arises partly to avoid the difficult feelings created by being powerless in the face of circumstances of helplessness, overwhelm or despair. It’s kept going by its judgement of vulnerability. In our culture one example is shaming boys for being “like girls” if they show tenderness or vulnerability.
Bringing a polarised system back to flow and health
A system (a person, a group, organisation or society) which is stuck in the polarised positions can be helped in a number of ways:
- The first step is always to recognise the nature of the system – to step outside being identified with one side or the other. In a system of power it’s particularly important that those identified with the active side start to see how the system works.
- Creating real communication between those who are experiencing the disempowerment and those with power can help to put the two parts of the system back together– so both can own their power and their vulnerability. Methods like Process Oriented Psychology (Arnie Mindell’s work) do this.
- Strengthening qualities like kindness and compassion – asking those who are active to have a practice of compassion and kindness towards their own vulnerability, or those others who are less able than them. And similarly, those experiencing powerless are helped if they can see that those with more power are also trapped and disconnected from life.
- Providing all the things that were missing as the system moved into being overwhelmed – support, listening, empathy, empowerment, feeling resourced, connected and safe.
This is emotionally charged territory – the desire for power, and to dominate, may originally be a response to dealing with overwhelming stress or trauma, but often brutal systems of domination and exploitation result. If or when these are overthrown there is a moment where the roles can simply switch to another group dominating; or there is an opportunity for peace.
For any group of human beings, I would say that its ability to stay identified with the place of balance and flow, and the ability to step out of and recognise distorted belief systems, is the definition of health. Groups with this kind of health will have ways of recognising when the distortions are starting to arise, and bring the system back to balance. This is shown on the diagram with the eye – able to see both parts of the system, and bring them back into relationship with each other, back to balance and flow.
Social Technologies which support health
There are many social technologies which explicitly recognise our capacity to fall into traps of distorted beliefs and stay there, which have developed practices to correct or heal people who get trapped. A while ago I wrote about the Haudenonee Confederacy and their principles of peacemaking, which include operating from “Upright mind” rather than “Deteriorating mind”. In their councils they have someone with a role to stop the meeting if its state of mind starts to deteriorate. Quakers use gathered silence as a way to quiet the mind and come back to a state of open receptivity. Buddhism has a very precise explanation of the “poisons” of the mind – aversion, greed and illusion – and specific practices to come back to reality and health.
For me this is the first model I’ve found which really explains how “power over” systems arise – not because of some power hungry gene we have, or because hurting other people gives us a kick, but because we have a stress system that can gradually take us out of balance, until we don’t even know that our state is dysfunctional.
When I look at our society I see this system operating in many of our systems. I see it in our belief that we have to keep growing our economic activity – a compulsion to “do” more and more. I see it in our need for busyness, distraction, activity, to be constantly entertained. I see it in the difficulty we find when we do stop – how uncomfortable it feels, as all the feelings we’ve been keeping at bay rush in. Bi-polar disorder is a precise description of someone swinging between the two distortions of manic activity and depression, unable to reach balance.
Unhealth in the health service
I read a great article in last Saturday’s Guardian about doctors in the health service suffering from health problems – depression, anxiety, mental health problems including bi-polar disorder. The culture of the health service, like many of our workplaces, is that limits to work, vulnerability, illness, and human fallibility are unacceptable. This quote is from Clare Gerada of the Royal College of General Practitioners:
“An atmosphere of fear and uncertainty pervades the NHS, adding to doctors’ anxiety about being perceived as weak or unwell. Doctors do not find it easy to get the right help, even if it is available to them. Their problems are, Gerada says, deep-rooted, psychological and social, part of a stigma in the NHS attached to weakness, addiction or mental illness.”
It’s as if the most extreme version of our medical model – that we are robots that need fixing when we break down – has been applied to doctors, who are expected to keep going without support for the extreme emotional challenge of their work, and often without enough time for proper rest.
Polarity in Movements for Positive Change
My enquiry into Doing and Being as a cause of unhealthy culture resulted in part from my experience and observations in the Transition movement, seeing how intense the drive to create change can be, and how easily that can tip us into a relentless urgent pressure to do. The scale of the change needed, the enormity of the consequences if we don’t succeed, and the emotional toll of working for something we care so deeply about all contribute to make Transition a compelling movement to keep on giving our time and energy to. The two main symptoms when we are doing too much are conflict – there’s not enough priority or time given to taking care of relationships – and burnout – when we’re just exhausted.
