# Eric Topol With Devi Sridhar on her new book- How Not to Die (Too Soon)

An episode of [Ground Truths](https://invisiblenetwork.ai/podcast/1728526108), 17 Jun 2025, 38 min.

Audio: https://api.substack.com/feed/podcast/165381691/2fcddec84d84c0d664f617c7ca58baa8.mp3

Thanks to so many of you who joined our live conversation with Devi Sridhar! Professor Devi Sridhar is the Chair of Global Public Health at the University of Edinburgh. Over the past 2 decades she has become one of the world’s leading authorities and advisors for promoting global health. Her new book —How No to Die Too Soon—provides a unique outlook for extending healthspan with a global perspective admixed with many personal stories. We talked about lifestyle factors with lessons from Japan (on diet) and the Netherlands (on physical activity), ultra-processed foods, air pollution and water quality, the prevention model in Finland, guns, inequities, the US situation for biomedical research and public health agency defunding, and much more. Get full access to Ground Truths at erictopol.substack.com/subscribe

## Transcript

[0:00] And I am thrilled today to have a chance to reconnect with
[0:04] Professor Debbie
[0:06] SPEAKER_00: Svitter,
[0:06] SPEAKER_00: who is a chair of global health at University of Edinburgh in Scotland.
[0:13] I've had the chance to interview her once before,
[0:15] years back when she had her book,
[0:18] Preventable.
[0:18] SPEAKER_00: She has a new book out, which is just getting in the U.S.
[0:21] right now,
[0:22] How Not to Die Too Soon,
[0:25] The Lies We've Been Told and the Policies That Can Save Us.
[0:29] SPEAKER_00: It's an extraordinary book,
[0:30] SPEAKER_00: and the convergence with the book I recently had published,
[0:33] SPEAKER_00: Super Ages,
[0:34] SPEAKER_00: is also notable.
[0:36] SPEAKER_00: We look at it very differently.
[0:37] I'm looking at it more from an individual level and Devi from
[0:41] the world level.
[0:42] I mean,
[0:42] she has a planetary perspective,
[0:44] which we'll get into,
[0:45] which is quite remarkable.
[0:46] SPEAKER_00: So welcome, Devi.
[0:48] SPEAKER_01: Yeah, thanks for having me.
[0:51] Yeah,
[0:51] well,
[0:51] it's such a treat to be able to talk to you about the insights
[0:55] you have.
[0:56] because you really are the wizard for me in global health and
[1:02] one of the leading
[1:03] SPEAKER_00: public health faculty professors,
[1:08] SPEAKER_00: resources in the world.
[1:09] SPEAKER_00: So first thing I wanted to get to is when you were putting this together,
[1:15] SPEAKER_00: what was the main premise about,
[1:20] SPEAKER_00: you know,
[1:21] SPEAKER_00: it wasn't,
[1:21] SPEAKER_00: I don't think,
[1:22] SPEAKER_00: longevity per se,
[1:23] SPEAKER_00: but maybe you could get us straightened out on it.
[1:26] SPEAKER_01: Yeah,
[1:26] I guess it was looking at the gap between our knowledge of
[1:30] health and how to live
[1:31] SPEAKER_01: longer and the amazing scientific research that's happened.
[1:35] SPEAKER_01: I should say research, but it's Americans.
[1:39] SPEAKER_01: And life expectancy going backwards,
[1:42] especially since the pandemic and also seeing the rise of
[1:44] chronic disease in
[1:45] SPEAKER_01: younger people like diabetes and cancers and trying to think,
[1:48] why is there this gap between our knowledge and actually what's
[1:52] happening?
[1:53] SPEAKER_01: Yeah.
[1:54] SPEAKER_01: And then in that course of it,
[1:56] SPEAKER_01: I started looking at people like Brian Johnson,
[1:58] SPEAKER_01: who I know you look at in your book,
[2:00] SPEAKER_01: thinking,
[2:00] SPEAKER_01: oh,
[2:00] SPEAKER_01: wow,
[2:00] SPEAKER_01: there are a lot of people thinking about this issue.
[2:03] SPEAKER_01: But the way I'm thinking about it was much more, I think, global.
[2:06] SPEAKER_01: I'm American, but I've lived in Britain.
[2:08] SPEAKER_01: I've lived in a bunch of different countries.
[2:11] SPEAKER_01: My team does research across the world.
[2:13] SPEAKER_01: And so trying to bring a global perspective to this, but also one where
[2:18] SPEAKER_01: We as individuals are much like social beings.
[2:21] SPEAKER_01: So actually where you live,
[2:23] SPEAKER_01: who you're around,
[2:24] SPEAKER_01: your communities have,
[2:25] SPEAKER_01: I would say,
[2:26] as much to do with your life expectancy than anything else and
[2:28] trying to shift the
[2:29] SPEAKER_01: perspective.
[2:29] SPEAKER_01: So in a way,
[2:30] SPEAKER_01: it's complementary,
[2:31] SPEAKER_01: I guess,
[2:31] SPEAKER_01: to individual takes,
[2:32] SPEAKER_01: but it's much more on what kind of societies,
[2:36] SPEAKER_01: what kind of policies enhance us.
[2:38] SPEAKER_01: Maybe not,
[2:39] we can call it not to die too soon in the sense of I put 100 as
[2:42] being like
[2:43] SPEAKER_01: meaningful,
[2:44] SPEAKER_01: realistic life expectancy.
[2:45] SPEAKER_01: Yeah.
[2:46] SPEAKER_00: Yeah, well, there's a lot of optimism and a lot of personal stories.
[2:52] SPEAKER_00: You start off the book with your own, I think, health concern.
[2:59] SPEAKER_00: And of course, there's many others that really bring it to the fore.
[3:03] SPEAKER_00: Maybe you can tell us a bit about that,
[3:06] because I think that really is a grabber from the very
[3:08] beginning of the book.
[3:10] SPEAKER_01: Yeah, so while I was writing the book, I went for my smear test.
