Transcriber: Fierah Livingstone Reviewer: Rhonda Jacobs
Such a pleasure to be here in Guernsey,
listening to all these amazingly disruptive speakers
about envisioning Guernsey as the best place to live in the world.
And I would say, in order for Guernsey to be the best place in the world,
it has to be the healthiest place in the world.
Now I'm going to make some pretty radical suggestions
about how we're going to get there today.
And it's going to include
drinking wine, getting dirty, and meeting new people.
So I just want to prepare you for that ahead of time.
You know, one of the reasons why you're in such a great position
here in Guernsey
is you don't have to ask anyone for permission.
We're not asking Brussels for permission, we're not asking London for permission,
we just have to do.
For the last ten years, I've been in the trenches
of health creation in America.
I've met thousands of doctors and I've had the opportunity
to interview everyone from Fortune 500 CEOs
to internationally respected gurus.
And one of the biggest problems that people -
one of the biggest frustrations that people share consistently
is that medicine is evolving too slowly to overcome the chronic diseases
that are now epidemic in America and all over the industrialized world
and Guernsey is no -
that's what's driving all of these costs that Mark just mentioned,
is these chronic diseases.
You know, five years ago, I was angry.
I wanted to rebel.
I wanted to get in touch with my representative.
And I wanted to...
I wasn't sure exactly what to do about it but I'd read this quote,
and this quote has been so powerful over the last five years,
and it's really driven my intention
of what I've been looking to do for the last five years.
And that quote is by Richard Buckminster Fuller.
And he says, "You never change anything by fighting the existing reality.
To change something, build a new model that makes the existing model obsolete."
So what is this new model?
Community, and not medicine, creates health.
The first place that we see that community, and not medicine,
creates health is the Blue Zones.
These are areas in different parts of the world
where people live consistently to 100 years old
with much lower incidence of chronic disease.
From Okinawa, Japan to Sardinia in Italy
to Nicoya in Costa Rica.
Now, all of these areas have certain things in common,
but by far the most powerful and exciting is community.
In all of these areas, the groups work together and support each other
as part of the tribes.
They eat together, they cook together,
they play together, and they pray together.
Now, you might say, "James, there are certain other things -
there are a lot of other things that happen in Blue Zones.
It's not just community.
You know, the Okinawans are eating tons of fermented soy,
and the Seventh-day Adventists in Loma Linda don't eat one day a week.
What is it about community that you think is so powerful?"
In his book, Malcolm Gladwell, in Outliers, he talked about
this really interesting community called Roseto, Pennsylvania.
And in Roseto, Pennsylvania, it was discovered in the 1950s
as a small community that had remarkably less chronic disease
than the towns and cities around it.
And what they found was this was a group of Italian-Americans
that had come from Italy to Pennsylvania
and had maintained the same social and community structure.
And there were some changes, there were certain changes
that were different from their life in Italy.
They ate a lot more animal fat, animal protein.
They also smoked and drank as much as the other towns around them in America.
But the outcomes remain the same.
In fact, they had lower levels of heart disease in the 1950s
when heart disease was absolutely epidemic in America.
And so the strongest thing that they had going for them
was community.
But yet they had significant changes in their food since then.
And so the other thing that was so important to them was community.
Now, in the next generation, when the kids Americanized,
when they left this social structure,
they were left like just every other American town:
fat, sick, and nearly dead, as the saying goes.
So, what the Blue Zones and what Roseto, Pennsylvania show us
is that it's community, not medicine, that creates health.
Now, another area where we can see that community, and not medicine,
creates health,
is with regard to the microbes that live on, in, and around us all of the time.
Germs. It's quite an onomatopoeic word, isn't it, "germs," when you say it.
But we can talk about microbes if you prefer.
But the new science on microbes is absolutely astounding.
You know, if you think about the 20th century,
it was all about our interaction with germs.
It's all about the human race dominating germs.
And through a combination of sanitation, nutrition, and antibiotics,
we conquered the germs that live on, in, and around us.
But there's a natural limit to this.
So much so, that the Deputy Director of the CDC recently said,
"We have reached the end of antibiotics. Period."
So, in 2011 there was a remarkable study
called The Human Microbiome Project.
And in that study, it should've really shook the foundations.
When I said earlier, you know,
that the speed of evolutionary change is too slow,
they say that it takes 17 years for new information
to make it into everyday clinical practice.
17 years, even today.
And The Human Microbiome showed that more than 99% of all of the germs
that live on, in, and around us were mutually beneficial,
aiding our digestion, immunity, and metabolism.
And we needed them, and they needed us.
And since then, in the last four years,
there's been a wealth of science to show that germs, particularly in our gut
affect the health outcomes from our brain to our joints.
Furthermore, by killing off these germs, particularly in our gut,
we're actually driving chronic disease.
All the inflammatory diseases, autoimmune disease,
the epidemics of allergies were all being driven
by killing all of these microbes, particularly in our gut.
There is an emerging field in medicine -
a niche in medicine, or niche,
I've started saying niche since I moved to America -
but it's called functional medicine
and it respects the inner ecology of the body,
the relationship between us and our germs.
And functional medicine, you know, for years the prevailing paradigm
has been to identify symptoms
and to use drugs to suppress those symptoms.
But in functional medicine, it turns everything on its head.