In Transition Network we took a look at our balance a few years ago, and as a result started to give more priority to Being. Here are some things we have in place that support Balance:
- Many staff have one to one professional mentors.
- Meetings usually start with a check-in, and include time to reflect on how the meeting went at the end. We’re adopting the National Hubs habit of appointing “Keepers of the time, record and heart”. The “heart” keeper reflects if the meeting feels charged or needs a break!
- Staff meetings are alternately “doing” meetings, focusing on tasks, and “being” meetings, looking at how we are, our culture and communication, organisational dynamics. Awaydays provide a deeper and more spacious meeting time for everyone.
Reflecting on Balance
After reading this you might be interested to enquire into your own culture – in your group, or yourself. Here are some questions that might help (I’ve written them as if for a group – but you could just use them for your own life):
- How are we already creating balance and health? How do we pay attention to how we work, and strengthening relationships, as well as what we do? What kind of things give a healthy balance to tasks (creativity? play? music? nature? stillness? what else?) What would it be like to have more balance? Would it mean doing less? Or more? Would we be more effective?
- What happens when I/we feel vulnerable, tired or am finding things difficult? Is there time to really explore what’s going on?
- What’s our identity? What words describe how we see ourselves? What’s not us (start with the opposite of what you are1?). Can we find those opposites somewhere in who we really are? How does it feel to own that as well?
Since our Awaydays I’ve talked to a number of people about the Doing / Being way of looking at life, and been amazed at how many people are talking about it in some form. These same archetypal principles of human existence were explored on my psychosynthesis therapy training as Love and Will – leading to Being and Doing.. As my teacher used to say, Frank Sinatra got it right about what life’s really about, singing.. Do be do be doo…
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28 May 2014
Kerry Lane (see right) is a Transitioner and Social Reporter, and in this post, she shares her thoughts on Transition and health, inspired by her recent move to the countryside.
Living out in the countryside gives you an interesting alternative perspective on health, you really are faced with an entirely different situation to urbanites. A lot of public health policy and, dare I say, Transition initiatives, have a fairly urban perspective. For a resilient, regenerative and nourishing culture we are going to have to get everyone involved. So having only relatively recently returned to the countryside it is interesting to consider my new health situation.
My public health situation
In the public health sense I am much further away from emergency medical care, these winding country lanes don’t make for fast response times. I am fortunate that there is a doctors surgery in the next village, which is the case for steadily fewer rural areas, but getting myself registered with an NHS dentist turned out to be a considerable challenge and although I have managed I still have to travel to the nearest big town, 8 miles away. Being pedal, foot and public transport powered means that this is an entire mornings excursion, similarly my nearest pharmacy is 5 miles, 30 minutes cycle away (and no buses in that direction…).
Wellbeing benefits of living rurally
So with that, less than resilient, public health situation (not even considering the resilience and suitability of the services when I get to them, see previous posts this month for thoughts on that) it is good job that I take responsibility for nurturing my own health, so I don’t need these services as much. In many ways I find it easier to be healthy in the countryside, in general there is a greater abundance of plants species which I use for health maintenance and minor complaints. I also get a lot more exercise as I regularly cycle and walk much further than I did in the town.
And a really big factor for me is being surrounded by much more nature, having quiet places to contemplate in, many more creatures to watch and get to know, many of whom like to join us in the house! For me connection with nature is fundamental to my wellbeing and I am not alone. The scientific evidence for what many of us intuitively know to be true, is really mounting up. I found a whole plethora of information here. We need nature, not just to provide all our other basic needs; food, drink, shelter, but also because we have evolved to be surrounded by and connected to it. Being ‘separated’ from nature lead to all kinds of psychological and physical health problems.
I also find that a connection to the place where I am, it’s heritage and culture, is important to my wellbeing. It connects me into the story of the area and helps me feel at home. Of course this is not something that is rural or urban specific, in fact it can often be a bit harder to find in rural areas. Living rurally isn’t always better for my wellbeing and health.
