Malcolm Gladwell: A happy and healthy-looking guy

It’s been well over a year since I wrote here. That’s a long story that I won’t tell today. Instead, I’d like to share an illuminating excerpt of Malcolm Gladwell’s upcoming book, “Outliers.”

The excerpt tells a short tale of a community of Italians that emigrated to Pennsylvania, and showed an extremely low rate of heart disease compared to the rest of the country. From the Wall Street Journal (emphasis is mine):

In transplanting the paesani culture of southern Italy to the hills of eastern Pennsylvania the Rosetans had created a powerful, protective social structure capable of insulating them from the pressures of the modern world. The Rosetans were healthy because of where they were from, because of the world they had created for themselves in their tiny little town in the hills.

“I remember going to Roseto for the first time, and you’d see three generational family meals, all the bakeries, the people walking up and down the street, sitting on their porches talking to each other, the blouse mills where the women worked during the day, while the men worked in the slate quarries,” Bruhn said. “It was magical.”

Wolf and Bruhn had to convince the medical establishment to think about health and heart attacks in an entirely new way: they had to get them to realize that you couldn’t understand why someone was healthy if all you did was think about their individual choices or actions in isolation. You had to look beyond the individual. You had to understand what culture they were a part of, and who their friends and families were, and what town in Italy their family came from. You had to appreciate the idea that community—the values of the world we inhabit and the people we surround ourselves with—has a profound effect on who we are. The value of an outlier was that it forced you to look a little harder and dig little deeper than you normally would to make sense of the world. And if you did, you could learn something from the outlier than could use to help everyone else.

This brings me to one of my lingering questions about natural medicine. It seems to be such an obvious answer to many of our health care ills, but yet it struggles to grow widely. Why is that? What does it need? It’s sad to me that stories like this, over 50 years old, still go largely untold.

Although many of us believe that a naturopathic approach to health, feels um, natural, you could argue that we are a small minority. Despite this, I don’t think the currently mainstream approaches to health are sustainable, and much as business and governments are being forced, so to say, to go green, I think consumers will increasingly be driven to the proactive and benign practices of natural medicine.

Because the natural medicine revolution is in its relative infancy (so far!), I love it when I get a chance to show shining success stories of naturopathic medicine and other alternative benign modalities.

The most common model you’ll see in such stories goes something like this:

  • person endures suffering in the form of illness/disease/deficiency
  • person endures additional suffering in the form of symptom suppression and lack of root-cause analysis from “traditional” medicine
  • person by serendipity or research finds natural medicine
  • person achieves previously unattainable levels of wellness and literally turn their lives upside-down

I have a similar story about how I found naturopathic medicine that I’ll have to share sometime. But one person, who has created one of the most candid and intimate blogs on the internet, has such a story.

This person is Gluten Free Girl, aka Shauna James Ahern. Her recent post, for those of you new to this site, gives an abbreviated version of her story. Here’s a little excerpt:

In the early spring of 2005, I was terribly ill. My body required 18 hours of sleep a day, my stomach ached all the time, and I could barely move without hurting. Doctors ordered one medical test after another, and none of them yielded answers.

My gastroenterologist refused to test me for it, even though it only required a blood test before I could stop eating gluten. He refused. Actually, he had his nurse call me. “Celiac is really rare,” she said on the message. “That’s a long shot. We’ll talk about it during your follow-up in two weeks.”

I went to a naturopath, who did the blood test. I stopped eating gluten.

When I received the official diagnosis — you have celiac — I clapped my hands and said yes! The naturopath was a little surprised to see my celebration.

The gastroenterologist was even more surprised, the next week, when I showed up for my follow-up appointment in great health, blood test results in hand. He confirmed it — I have celiac. And he left the room, embarrassed.

Yes! It’s a great story, and as you’ll see if you follow Shauna’s blog, her life really has been revolutionized since. I’ve been reading her blog for a long time now. I originally found it looking for gluten-free recipes and now that my wife is baking and selling gluten-free goodies at her work, we feel like Shauna is an old family friend.

The other story I have to share is over at the Helfgott blog: Bill Maher talks healthcare. Love him or hate him, Bill gives it to you straight. In this snippet of his show, he talks about the need for folks to forget about healthcare reform (sound familiar?) and throws light on my point that the consumers of health care should stop taking so many aptly-named “drugs,” and start simply doing something, anything.

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Have you stopped and asked yourself this question?

One idea clarified in 7 Habits of Highly Effective People is that you should begin with the end in mind. Clarify your end goal and then plot the course to get there.

An interesting extension of this is to consider what you want to leave behind when your time on this planet is up. What comes to your mind? Leaving your family better off? Making a positive imprint on your community through your job or through other efforts?

Somewhere in the busyness of life, I think a lot of folks forget about their health, at least until a problem arises. The question this brings forth is, what is your health legacy?

Did you make the most of that astounding human body? That complex organism that defies and eludes the greatest minds of science? Were you able to teach your kids/friends/family/colleagues/acquaintances how to eat well, how to strengthen the body and how valuable that knowledge can be?

I hope I do this myself. I think I owe it to my fellow humans. I think I’m obligated to help the next generations achieve new levels of success, and to do that, they must be healthy.

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A couple weeks ago at the Corporate Wellness Insights blog, Juliet expressed a possible conflict between companies’ efforts to reduce environmental impact and efforts for proactive employee health:

I worry that some of the funds used to create and implement these [environmental] programs might be taken away from other employee programs that encourage health, balanced lifestyle, and fitness.

She brought up Wal-Mart’s recent announcement to invest $500 million in sustainability and wondered how much of that might have been used for employee wellness. I think this is a legitimate concern, but I don’t think these two things have to be mutually exclusive.

