Overcoming systemic roadblocks to sustainable health

Beddoe et al. (1) provide a powerful concept for analyzing the present and for devising a sustainable future socio-ecological regime. This framework might also facilitate a related transition, that to sustainable health.

Today's major health challenge in the developed world is not biomedical but related to worldviews, institutions, and technologies at odds with sustained health in a modern world. People who are physically inactive, overweight, eat fewer fruits or vegetables, smoke, or drink excessively live, on average, 14 years less and are cognitively more impaired than others (2, 3). Overall, 50% of premature deaths are attributable to maladaptive health regimes (4).

Worldviews supporting present health regimes emerged in times of food scarcity, physical demands, and infectious threat, requiring interventions only in case of acute disease. Conversely, today's world is calorically overloaded, deprived of physical challenges, and has little infectious threat with a corresponding increase in average life expectancy. The bulk of medical conditions are chronic, necessitating early and continuous collaborative interventions (5). Relevant institutions are dominated by producing industries geared toward increasing consumption of foods, appliances, and drugs, thus subserving a constant caloric oversupply, a physical undersupply, and a consumer attitude towards health. Technologies such as automobile transportation not only facilitate food access and obviate the need for physical activity but further render local environments degraded for physical activities by others. Extending the conclusions by Beddoe et al. (1), changes in interconnected worldviews, institutions, and technologies are not only needed to achieve a lifestyle better adapted to environmental realities but also to requirements of our own bodies.