Wellbeing challenges of living rurally
Slightly counter intuitively considering where most of our food is grown, it can actually be harder to get healthy food in the countryside, without easy access to the independent health food shops and markets of urban areas. I do have a village shop near me with some locally grown veg, but it would be quite challenging to have a healthy diet from what it sells. So I currently rely on veg boxes and occasional excursions to the wholefood shops, 8 miles away. I can also imagine it being very difficult to find space to grow your own if you didn’t have land, as allotments are much rarer in rural areas.
Depending on where you live rurally there is also the health threat of agricultural chemicals. I remember going out for a walk last year and having to turn back as I really did not want to inhale the wind drift of whatever they were spraying on the crop. I suppose it is just different chemicals from the car fumes you get to inhale in the cities, but never-the-less not ones I want to come into contact with if I can help it.
A challenge which I hadn’t anticipated affecting my health, when I moved out to the country, is isolation. Now I don’t mean there aren’t a good number of people around, as it definitely isn’t deserted where I live, but I have found it much more challenging to find people and local activities I can get involved in which share my values of Earthcare, Peoplecare and Fairshares. I think I took it for granted in urban areas, all of the different interesting activities I could get involved in and how there was nearly always a ‘green’ group of some sort to join with people who were striving towards a similar vision as me.
And my, my is it challenging to do this in the countryside, or at least I am guessing it takes considerably longer to establish your network of friends and activities. In the meantime you feel quite isolated and drawn to doing lots of travelling into your nearest urban area. Isolation really isn’t good for my wellbeing.
Building bridges to share the yields
But Transition is all about solutions and doing, so surely something can be done? A lot of the posts this month have focussed specifically on public health (it is the theme after all!), but I want to explore the huge opportunities to be found by thinking laterally.
I am working at the moment on a project which could help share some of the health benefits between urban and rural dwellers. At first glance you wouldn’t think it had much to do with health – Nearly Wild Camping, creating a network of ‘wilder’ locations for basic camping and ambassadors for the countryside across the UK – but in the wider context of health creation and wellbeing it has a lot to offer. It creates the opportunity for both sides to get some of the benefits associated with the other.
Exploring the world around you
For people living in urban areas it provides opportunities to spend time exploring the wilder corners of our countryside, sleeping under the stars and getting up close to the creatures that make their homes there. It is very easy as someone living in the countryside to think that all people need to do is get out of the cities and find it, but if you’re not familiar with an area or the ways of the UK countryside it is actually very difficult to know where you can go.
At many Nearly Wild locations there is also the opportunity to learn from the people who live and work there and are passionate about their local wildlife, heritage and culture. We have only been official for a few weeks, but already have a variety of locations that could offer a real range of different experiences, including a private nature reserve and permaculture smallholdings. From experience at the original Nearly Wild location, Underhill Farm, we found that this informal mentoring in exploring the world around you and introducing people to new ways of thinking really inspires them, with unpredictable results. A local woman who had never camped before came with friends to an early Underhill Farm event and is now the local cub scouts leader!
As I mentioned earlier, this connection to the world around you is really very important in creating and maintaining wellbeing. I even saw some research the other day that sleeping in a tent for a week, without electrics lights could help cure insomnia! Although I imagine where your tent is and what the weather is doing are fairly important factors…
Creating a community
And the benefits go both ways, for the people providing the locations, being involved can reduce their isolation. Sharing their passions with interested people who come to visit and also being part of a network of people across the country, who are trying to do similar things and can share experiences, advice and support each other. We have set up Nearly Wild Camping as a co-operative to really try and encourage and embed this aspect of it.
Of course it also gives location providers another source of earth-friendly livelihood, which can also be harder to come by in the countryside.
As in nature, it is establishing the connections and the beneficial relationships that makes something resilient and abundant. We are hoping with Nearly Wild Camping to enable some of these connections and help create wellbeing both for those living in urban areas and those in the countryside, so if you know any locations or campers who might want to be involved then send them our way.
This is of course just one of many possibilities out there. I would be really interested to hear of any other ‘unconventional’ routes to health that people know of or are involved in, particularly those that span rural and urban areas.