And it uses symptoms as a way to be able to understand
what's going on and the root cause of dysfunction,
and then be able to remove that root cause and allow the body to heal.
Now, functional medicine has an ecological system
and just last year,
this functional medicine showed that it was ready for prime time,
with the Cleveland Clinic,
one of the most respected and innovative health organizations in the world,
building a new functional medicine center.
And betting on it for the future of chronic disease management.
So again, we see that it's a community of microbes,
and not medicine, that creates health.
I just want to talk a minute about the use of community in medicine.
Does the medical system right now
take any advantage, or maximum advantage of community?
Not really.
The majority of your interactions with a doctor are one-on-one.
So the question we have to ask ourselves is,
Are there any examples of community being used successfully in medicine,
starting from scratch?
And the answer is a resounding "Yes."
We are now standing at the intersection of community and medicine.
There was an amazing project in America called The Daniel Plan.
And leading functional medicine doctors came together with the Saddleback Church
to create The Daniel Plan.
And 15,000 of the people that go to the church
lost a combined 250,000 pounds.
And enjoyed extremely positive health outcomes
by working together in small groups to empower behavior change.
Furthermore, some of the most exciting results
that we're seeing in functional medicine are in a non-traditional style.
In the old system, one doctor would just go room to room to room
seeing patients individually.
In group visits, two providers see patients in groups.
There's so much power and value, in people working together
with a group of your peers.
In terms of empowerment and vulnerability and support.
Now, this is all what's happening now.
But the most exciting thing,
and what could really scale this up, is technology.
Technology is coming along and empowering communication in new and exciting ways.
And one of the biggest beneficiaries of that is communication.
Seamless communication.
I have a friend who lives in Iceland
and even though we're not together physically,
he is challenging me every day, with the number of steps that he walks,
or the miles that he runs,
to be able to challenge me with his fitness tracker.
And I'm not the only person that he does this with.
He has a whole community of people all around the world
that egg each other on to be healthier through technology.
We've also had the opportunity to work with lots of medical clinics
that create online forums and discussion meetings
where patients are able to communicate with other patients
and provide peer-to-peer support.
You know, just imagine how much value and how much knowledge
a mother accumulates having a child on the autism spectrum
over ten years of looking after that child.
And then imagine how much value is created when they can communicate
what they've learnt over a period of time to other parents in the community
who may be completely overwhelmed with an autism diagnosis.
This is all free and powered by technology
and completely scalable.
Now what about doctors?
For the last hundred years, a combination of reductionist science and industy
have driven doctors' behavior and told them what to do.
So much so that it's almost a joke in America now,
how pharmaceutical reps come and tell the doctor
what to do with each of their patients.
But I've been to Silicon Valley, and I've seen the future,
and it's democratization.
It's doctors working together in real time giving feedback and best practices
between them and the groups and contributing to a hive mind
aggregating best practices.
So you can see, that it's community, and not medicine, that creates health.
So what can we do right now, all of us in this room,
to start this process of building community in Guernsey
and developing the healthiest place to live in the world?
How can we make Guernsey the sixth Blue Zone by 2020?
Well the beauty of the functional medicine operating system
is that it's participatory.
The future of medicine isn't going to be something that's done to you,
and you're just a passive patient taking what the doctor gives you.
You're an active participant in your health.
So right now you don't have to ask anyone's permission
to eat more plants, to think differently about your stress,
and to move regularly.
You also don't need to ask anyone's permission,
to be able to improve your internal microbiome.
You can take a probiotic, you can get into nature, get a pet.
One of the best things - the emerging science that's coming out right now,
Citizen Science Project, is showing the best way
to improve your internal microbiome is to get your hands in the dirt.
Start planting a garden.
Topsoil is one of the most precious resources that we have.
And I think getting our hands in the dirt, and coming to connection with that,
is something that we can all do for free right now.
And what about doctors?
You can start to take advantage of this community
and do things like group visits, to be able to start to take benefit
of the peer-to-peer communication
and peer-to-peer support that's available through that type of model.
Get together groups of doctors to learn about functional medicine.
Learning is easier in community too.
It's community, not medicine, that creates health.
Now, what is the most evidence-based thing that you could all do today
to start this process of developing community
and creating better health outcomes?
Dan Beuttner, who is the person responsible for the Blue Zone research,
they'd been trying to create Blue Zones already.
For the last five years since they'd worked it out,
"How can we create Blue Zones?"
And what they found is the most evidence-based strategy,
the most effective strategy for anyone to start in a community like this,
is to take people who are ready to change and introduce them to each other,
to form new communities.
Now I would bet that the kind of people that come to a TEDx event like this
are those people within a community that are ready for change.
So what I'm going to recommend today
is you're going to start the process of meet - just look around.
Meet five people in this room today.
Share a couple of glasses of wine this evening,
just like the Sardinians do in their Blue Zone every day.
And feel the power of new community.
One of my favorite quotes
that really embodies what I think is the strategy that we can use
to really change health here in Guernsey,
comes from and is attributed to Thich Nhat Hahn, and he says,
"Community is the guru of the future."
I trust that Guernsey will be a 65,000-person petri dish
for the future of medicine.
A community that empowers each of us to be healthy and reduce chronic disease.
Because it's community, and not medicine, that creates health.
Thank you.
(Applause)