[3:14] SPEAKER_01: So here at the NHS,
[3:15] SPEAKER_01: you get a letter,
[3:16] SPEAKER_01: you go in,
[3:17] SPEAKER_01: you just get your yearly checkup and just forgot about it.
[3:21] SPEAKER_01: And then a couple months later,
[3:22] I got a letter back because things here were quite delayed
[3:24] after the pandemic that
[3:26] they had found high-risk HPV and that actually they found
[3:30] abnormal cells and I
[3:30] SPEAKER_01: needed to get treatment.
[3:32] SPEAKER_01: But unlike,
[3:33] SPEAKER_01: I guess,
[3:33] SPEAKER_01: the United States,
[3:34] SPEAKER_01: the UK NHS is a public system and you're just in the waiting list.
[3:37] SPEAKER_01: And so I was being told nine months till you get seed, maybe six months.
[3:41] SPEAKER_01: We don't know because there was such a backlog.
[3:44] SPEAKER_01: So I talked to my editor because we had agreed this title.
[3:46] SPEAKER_01: And I thought I should change it to how to die too soon and write,
[3:50] SPEAKER_01: you know,
[3:50] SPEAKER_01: some kind of spiritual book about accepting early cancer.
[3:53] SPEAKER_01: I was 38 at the time.
[3:56] SPEAKER_01: And I was like, actually, not really.
[3:57] I think most people,
[3:58] when they're faced with their mortality,
[4:00] don't accept it.
[4:01] SPEAKER_01: They actually want to fight it.
[4:03] SPEAKER_01: Luckily, I was treated.
[4:04] SPEAKER_01: I was able to get an appointment after a few months,
[4:08] but it did lead me to think about how one of the factors is
[4:11] your access to medical
[4:11] SPEAKER_01: care.
[4:12] SPEAKER_01: And if I was living in India or Malawi,
[4:15] SPEAKER_01: somewhere else in the world,
[4:15] SPEAKER_01: I wouldn't even have access to a screening program,
[4:18] SPEAKER_01: most likely.
[4:18] SPEAKER_01: If I was in the States, it would depend on my insurance.
[4:21] SPEAKER_01: Could I pay for it?
[4:22] SPEAKER_01: The nearest clinic?
[4:23] SPEAKER_01: And here in the UK,
[4:24] SPEAKER_01: it was dependent on the wait lists and actually trying to get in in time,
[4:28] SPEAKER_01: which is the biggest problem with the NHS,
[4:29] SPEAKER_01: I think.
[4:30] SPEAKER_01: There are barriers to care,
[4:31] and that's what I talk about in the book between the United
[4:33] States and Britain.
[4:34] SPEAKER_01: In the States,
[4:34] SPEAKER_01: it seems to be cost and having insurance,
[4:36] SPEAKER_01: where in Britain,
[4:37] SPEAKER_01: it's actually,
[4:38] SPEAKER_01: there is no cost.
[4:38] There is no bill when you go to the doctor,
[4:41] but the biggest issue is a wait list.
[4:42] SPEAKER_01: Will you actually see someone in the end?
[4:44] SPEAKER_01: So yeah, so I started with that to kind of reflect a bit on
[4:47] You know,
[4:47] I'm someone who tries to,
[4:48] I guess,
[4:49] similar to you or others in health.
[4:51] SPEAKER_01: We try to like do everything we can.
[4:52] SPEAKER_01: We take the supplements.
[4:53] SPEAKER_01: We do our exercise.
[4:55] SPEAKER_01: We eat well.
[4:55] SPEAKER_01: You know, we think we're doing everything right.
[4:57] SPEAKER_01: But actually,
[4:57] SPEAKER_01: in the end,
[4:58] SPEAKER_01: if you need medical care,
[4:59] SPEAKER_01: it doesn't matter how much wellness or well-being you do.
[5:03] SPEAKER_01: In the end, you need access to someone who's experienced.
[5:05] SPEAKER_01: You need access to labs.
[5:07] SPEAKER_01: And that depends on the place you live and what you have access to there.
[5:12] SPEAKER_00: Yeah,
[5:12] and I think the place that you're living and some of the things
[5:17] we learn from other
[5:18] SPEAKER_00: countries,
[5:19] that's what I really got out of the book is how you have such
[5:22] wisdom about the
[5:23] SPEAKER_00: culture of places around the world.
[5:25] SPEAKER_00: So I thought maybe we'd start with the diet story.
[5:29] SPEAKER_00: Of course,
[5:30] we share in the UK and US the worst consumption of
[5:33] ultra-processed foods in the
[5:35] SPEAKER_00: world.
[5:36] And there's still people doubting these ultra-processed foods,
[5:39] which I find quite remarkable.
[5:41] SPEAKER_00: Can you give us your perspective about that?
[5:44] SPEAKER_00: Because I'm not aware of countries that are really bearing down on this.
[5:48] SPEAKER_00: It's almost like we're tolerating and not taking on big food,
[5:52] whereas this seems like a real recipe for adding to the burden
[5:58] of chronic diseases
[6:00] SPEAKER_00: and chronic inflammation.
[6:01] SPEAKER_00: What do you think?
[6:02] SPEAKER_01: Yeah, completely.
[6:03] And that was something that I think,
[6:04] especially in the past 10 years,
[6:06] has come to light.
[6:07] SPEAKER_01: If I think back to when I was a kid in Miami,
[6:09] eating my Lucky Charms and my Froot Loops and just giving me
[6:11] ADHD and everything
[6:12] SPEAKER_01: else we now know from the additives,
[6:14] SPEAKER_01: I don't think we had the knowledge.
[6:16] SPEAKER_01: I don't think the research was done yet on these.
[6:18] SPEAKER_01: But now there's such growing research,
[6:20] SPEAKER_01: and I know you cover it in your book,
[6:22] SPEAKER_01: about the not only tendency to become obese or put on weight,
[6:26] SPEAKER_01: so even for the same amount of calories,
[6:28] SPEAKER_01: ultra-processed food is worse for you,
[6:30] SPEAKER_01: but also messing up your gut microbiome,
[6:32] SPEAKER_01: you know, changing actually your immune response.