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27 May 2014
One of the most fascinating things I read recently was The Lancet’s Manifesto for Planetary Health (printed in full at the end of this post). For one of the most august and respected medical journals to argue that “the idea of unconstrained progress is a dangerous human illusion”, to call for “a new vision of cooperative and democratic action at all levels of society” and to state that “our patterns of overconsumption are unsustainable and will ultimately cause the collapse of our civilisation” is remarkable, and timely. Here’s a short video in which The Lancet’s editor, Richard Horton, explains more about the Manifesto:
We talked to Martin McKee, Professor of Public Health at the London School of Hygiene and Tropical Medicine, and one of the report’s authors.
Reading around in other things about the manifesto, there’s a term that comes up that I’d not come across before, which was “social medicine”. What’s social medicine?
Social medicine is a term that actually goes back to at least the 1920s and the 1930s. In more recent years it’s been termed public health. This is essentially the idea that we should be looking at the health of populations and in particular that governments have a role to play in promoting health. Quite simply put, there is such a thing as society and individuals do need the support to make healthy choices. As has been said before, we all do make choices but not always in the circumstances of our own choosing.
Is the Manifesto arguing that capitalism is bad for our health?
If you look back historically, back to the late 1980s, we saw that one of the alternatives, communism, clearly was very bad for people’s health. Life expectancy was stagnating under the communist regimes and I think there is now really no doubt that the model of communism that had been implemented in the Soviet Union and in the countries of Eastern Europe had failed and was rejected by the population.
If we look at the model of capitalism – and I stress I’m not talking about either of these in their totality – but if we look at the particular model of capitalism we have at the moment and we look at the way in which it brought about the economic crisis with essentially as Adair Turner said, the global stock markets serving “no socially useful purpose”, we can see that that particular model has failed. Failed in terms of delivering benefits to the wider population. The US and the UK have seen virtually no increase in median earnings over the last three decades, so it’s certainly not working in terms of the economy.
There’s no doubt that both the communist system that was in place before 1990 and the capitalist system that led to the economic crisis have both failed abysmally and we need a new way of doing things. Is the capitalist system that we have at the moment bad for our health? Well clearly it is because we’re seeing a vastly more unequal society. People are not sharing equally in the game. The French economist Thomas Picketty has written a damning critique of the system as it is, showing that things are going to get worse.
So although I’m not talking about capitalism in its totality I would refer back to the work of people like Adam Smith, he of “the invisible hand of the market”. He balanced his call for markets in his second book A Theory of Moral Sentiment recognising that free markets have many problems. The capitalist system has potentially within it the seeds of its own destruction unless it can balance whatever its dong with some socially useful purpose.
In the Manifesto, you write at the end ‘together with empowered communities we can confront entrenched interests and forces that jeopardise our future.’ Is there a case, do you think, that Transition groups and such initiatives could actually gain more profile and by arguing what they do not just in terms of sustainability but in terms of public health?
Yes, I think so. The very heart of what we’re advocating is the idea that the two are linked. We cannot have a healthy population without a healthy planet, but the difficulty is that one of course needs to frame one’s argument differently for different audiences. In the past, the public health community has very much focused discussions on the way better health is better for the economy. But we also have to realise that we need to square that circle to some extent.
I was very interested in the bit about ‘the idea of unconstrained progress is a dangerous human illusion.’ With people like Matt Ridley’s book about The Rational Optimist and James Delingpole writing this week about how young people today have never had it so good and they should stop moaning and just be aware that they live at the pinnacle of civilisation. That’s a really dangerous and complacent perspective isn’t it?
It also ignores the basic laws of physics. And we go back to the issue of entropy. Whenever the earth was formed, without getting too much into geological timescales, all sorts of things were distributed in ways that were easily extractable, rare earths and petroleum in the Carboniferous period, the vegetable matter that lead to the development of oil and gas and so on. Obviously, if we take, we redistribute all of these things or use them up from the settings in which they’re constructed. We’re not going to be able to use them twice, and inevitably we’ll run out of things.
