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The Future of Health

The Future of Health Care is Staying Healthy

The US currently spends over $3 trillion dollars (or 18% of its GDP) on health care. This is significantly higher than most other countries and is twice the per capita average of other developed countries. Further, partially driven by an aging population, health care is expected to reach 20% of GDP by 2025, representing nearly $5.5 trillion dollars. These are huge numbers.  While health care is a complicated and controversial subject, it is clear that we need to find ways to rein in spending.

The future of health care is staying healthy. This was a theme of the recent Lake Nona Impact Forum, an annual gathering that brings together the nation’s top CEOs, health care innovators and thought leaders. One health expert, Ezekiel Emanuel, concluded that our country is “over hospitaled”, estimating that over 1,000 hospitals, or approx. 20% of the nation’s supply, are destined to close with a shift away from services provided in institutions to those in the community. All agreed that changes ahead are profound.

Not a Triple but a Quadruple Aim -> Consumer Engagement

Back in 2010, the US health care administration introduced the goal of a “triple aim”: (i) improving quality of care, (ii) improving health of populations, and (iii) reducing the per capita cost. Today, some argue it should be a “quadruple aim” adding consumer engagement. We need to find ways for more people to be motivated to stay healthy so we can shift resources from managing sickness to staying healthy. This is a particularly important task for insurers as well as certain states, such as Maryland and Vermont, who have chosen to be accountable for their total health care spend.

Increasing Role of Technology and Personal Data

Just as it has for other parts of our lives, technology and personal data will play an increasing role in our health. These advances promise to improve outcomes and reduce cost. Telehealth is now a common feature among commercial insurance plans, including UnitedHealth and Kaiser, and consumers have appreciated its convenience and effectiveness. Originally of Jeopardy fame, IBM Watson has focused energies on health care and has partnered with various health care institutions to accelerate health research. Joe Biden’s Cancer Moonshot is a bet on the ability to learn from metadata of millions of people.

Powerful tools are increasingly available to consumers to help stay informed and healthy. Daniel Kraft, a speaker at this year’s Impact Forum, highlights what’s possible with smartphones, peripherals and specialized health apps (“There’s an App for That”). I wear an Oura ring that provides accurate insights on activity and sleep patterns, including periods of light, deep and REM sleep. Internet of health things devices, like the Oura ring, can connect to new data consumer platforms, like Curious, to allow people to share data and learn from others.

Housing as Platform for Improved Health

Particularly as we shift from managing sickness to staying healthy, housing, one of the social determinants of health, plays an increasingly significant role. Work at the Bipartisan Policy Center has highlighted the important interplay of housing and health and the need to promote best-in-class options.  Innovative seniors housing providers, such as Juniper Communities, have demonstrated the positive impact of new housing models, including reduced costs and increased health.

At Smart Living 360, enhancing personal well-being is paramount. This thinking influences location strategies, design sensibilities and community culture.  We target walkable mixed-use locations, typically with a grocer in close proximity. Our design integrates in-unit features that accommodate people of all ages and stages, and common spaces are laid out to optimize interaction and utility.  Fitness rooms include a range of equipment to meet a variety of needs and are technology forward. Community programming, facilitated by our Lifestyle Ambassador, is oriented to increasing purpose, personal connection and physical well-being. Our residents report that it makes a difference.

The Evolving Empowerment of You

There has never been a better time in history to live a long, healthy and productive life. As we progress forward, changes in health care delivery, technology and housing will further empower us to take advantage of our increased longevity.

Sardinia

Lessons from Blue Zones

Lifestyle is the Wonder Drug for Longevity

I recently spoke at an event hosted by the Capitol Hill Village entitled Designed for Longevity. One of my co-presenters was Harriett Jameson, a Landscape Designer at Michael Vergason Landscape Architects. She shared stories of her time studying the impact of environments and longevity in Sardinia, Italy, a place with a reputation for both extended lifespan and vigor of its centenarians. She chronicled stories of these elders riding bikes and chopping wood and even Teresa Melledu, age 85, who walks up seven flights of stairs daily.

Sometimes, we think our longevity is closely linked to that of our parents and ancestors. This is not so. Researchers tell us only about 10% of how long we live is dictated by genes. The other 90% is dictated by our lifestyle. In this sense, lifestyle is the wonder drug for longevity. Harriett witnessed this in Sardinia as she saw how landscape design, including walking paths, access to garden space and linkages to others in the community, influenced daily behaviors and routines and positively impacted health and well-being.

What are Blue Zones?

Dan Buettner, founder of Blue Zones (see TED talk “How to Live to be 100+” and book Blue Zones), identifies Blue Zones as areas where people are living to age 100 at rates up to 10 times greater than in the United States, areas where life expectancy is an extra dozen years or so.  Dan teamed up with National Geographic and the National Institute on Aging to find geographic areas that stood out from others. In the end, they studied three areas: Sardinia, Italy, Okinawa, Japan and Loma Linda, California. Sardinia is remarkable in the way the society reveres its elders and models intergenerational activity. Okinawa stands out for its plant-based diet and portion control, sense of daily purpose and ability to maintain very close relationships with a cluster of friends for the duration of their lives. Loma Linda is noted for the importance of their faith (it’s a largely Seventh Day Adventist community), strong social network and connection to nature.

What can be Learned from Blue Zones?

The study of these Blue Zones has led to a number of observations that is informative to those living outside of these marked Blue Zones. Dan and his colleagues have narrowed the lifestyle commonalities across Blue Zones into nine areas, called the Power 9:

  1. Moderate, regular physical activity.
  2. Life purpose.
  3. Stress reduction.
  4. Moderate caloric intake.
  5. Plant-based diet.
  6. Moderate alcohol intake, especially wine.
  7. Engagement in spirituality or religion.
  8. Engagement in family life
  9. Engagement in social life.

Blue Zones Pyramid

Credit: Blue Zones

How Can These Lessons be Incorporated into the Design of Living Environments? 

Both Harriett and Dan speak to the importance of how one’s living environment can nudge someone towards better lifestyle decisions. For Harriett, subtle approaches in landscape design can make it easier for people to be active outside and connect with those around them. For Dan, he points out how certain features in a home can help promote better lifestyle habits.

At Smart Living 360, we feel the same way: designing spaces and environments for enhanced well-being can make a difference. For example, we design fitness rooms that have a wide range of equipment to support uses for people of all ages. Our residents have reported an increase in physical activity. Indeed, research has also shown the impact of convenience on frequency of activity. We design community spaces conducive to social interaction.  These spaces, coupled with a friendly culture facilitated by our Lifestyle Ambassador, have led to increased social engagement, including intergenerational connection. In addition, we provide access to lifestyle and health services intended to make life easier and less stressful, and promote a lifestyle of simplicity which allows people to focus on what’s most important.

The Choice is Yours

Increasing longevity is most beneficial to us if we have a high quality of life in those extra years. The good news is that the choice is largely ours. Each of us can take steps now, like instituting elements of the Power 9, towards a longer and healthier life.