[6:37] SPEAKER_01: So actually,
[6:37] SPEAKER_01: I kind of come down in the book on,
[6:39] SPEAKER_01: you know,
[6:40] SPEAKER_01: on diet saying there's so many complex diet rules,
[6:43] SPEAKER_01: so many different fads,
[6:44] SPEAKER_01: you know,
[6:44] SPEAKER_01: veganism,
[6:45] SPEAKER_01: not veganism,
[6:46] SPEAKER_01: you know,
[6:46] SPEAKER_01: dairy free,
[6:47] SPEAKER_01: eat fish.
[6:48] SPEAKER_01: And I'm like, actually, let's simplify it.
[6:50] SPEAKER_01: If I could say one thing, it's just reduce your ultra processed foods.
[6:53] SPEAKER_01: But you're saying that's the knowledge.
[6:55] SPEAKER_01: But if you look at like school meals,
[6:57] SPEAKER_01: Here in Scotland,
[6:58] SPEAKER_01: all kids who go to public school,
[7:00] SPEAKER_01: it's called state school,
[7:02] SPEAKER_01: get free school meals until the age of 10.
[7:04] SPEAKER_01: The idea being that children get a meal.
[7:06] SPEAKER_01: About 70 to 80% of those calories are ultra-processed.
[7:10] SPEAKER_01: So you're feeding children,
[7:11] but actually what you're feeding them is actually we're
[7:13] learning in 10 to 20 years
[7:14] is it going to lead to early onset cancer and increasingly
[7:17] convinced by what they
[7:19] SPEAKER_01: call what is the birth cohort effect with cancer,
[7:20] which is every generation seems to have higher rates of
[7:25] digestive linked cancers.
[7:27] SPEAKER_01: So it used to be it was something over 60, now it's over 50.
[7:29] SPEAKER_01: And they're saying, is this linked to something in the diet?
[7:31] SPEAKER_01: And one big factor is the rise of ultra processed foods in our diet.
[7:34] SPEAKER_01: Yeah.
[7:36] Governments are reluctant here as lobbies,
[7:38] very difficult to get anything in.
[7:39] SPEAKER_01: And there is a sense of fatalism, which is like it's cheap.
[7:43] SPEAKER_01: It's there in stores.
[7:45] SPEAKER_01: It has long shelf life.
[7:48] And and so I don't think any place has figured out how to
[7:50] manage it beyond.
[7:52] SPEAKER_01: I give the positive examples of like Denmark,
[7:54] SPEAKER_01: Netherlands,
[7:55] SPEAKER_01: South Korea,
[7:56] SPEAKER_01: Japan,
[7:56] SPEAKER_01: places that are kind of reversing childhood obesity,
[7:59] SPEAKER_01: which is the like the outliers compared to the rest of the world.
[8:03] SPEAKER_01: And there they seem to be focusing on children and saying,
[8:06] SPEAKER_01: actually,
[8:06] if you can prevent the first 10 years obesity and get diet in
[8:10] place for then,
[8:10] SPEAKER_01: it seems to maintain itself.
[8:14] But if children become obese by the age of 5 or 10,
[8:17] it's very,
[8:18] very difficult to reverse that.
[8:19] SPEAKER_01: And that's tied into kind of the diet as well and the diet environment.
[8:22] SPEAKER_00: Yeah,
[8:23] SPEAKER_00: I mean,
[8:23] SPEAKER_00: I think the link to young people's cancers,
[8:26] SPEAKER_00: as you mentioned,
[8:27] SPEAKER_00: is something that's so notable.
[8:28] SPEAKER_00: And we don't have to hunt too far to find an incriminating factor.
[8:32] SPEAKER_00: But one of the things I really liked was the 80% rule.
[8:36] SPEAKER_00: What's that?
[8:39] SPEAKER_00: And tell us a little bit about that,
[8:41] SPEAKER_00: because,
[8:42] SPEAKER_00: you know,
[8:42] SPEAKER_00: I wasn't familiar with that rule before I read your book.
[8:46] Yeah,
[8:46] so,
[8:47] you know,
[8:47] talking about,
[8:48] like,
[8:49] you know,
[8:49] people who study,
[8:50] people who make it to 100.
[8:50] SPEAKER_01: And they were saying, oh, they have nothing in common.
[8:53] SPEAKER_01: And I'm like, but they seem to be a lot of them in Japan.
[8:55] SPEAKER_01: I was like, there's something going on there.
[8:58] SPEAKER_01: And so they're looking at places like Okinawa,
[9:01] SPEAKER_01: and I should say it's changing now,
[9:02] SPEAKER_01: actually,
[9:02] SPEAKER_01: they are going backwards.
[9:03] SPEAKER_01: Yeah.
[9:05] SPEAKER_01: You do see that they follow this dietary rule of eating to 80% full,
[9:09] SPEAKER_01: meaning you don't have to eat.
[9:10] Think of like Thanksgiving in the States or Christmas here
[9:12] where you just eat to
[9:13] SPEAKER_01: like you feel sick.
[9:15] SPEAKER_01: Like there it's learning the opposite.
[9:17] It's learning actually I could eat a bit more,
[9:19] but I'm going to stop because I've had enough.
[9:21] SPEAKER_01: I'm not hungry, but I'm not like stuffed.
[9:24] SPEAKER_01: I've tried instituting it since reading about it.
[9:26] SPEAKER_01: Let's see if you could try it.
[9:27] SPEAKER_01: And it's hard.
[9:29] SPEAKER_01: It's really hard to stop.
[9:31] SPEAKER_01: Because we're so conditioned to finishing your plate,
[9:34] SPEAKER_01: eating till you're like absolutely full to be like,
[9:36] SPEAKER_01: I'm okay.
[9:37] SPEAKER_01: But also even things like they use sweet potato as a main source of carb.
[9:41] SPEAKER_01: which is such a healthy aspect.
[9:45] But also the idea of like your body is a temple and that what
[9:49] you eat actually is
[9:50] SPEAKER_01: nutritious and should be like feeding that and it's not kind of a garbage
[9:54] SPEAKER_01: dispenser.