An urgent transformation is required in our values and our practices based on recognition of our interdependence and the interconnectedness of the risks we face. We need a new vision of cooperative and democratic action at all levels of society and a new principle of planetism and wellbeing for every person on this Earth – a principle that asserts that we must conserve, sustain, and make resilient the planetary and human systems on which health depends by giving priority to the wellbeing of all. All too often governments make commitments but fail to act on them; independent accountability is essential to ensure the monitoring and review of these commitments, together with the appropriate remedial action.
It’s not just running out of oil. It’s running out of some of the things that we depend on, like tantalum in mobile phones or iridium in GPS devices and things like that. Some of the rare earths that we use, neodymium and lanthanide in some of the low energy hybrid cars and things like that.
Fundamentally we will end up taking the things from fairly concentrated deposits in the earth’s crust and depositing them into land sites all over the world and not be able to have any economically viable way of extracting them again. That’s just an inevitability.
Jared Diamond has written a very good book called Collapse. He describes how so often in the past very well-developed civilisations going back to the Indus valley and onwards have actually presided over their own fundamental collapse as they’ve brought about environmental degradation. It’s nice that people are optimistic but it defies the laws of physics and it also defies the historical experience.
The Manifesto for Public Health
This manifesto for transforming public health calls for a social movement to support collective public health action at all levels of society – personal, community, national, regional, global, and planetary. Our aim is to respond to the threats we face: threats to human health and wellbeing, threats to the sustainability of our civilisation, and threats to the natural and human-made systems that support us. Our vision is for a planet that nourishes and sustains the diversity of life with which we co-exist and on which we depend. Our goal is to create a movement for planetary health.
Our audience includes health professionals and public health practitioners, politicians and policy makers, international civil servants working across the UN and in development agencies, and academics working on behalf of communities. Above all, our audience includes every person who has an interest in their own health, in the health of their fellow human beings, and in the health of future generations.
The discipline of public health is critical to this vision because of its values of social justice and fairness for all, and its focus on the collective actions of interdependent and empowered peoples and their communities. Our objectives are to protect and promote health and wellbeing, to prevent disease and disability, to eliminate conditions that harm health and wellbeing, and to foster resilience and adaptation. In achieving these objectives, our actions must respond to the fragility of our planet and our obligation to safeguard the physical and human environments within which we exist
Planetary health is an attitude towards life and a philosophy for living. It emphasises people, not diseases, and equity, not the creation of unjust societies. We seek to minimise differences in health according to wealth, education, gender, and place. We support knowledge as one source of social transformation, and the right to realise, progressively, the highest attainable levels of health and wellbeing.
Our patterns of overconsumption are unsustainable and will ultimately cause the collapse of our civilisation. The harms we continue to inflict on our planetary systems are a threat to our very existence as a species. The gains made in health and wellbeing over recent centuries, including through public health actions, are not irreversible; they can easily be lost, a lesson we have failed to learn from previous civilisations. We have created an unjust global economic system that favours a small, wealthy elite over the many who have so little.
The idea of unconstrained progress is a dangerous human illusion: success brings new and potentially even more dangerous threats. Our tolerance of neoliberalism and transnational forces dedicated to ends far removed from the needs of the vast majority of people, and especially the most deprived and vulnerable, is only deepening the crisis we face. We live in a world where the trust between us, our institutions, and our leaders, is falling to levels incompatible with peaceful and just societies, thus contributing to widespread disillusionment with democracy and the political process.
An urgent transformation is required in our values and our practices based on recognition of our interdependence and the interconnectedness of the risks we face. We need a new vision of cooperative and democratic action at all levels of society and a new principle of planetism and wellbeing for every person on this Earth – a principle that asserts that we must conserve, sustain, and make resilient the planetary and human systems on which health depends by giving priority to the wellbeing of all. All too often governments make commitments but fail to act on them; independent accountability is essential to ensure the monitoring and review of these commitments, together with the appropriate remedial action.
The voice of public health and medicine as the independent conscience of planetary health has a special part to play in achieving this vision. Together with empowered communities, we can confront entrenched interests and forces that jeopardise our future. A powerful social movement based on collective action at every level of society will deliver planetary health and, at the same time, support sustainable human development.
Richard Horton, Robert Beaglehole, Ruth Bonita, John Raeburn, Martin McKee, Stig Wall
You can sign up to the Manifesto here.
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