Bloggers Unite - Blog Action Day

Coupled together, employee health and environmental sensitivity are mandatory pieces of any corporate social responsibility (CSR) program.

For instance, commuter challenges such as the BTA’s Bike Commute Challenge have the double benefit of reducing pollution and congestion caused by employees driving to work and of getting employee bodies moving. These types of jump-start efforts are extremely low cost to all involved. To keep employees riding, employers should jump in and provide facilities and incentives and maybe even create periodic competitions throughout the year.

Further, encouraging employees to be more active invariably gets them outside more, slowly increasing their appreciation for the value of open space and quality air. I may be pushing my luck a little here, but I think it’s a logical possibility. People whose outdoor engagement consists of walking from the garage door to the car and then from the car to the office door certainly don’t have the same experience as folks traveling through town by bike. Getting folks to add some more activity to their lives has the distinct probability of increasing their overall appreciation and value of their environment. Or at least that would be my hope!

It is only the most advanced employee health management programs that provide the facilities to help employees make the lifestyle changes required to transform their health, which might include gyms, clinics and various coaches and practitioners. However, even the most lightweight program can leverage the extensive resources available in the community to encourage physical activity, healthier eating and more environmentally-friendly living. I believe it can and should accomplish both goals of maximum health and minimum environmental impact.

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The idea of sharing the methodologies and technologies of employee health management programs with public health efforts outside of companies hit me as I wrote corporate wellness: beyond the corporation? I want to call it Open Source Health Management (not to be confused with open source health care software). Since then, I’ve tried to find out if this really is a “revolutionary possibility” or if it’s already happening somewhere.

The first thing I discovered is that this is a complex subject to search for! As with any internet search, the words you use in the search, the search engine and even the ordering of the words can affect the quality of what you find. In my not-so thorough search so far, I haven’t found much. If you search for “corporate social responsibility” (CSR) and “public health,” you mostly get references to articles that refer to a company’s responsibility to not damage public health. For instance, you’ll find an article that talks about the Woburn, MA case where leukemia in children was linked to contaminated municipal wells [PDF]. I think it’s obvious that companies should not be a danger or detriment to the health of the communities in which they operate. The question is, should they take part in the proactive health of that community?

The Center for Corporate Citizenship (another term for CSR, further confounding research) includes in its definition of corporate citizenship the statement that companies should be participating voluntarily to help solve social problems (such as education, health, ….). Right! As far as I can tell so far, it’s not happening.

Although many companies are starting to go so far as hosting clinics for their employees, there doesn’t seem to be any effort to expand the pro-active, lightweight and very effective methods (dare I say, naturopathic?) of employee health management beyond employee populations. The key factor in motivating companies to participate in CSR-related efforts is that they get something back: brand recognition, profit, productivity or some other identifiable return. The increase in the “greening” of corporations is currently teetering between responsibility to not damage the environment (think of giant smoke stacks) to being pro-active in achieving a healthier planet (utilizing renewable materials and energy, for instance). Going for the latter, companies advertise and market their greenness, and evidence is showing that there’s value in doing so.

Now, we have two more questions: 1) would corporations gain in some way by contributing knowledge, effort and technology to improving community health and 2) how would they do it?

It would take some rigor to answer both questions, but at this point, I think it would be worth a look. However, I’m not encouraged by what I’ve found so far. The National Business Group on Health defines itself as “the national voice of large employers dedicated to finding innovative and forward-thinking solutions to the nation’s most important health care issues.” Reading on the site, it appears the main point of this group is to share methods between companies and to serve as a voice in our nation’s capital, including working to “Counter Employer Coverage Mandates.”

The Partnership for Prevention (dig that name) sounds more promising. The group’s goal is to “seek to increase investment in preventing disease and promoting health and to make prevention a national priority.” Unfortunately, this again looks mostly like an organization focussed on influencing political policy:

Working closely with the Congressional Prevention Caucus, a bipartisan caucus formed in 1998, Partnership raises the level of knowledge in Congress about prevention and identifies strategies that can lead to a healthier nation.

Is this the way real changes are going to happen, by informing Congress? I do think that getting prevention in the minds of policy makers and into the agenda is a good thing to do. But where’s the action? Am I asking too much?

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I ran into a great post today: 10 Big Lessons from Little Kids. I’d have to agree with Henrik of the Positivity Blog that #7 really jumps out of this list:

Your body was designed for throwing baseballs, shooting hoops, and jumping off diving boards and stuff. In the secret language of children, the word “fitness” doesn’t exist. It’s called “having fun.”

As I said before, “fitness” in some form or another has always been part of my life. I think it’s an important part of being a human being to make the most of this body. I’ve gotten flattering feedback from friends and colleagues that I influenced them to live healthier, more active lives. For me, the key keeping active, and heck, being happy in general, is to have fun doing it.

My favorite exercise is without question riding my bike, where I get out in the fresh air, see a variety of landscape and scenery, and have the opportunity to ride as easy or hard as I want. Sometimes I do go to the gym, but even there, I still enjoy it! That’s probably not a very popular idea. It seems most people who have a gym membership sign up with the hope that that will be motivation enough, but the fact that they don’t really enjoy that atmosphere overrides it and stops them from going. Gyms count on this behavior.

So why do big companies have gyms? My guess is that it’s the easiest type of facility to implement, and they likely get insurance rate discounts by having it. But maybe a gym is too elaborate. How about some frisbees? Or walking trails? Let people get creative. Again from the article:

Everything can be a game. Why slog through the same workout routines in boredom, when you can add a little fun?

Great point. What good is any routine if you’re not enjoying it? It won’t be much a routine for long if you stop doing it. Whatever exercise you do, keep the mission clear: have fun!

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