[9:55] SPEAKER_01: And sometimes,
[9:55] SPEAKER_01: I guess,
[9:56] SPEAKER_01: when you're at an all-you-can-eat buffet,
[9:57] SPEAKER_01: you're actually just trying to finish stuff,
[9:59] SPEAKER_01: right?
[9:59] SPEAKER_01: And like kind of you're just piling it in.
[10:00] SPEAKER_01: So...
[10:01] SPEAKER_01: I did find it fascinating that Japan is one of the countries,
[10:04] SPEAKER_01: I think the country of the G7 with the lowest obesity rates,
[10:07] SPEAKER_01: lowest chronic disease,
[10:09] SPEAKER_01: best survival.
[10:10] And it has to be tied to their diet and how they've tried to
[10:13] maintain that.
[10:14] Even though I didn't put it into the book,
[10:16] the idea that they have nine a day.
[10:17] SPEAKER_01: It's not the five fruits and vegetables, it's nine a day.
[10:20] SPEAKER_01: And that's actually part of their diet.
[10:22] SPEAKER_01: And many kids are getting that.
[10:24] SPEAKER_01: So there is something to be learned from that, I guess.
[10:27] SPEAKER_00: Yeah.
[10:28] SPEAKER_00: I think it's fascinating.
[10:30] SPEAKER_00: I'm going to start trying to implement that too.
[10:34] SPEAKER_00: Exercise,
[10:35] SPEAKER_00: you're unique because here you are,
[10:36] SPEAKER_00: you're a global health expert,
[10:40] SPEAKER_00: and you also became a personal trainer.
[10:41] SPEAKER_00: Yeah,
[10:44] SPEAKER_00: and you tell us about,
[10:46] SPEAKER_00: this is,
[10:46] SPEAKER_00: I find remarkable,
[10:48] SPEAKER_00: that in the Netherlands,
[10:49] SPEAKER_00: the Dutch,
[10:49] SPEAKER_00: 96% of them are really fit with exercise.
[10:54] SPEAKER_00: In the U.S., it's not even 25%.
[10:57] And I guess it's not that much better in the UK,
[11:01] somewhat better than the US.
[11:02] What's the story and what prompted you to add to your mix of
[11:07] your portfolio of what
[11:10] SPEAKER_00: you can offer folks?
[11:12] Well,
[11:13] I guess,
[11:13] I mean,
[11:13] you talk about it in your book,
[11:15] combining like a clinical career.
[11:16] You love seeing patients with the research and the writing and
[11:19] the outreach.
[11:20] SPEAKER_01: And I thought,
[11:21] SPEAKER_01: well,
[11:23] what about combining a similar thing of doing public health
[11:25] outreach and that,
[11:26] SPEAKER_01: but actually instead of seeing patients,
[11:27] SPEAKER_01: you see people who hopefully won't be patients,
[11:30] SPEAKER_01: which is actually getting people more active.
[11:33] SPEAKER_01: Because actually in kind of personal,
[11:35] SPEAKER_01: my personal training kind of certification,
[11:37] SPEAKER_01: you do learn about optimal exercise,
[11:39] SPEAKER_01: anatomy,
[11:40] SPEAKER_01: you know, where different kinds of chronic pain come from.
[11:43] SPEAKER_01: So for example, lower back pain is often tied to tight hip flexors.
[11:46] SPEAKER_01: So actually,
[11:47] SPEAKER_01: how do you prevent back pain,
[11:49] SPEAKER_01: which is one of the major disabling conditions worldwide.
[11:51] SPEAKER_01: And you also learn about diet and nutrition, how you construct kind of
[11:55] SPEAKER_01: So actually, I think it's really complementary.
[11:57] People don't see it as complementary,
[11:58] but really complementary both to medicine,
[12:02] right?
[12:02] SPEAKER_01: So medicine sees people once they're unwell and tries to help them,
[12:07] but also really complementary to research because you actually
[12:11] can start to talk to
[12:12] SPEAKER_01: people at an individual level to understand,
[12:15] SPEAKER_01: I guess,
[12:15] SPEAKER_01: similar to medicine,
[12:16] SPEAKER_01: like the larger studies,
[12:17] SPEAKER_01: the larger epidemiological studies and say actually at your level,
[12:19] SPEAKER_01: right?
[12:20] SPEAKER_01: And the reason I brought up Netherlands is,
[12:23] SPEAKER_01: again,
[12:23] it has to do with you or I or anyone else in the States moved
[12:26] to the Netherlands,
[12:27] SPEAKER_01: to Amsterdam.
[12:28] You're likely to be more active just by moving there because of
[12:32] how the city is set
[12:33] SPEAKER_01: up,
[12:34] SPEAKER_01: how life is set up,
[12:35] SPEAKER_01: what everyone else around you is doing.
[12:37] All of a sudden,
[12:38] it's actually you don't need to have special willpower to go to
[12:41] a gym.
[12:42] You don't need to figure out how in your busy day you're going
[12:46] to get your 30
[12:46] SPEAKER_01: minutes of steps or your 10,000 steps.
[12:49] SPEAKER_01: It's built into natural life.
[12:51] SPEAKER_01: And it just made me think, actually, it's invisible.
[12:53] SPEAKER_01: It's accessible.
[12:54] SPEAKER_01: It's free.
[12:55] SPEAKER_01: And more importantly, there are some people who don't like sport.
[12:58] SPEAKER_01: Like, they just don't like exercise.
[13:00] SPEAKER_01: But if you make it that it's not exercise or sport,
[13:03] SPEAKER_01: it's literally go get your shopping,
[13:05] SPEAKER_01: get to work,
[13:06] SPEAKER_01: go to school.
[13:07] SPEAKER_01: Yeah.
[13:08] SPEAKER_01: You're not doing exercise.
[13:09] SPEAKER_01: You're just going about your day and inadvertently getting it.
[13:13] So I thought that was such an interesting way to think about
[13:17] exercise and sport
[13:18] SPEAKER_01: beyond,
[13:19] SPEAKER_01: you know,
[13:20] SPEAKER_01: the kind of campaigns.
[13:21] SPEAKER_01: And I talk about Dubai and Delhi and Ghana,
[13:24] SPEAKER_01: where it's just like YouTube campaigns,
[13:26] SPEAKER_01: which kind of reaches the people who are already fit.
[13:28] SPEAKER_01: It's like saying...
[13:30] You already are kind of probably exercise isn't a reason you're
[13:33] going to die too
[13:33] SPEAKER_01: soon,
[13:34] SPEAKER_01: but you're trying to optimize.
[13:35] SPEAKER_01: And that's what you see a lot in like the fitness influencer community.
[13:37] SPEAKER_01: It's people who are already like 98% fit.
[13:40] And they're like,
[13:41] how do I get,
[13:42] you know,
[13:43] 1.5% more do 60 press ups instead of 30?
[13:46] SPEAKER_01: Or, you know, how do I do?
[13:48] SPEAKER_01: And I'm like, okay, that's fine.
[13:49] SPEAKER_01: As you're saying, what do you do with all the people who are sedentary?
[13:53] SPEAKER_01: Right?
[13:53] Like that's the real population challenge and where we are
[13:56] seeing how you get that going.
[13:58] SPEAKER_01: Yeah.
[13:58] SPEAKER_00: Well, I mean, I didn't know about this Dutch capability of 96%.
[14:03] SPEAKER_00: I think it's just, imagine if the whole world was like that.
[14:08] SPEAKER_00: Wow.
[14:10] SPEAKER_00: Now,
[14:11] you basically get into every aspect of how we can have better
[14:17] health span on a
[14:19] SPEAKER_00: global level,
[14:19] this unique picture of knowing pockets around the world that
[14:23] are best and worst
[14:25] SPEAKER_00: practices,
[14:25] SPEAKER_00: I guess.
[14:27] SPEAKER_00: Air quality.
[14:28] This is a big one because we know air pollution is a potent
[14:33] pro-inflammatory risk
[14:35] SPEAKER_00: of cancer,
[14:36] SPEAKER_00: cardiovascular neurodegenerative disease.
[14:40] SPEAKER_00: This pollution fatalism that you
[14:42] SPEAKER_00: refer to.
[14:44] SPEAKER_00: And the fact like,
[14:45] SPEAKER_00: for example,
[14:46] SPEAKER_00: in Delhi,
[14:47] it's like just breathing the air there is like having 10 or 15
[14:50] cigarettes a day,
[14:52] SPEAKER_00: which is incredible.
[14:55] SPEAKER_00: Nothing seems to be getting done to get this on track.
[15:00] SPEAKER_00: And there's only a little bit we can do with having air purifiers.
[15:06] SPEAKER_00: What are we going to do about this mess?
[15:07] SPEAKER_00: I mean, part of it, of course, is entangled with the climate crisis.
[15:12] SPEAKER_00: Any thoughts about that?
[15:14] SPEAKER_01: Yeah, it is really tricky.
[15:15] And I didn't realize till I did the research for that chapter,
[15:19] how bad diesel is for our health.
[15:21] I think like so much of the air pollution debate has been tied
[15:23] into the climate
[15:24] SPEAKER_01: emergency,
[15:25] SPEAKER_01: which is important,
[15:26] SPEAKER_01: but it feels delayed.
[15:27] SPEAKER_01: It's like talking about your children or your children's children.
[15:30] But actually what I was amazed at doing the air pollution
[15:32] research is how much it's about us.
[15:34] SPEAKER_01: Like the person driving a diesel vehicle is ruining their lungs.
[15:37] SPEAKER_01: They're ruining the people who are in that vehicle.
[15:40] SPEAKER_01: So bringing the urgency to actually it's a health issue.
[15:43] It's not just a kind of a long distance climate issue for 10 or
[15:46] 15 or 20 years.
[15:48] SPEAKER_01: You do see places stepping out.
[15:49] SPEAKER_01: And that's why I try to give positive examples.
[15:51] SPEAKER_01: London introducing,
[15:53] SPEAKER_01: you know,
[15:53] SPEAKER_01: a low emission zone and an ultra low emission zone saying within this,
[15:57] SPEAKER_01: you know,
[15:58] SPEAKER_01: trying to reduce congestion,
[15:59] SPEAKER_01: trying to get people moving through,
[16:01] SPEAKER_01: you know,
[16:03] SPEAKER_01: you know,
[16:03] SPEAKER_01: non-polluting vehicles or public transport.
[16:06] SPEAKER_01: You do see this in places like Zurich,
[16:08] SPEAKER_01: the cleanest air in the world,
[16:10] SPEAKER_01: but also even places like Tokyo,
[16:12] SPEAKER_01: which given the population density,
[16:14] you'd expect to have much more pollution and they're not using
[16:17] newer tech.
[16:18] And so I guess the idea being that once you put a plan in place
[16:22] and it is a problem
[16:23] SPEAKER_01: and you want to fix it,
[16:24] SPEAKER_01: generally solutions work and it gets better.
[16:27] SPEAKER_01: That's one of,
[16:27] SPEAKER_01: I guess,
[16:27] SPEAKER_01: the big lessons in the book,
[16:28] SPEAKER_01: that actually once you decide something is fixable,
[16:31] SPEAKER_01: it gets fixed.
[16:32] SPEAKER_01: And when you decide something is not fixable,
[16:35] SPEAKER_01: guess what?
[16:36] SPEAKER_01: It doesn't get fixed.
[16:37] SPEAKER_01: And I think they're the first thing.
[16:38] SPEAKER_01: You see in Cape Town,
[16:40] SPEAKER_01: I raise in South Africa,
[16:41] SPEAKER_01: the first thing is recognizing it's a problem and putting in solutions,
[16:46] SPEAKER_01: meaningful ones.
[16:47] SPEAKER_01: And it's interesting.
[16:48] I mean,
[16:49] I also raise it because here,
[16:50] let's say in Edinburgh,
[16:51] we have a new low emission zone.
[16:52] There's huge efforts to make the air clean,
[16:56] but people take them for granted.
[16:58] SPEAKER_01: And that's why I bring these examples of places where they don't
[17:01] SPEAKER_01: Nothing is done.
[17:02] SPEAKER_01: And I say, that's what it could be.
[17:04] That's the future if we don't actually actively manage our air
[17:07] quality and what it
[17:08] SPEAKER_01: does to our lungs.
[17:09] SPEAKER_01: And coming back to Delhi,
[17:10] SPEAKER_01: the idea that 50% of kids living in the city have damaged lungs already.
[17:14] SPEAKER_01: I'm like, you can go about your day, do what you can.
[17:17] SPEAKER_01: And then the rise of the bottled air industry,
[17:18] SPEAKER_01: which I hadn't known about,
[17:20] SPEAKER_01: which is like modeled off bottled water,
[17:22] which is trying to bottle air and bring it to places that don't
[17:24] have clean air so
[17:25] SPEAKER_01: you can individually breathe your clean air alongside your air purifier.
[17:29] SPEAKER_01: But,
[17:30] SPEAKER_01: yeah,
[17:30] it's a huge challenge for the world and probably the thing that
[17:33] invisibly affects
[17:34] SPEAKER_01: us when we don't think about.
[17:36] Or even the idea I talk about that if you're in a place with
[17:39] air pollution,
[17:40] SPEAKER_01: if you're outside running or cycling,
[17:42] you could be doing more harm to your health doing that than
[17:44] actually the good of
[17:45] SPEAKER_01: the exercise because of the pollution going through your system.
[17:48] SPEAKER_01: Yeah.
[17:50] I brought it up in the book because I think it's something that
[17:52] people do feel it's
[17:53] SPEAKER_01: beyond their control.
[17:54] SPEAKER_01: They might follow like their quality indicator,
[17:56] but we need to have like collective action to actually say this
[18:00] is a problem.
[18:00] SPEAKER_01: It matters to health.
[18:02] SPEAKER_01: And this is why.
[18:02] SPEAKER_01: And these are solutions.
[18:04] SPEAKER_01: And these are places trying to do things differently.
[18:05] SPEAKER_01: And if we don't take these measures,
[18:08] SPEAKER_01: we could into a place where too many kids are having,
[18:11] SPEAKER_01: you know,
[18:13] very severe asthma episodes because actually they're being
[18:16] triggered by that.
[18:16] SPEAKER_01: And you can have as many hospitals as you want,
[18:18] SPEAKER_01: but if you're not fixing the air,
[18:20] SPEAKER_01: how do you actually manage it?
[18:21] SPEAKER_01: So, yeah.
[18:23] Well,
[18:23] I hope we'll get over this kind of fatalistic approach here and
[18:26] really get on it.
[18:27] SPEAKER_00: It's such a critical matter.
[18:29] It's just not getting enough attention and you really brought
[18:32] it to the fore book.
[18:36] SPEAKER_00: Like air is also the desire to have clean water and
[18:40] SPEAKER_00: And here,
[18:40] SPEAKER_00: I think,
[18:41] SPEAKER_00: along with there,
[18:42] SPEAKER_00: you highlighted Switzerland as a place that seems to be more into this,
[18:48] SPEAKER_00: trying to aspire to the cleanest water.
[18:53] SPEAKER_00: What are we going to do about the water?
[18:54] SPEAKER_00: Because this is another serious mess that we're in.
[19:00] SPEAKER_01: Yeah,
[19:00] so I think I talk about water because I guess people reading it
[19:03] might be in a place
[19:04] SPEAKER_01: where they have great tap water and they can drink it.
[19:07] SPEAKER_01: I'm lucky in Scotland.
[19:08] SPEAKER_01: So Scottish Water is publicly owned.
[19:11] SPEAKER_01: It provides basically kind of free tap water throughout the country.
[19:15] SPEAKER_01: There's water stations you can go to in parks.
[19:17] SPEAKER_01: It's not like Brussels and Paris, which have sparkling water stations.
[19:20] SPEAKER_01: You can go kind of get your...
[19:22] SPEAKER_01: your water.
[19:23] But tying into here,
[19:26] the idea that water is something that if you do not have,
[19:28] you die of.
[19:29] SPEAKER_01: It is not a luxury.
[19:30] SPEAKER_01: It is not a commodity.
[19:32] But in many places in the world,
[19:33] bottled water is actually the main provider of water.
[19:37] SPEAKER_01: And that's true in parts of the States, depending where you live.
[19:40] SPEAKER_01: It's true in
[19:41] SPEAKER_01: Egypt, across much of the developing world.
[19:45] SPEAKER_01: And so looking at actually what does water provision mean?
[19:48] SPEAKER_01: How do we get that right?
[19:50] And learning the lessons of building those kind of
[19:52] infrastructure and systems so
[19:55] SPEAKER_01: people don't have to think about water.
[19:56] SPEAKER_01: It's something that just comes out of your tap.
[19:58] SPEAKER_01: It's clean and it's filtered.
[20:00] SPEAKER_01: Yeah.
[20:18] SPEAKER_01: And so I brought up that example to say,
[20:20] SPEAKER_01: even in places like Britain,
[20:21] SPEAKER_01: which are very advanced and in the States,
[20:23] SPEAKER_01: I talk about Jackson,
[20:24] SPEAKER_01: a place where it keeps the water system has not been invested in.
[20:29] You have schools closed down because they have no water they
[20:31] can provide to their students.
[20:33] SPEAKER_01: But actually,
[20:34] SPEAKER_01: we can't let those gains go like these gains are because,
[20:37] SPEAKER_01: you know,
[20:37] SPEAKER_01: a couple of centuries ago,
[20:39] SPEAKER_01: people realized water and sanitation were a major reason.
[20:42] SPEAKER_01: That,
[20:42] SPEAKER_01: you know,
[20:42] SPEAKER_01: not having those where people were dying with Jon Snow,
[20:45] SPEAKER_01: with the cholera epidemic in London,
[20:47] SPEAKER_01: and then since then waterborne diseases.
[20:49] And if we don't kind of maintain those gains and invest in
[20:52] these systems,
[20:54] you know,
[20:55] people die.
[20:55] SPEAKER_01: And I give the example also places where it's not yet fixed, like Haiti.
[20:59] SPEAKER_01: Waterborne diseases are the number one cause of dying too soon, right?
[21:02] SPEAKER_01: And so also to bring the example that just because of where we live,
[21:06] SPEAKER_01: we could be like in a very kind of bubble where it works,
[21:08] SPEAKER_01: but there are many places it doesn't work.
[21:11] And we have to not only fix those,
[21:12] but think about making sure we maintain where we are.
[21:15] SPEAKER_00: Yeah, no, it's so important.
[21:16] SPEAKER_00: I mean,
[21:18] you're getting into the big topics that so far have not nearly
[21:22] the attention or the
[21:23] SPEAKER_00: action,
[21:24] SPEAKER_00: not just the talk,
[21:25] SPEAKER_00: but the walk.
[21:27] SPEAKER_00: And that gets us also to the topic of inequities that you,
[21:31] SPEAKER_00: as a chair of global health at a great university,
[21:35] SPEAKER_00: this quote I thought really grabbed me.
[21:38] This grotesque inequality is breaking the bonds that hold us
[21:41] together in humanity.
[21:42] SPEAKER_00: This is inequality that literally kills.
[21:46] SPEAKER_00: So,
[21:47] SPEAKER_00: so much of what we've been talking about,
[21:49] SPEAKER_00: of course,
[21:49] SPEAKER_00: is exacerbated greatly because of inequities.
[21:55] And there doesn't seem to be nearly enough work on that if
[21:59] we're going to have this
[22:02] SPEAKER_00: idea of a better,
[22:03] SPEAKER_00: healthy,
[22:04] SPEAKER_00: approaching much greater than where we are today,
[22:08] SPEAKER_00: which is in the 80 or so category for lifespan,
[22:11] SPEAKER_00: but not necessarily at all for healthspan.
[22:15] SPEAKER_00: Are you optimistic that we can address this?
[22:17] For example,
[22:17] I know there was some work in the UK which was specifically
[22:21] intended for
[22:22] SPEAKER_00: for example,
[22:22] a mental health app that was for people in greater need rather
[22:29] than just putting
[22:30] SPEAKER_00: out there for everyone.
[22:32] SPEAKER_00: What do you think about it?
[22:34] Yeah,
[22:34] I mean,
[22:35] I think this is almost like the elephant in the room for a lot
[22:37] of issues.
[22:38] SPEAKER_01: I'll give you an example.
[22:39] SPEAKER_01: So we know GLP-1s are seen as these wonder drugs.
[22:42] So I was asked,
[22:43] should we just distribute them in Scotland or even obesity
[22:45] problems?
[22:46] SPEAKER_01: The NHS just buy them and give them to children.
[22:48] SPEAKER_01: And I said, but my question back is,
[22:51] SPEAKER_01: Why is it that you can correlate house prices to childhood obesity?
[22:54] SPEAKER_01: That actually I can tell you where obesity is based on house prices.
[22:57] SPEAKER_01: That tells me it's not a metabolic issue.
[22:59] It's not that these children are different in terms of their
[23:02] biological makeup.
[23:03] SPEAKER_01: It tells me it's where they're living and probably what things cost.
[23:06] SPEAKER_01: And that's where inequality comes into it.
[23:09] And it's a really tricky conversation because it gets into how
[23:13] do you actually
[23:14] SPEAKER_01: create some kind of balance within a society?
[23:17] SPEAKER_01: And looking at the bottom 20 or 30 percent and saying,
[23:21] SPEAKER_01: how do we lift people up who are really struggling?
[23:23] SPEAKER_01: That has to come through some kind of redistribution.
[23:26] And nobody likes talking about that because it's the idea of
[23:29] taxation,
[23:31] social investment.
[23:32] And there,
[23:33] I guess I do probe at the end,
[23:34] which is,
[23:35] you know,
[23:36] when is enough enough?
[23:38] SPEAKER_01: And do we accept the growth,
[23:40] SPEAKER_01: the number of billionaires,
[23:41] SPEAKER_01: which COVID brought,
[23:42] SPEAKER_01: you know,
[23:43] SPEAKER_01: record number of billionaires created with the rise in extreme poverty?
[23:46] SPEAKER_01: At what point do we say,
[23:48] SPEAKER_01: actually,
[23:49] SPEAKER_01: you have enough if you have 100 million or if you have 500 million?
[23:52] SPEAKER_01: After that, you need to put back things.
[23:54] SPEAKER_01: And the idea that actually the tax is being paid by the super wealthy.
[23:58] SPEAKER_01: I don't mean people who are working as doctors or lawyers.
[24:01] SPEAKER_01: I mean, people who are like,
[24:03] SPEAKER_01: you know,
[24:04] SPEAKER_01: billionaires,
[24:04] SPEAKER_01: literally,
[24:05] SPEAKER_01: or,
[24:05] SPEAKER_01: you know,
[24:05] multimillionaires often pay a smaller percentage of tax than
[24:10] someone who's there.
[24:10] SPEAKER_01: It's true in the States.
[24:11] SPEAKER_01: It's true and true in Britain.
[24:13] SPEAKER_01: And you do have people like Abigail Disney,
[24:16] SPEAKER_01: you know,
[24:16] SPEAKER_01: Disney Harris saying,
[24:18] SPEAKER_01: well,
[24:18] SPEAKER_01: actually,
[24:18] SPEAKER_01: we do need to have some kind of idea where you give back.
[24:22] SPEAKER_01: And so I bring the example of Finland and that social contract that
[24:26] SPEAKER_01: which is not saying that you do away with distribution of wealth,
[24:29] SPEAKER_01: like,
[24:30] SPEAKER_01: but at what point do you say if you've got 10 houses,
[24:32] SPEAKER_01: actually,
[24:33] SPEAKER_01: maybe instead of having 11th house,
[24:35] SPEAKER_01: you invest so that someone's not homeless,
[24:37] SPEAKER_01: or that there's,
[24:38] SPEAKER_01: you know,
[24:38] SPEAKER_01: social services provided.
[24:40] And so I don't know how we can have that kind of debate without
[24:42] it descending into
[24:44] SPEAKER_01: increased taxation for all government overthrow,
[24:46] SPEAKER_01: you know,
[24:47] SPEAKER_01: nanny state,
[24:47] SPEAKER_01: all the kind of things we hear.
[24:49] SPEAKER_01: But just saying that actually,
[24:51] SPEAKER_01: When do we say enough is enough for someone and say,
[24:54] SPEAKER_01: okay,
[24:54] SPEAKER_01: when do you start actually helping the bottom 20% to lift?
[24:58] Because the only way to avoid that increase in life expectancy
[25:01] where we know we
[25:02] SPEAKER_01: have it here in Scotland,
[25:04] SPEAKER_01: sure in the States,
[25:04] between different populations is actually to start thinking
[25:06] about that inequality
[25:07] SPEAKER_01: and
[25:09] SPEAKER_01: in the social determinants of health as well.
[25:11] SPEAKER_01: And that comes into issues around diet,
[25:14] SPEAKER_01: physical activity,
[25:14] SPEAKER_01: green spaces,
[25:15] SPEAKER_01: housing,
[25:17] SPEAKER_01: but a really tricky debate to have.
[25:18] SPEAKER_01: So I kind of go into it in the book a bit and kind of probe a bit,
[25:22] SPEAKER_01: but by also saying it is really,
[25:24] really difficult because I think there is this kind of recoil
[25:28] to any idea of kind
[25:29] SPEAKER_01: of the state intervening in that kind of way.
[25:31] But I think we do need to have that as a conversation,
[25:33] which is once you've had,
[25:35] you know,
[25:37] SPEAKER_01: Again, you have $100 million.
[25:38] SPEAKER_01: I think it was Abigail Disney said that once she reached $100 million,
[25:41] SPEAKER_01: she's like,
[25:41] SPEAKER_01: $130 million didn't change my life.
[25:45] SPEAKER_01: And I'm not...
[25:45] SPEAKER_01: Yeah,
[25:46] SPEAKER_01: and actually the threshold being whatever it is,
[25:48] SPEAKER_01: I don't think it's within...
[25:49] SPEAKER_01: I mean,
[25:50] SPEAKER_01: here in Britain,
[25:50] they're talking about a tax and people making over $10 million
[25:53] pounds a year
[25:54] SPEAKER_01: saying,
[25:55] SPEAKER_01: actually,
[25:55] SPEAKER_01: should we have there?
[25:56] SPEAKER_01: But ironically,
[25:57] SPEAKER_01: if you're in that kind of band,
[25:58] you probably have very advanced tax lawyers who can help you
[26:01] not have to contribute
[26:02] SPEAKER_01: at all.
[26:03] SPEAKER_01: And I think that's the dilemma we're in, so...
[26:05] SPEAKER_00: Yeah, no question.
[26:07] SPEAKER_00: Well, interesting approach there.
[26:09] SPEAKER_00: Now,
[26:09] SPEAKER_00: you mentioned Finland,
[26:11] and that was one of the things I also wanted to highlight with
[26:14] you with the book,
[26:16] SPEAKER_00: that this is a place where prevention is really a big thing.
[26:22] And all the things that we've been talking about are trying to
[26:25] prevent major
[26:27] SPEAKER_00: diseases,
[26:28] SPEAKER_00: promote health.
[26:30] SPEAKER_00: What do you think about Finland?
[26:31] SPEAKER_00: Is that the right model?
[26:33] SPEAKER_01: Yeah.
[26:34] SPEAKER_01: So when I looked across different metrics in terms of like happiness,
[26:37] SPEAKER_01: health,
[26:38] SPEAKER_01: health systems,
[26:38] SPEAKER_01: longevity,
[26:39] SPEAKER_01: Finland just emerged as a country.
[26:42] SPEAKER_01: It can't be due to the weather, saying it's Scotland.
[26:44] SPEAKER_01: It's so far north.
[26:45] SPEAKER_01: They do have very dark winters.
[26:47] SPEAKER_01: So it must be obviously something else going on there.
[26:50] SPEAKER_01: And I think just looking back that it was a set of policy choices.
[26:54] One of the most interesting ones was in the 20s and 30s about
[26:57] gender equality.
[26:58] And actually raising the position of women through employment
[27:01] laws,
[27:02] I mean,
[27:02] representation.
[27:03] SPEAKER_01: And that's,
[27:05] SPEAKER_01: I think,
[27:05] SPEAKER_01: one of the really interesting stories is actually how can something...
[27:08] SPEAKER_01: And I know,
[27:08] SPEAKER_01: like,
[27:09] SPEAKER_01: Bill Gates came to this and Melinda Gates as well,
[27:11] SPEAKER_01: that actually how can gender do with health?
[27:13] And you start reeling,
[27:14] actually,
[27:14] there is something that connects those agendas.
[27:17] SPEAKER_01: And so...
[27:18] SPEAKER_01: Yeah,
[27:18] SPEAKER_01: I guess it's called the happiest place on earth,
[27:20] SPEAKER_01: not only because I guess Santa Claus lives there in Lapland,
[27:23] but because they have really progressive ways of approaching
[27:28] provision and
[27:29] SPEAKER_01: prevention.
[27:29] And Finland was one of the few countries that saw life
[27:33] expectancy increases despite
[27:34] SPEAKER_01: the COVID pandemic because of how active they were.
[27:37] SPEAKER_01: Yeah, yeah.
[27:56] SPEAKER_01: And as well,
[27:57] SPEAKER_01: I'd mentioned that they have like basically eradicated rough sleeping or
[28:02] SPEAKER_01: homelessness.
[28:02] SPEAKER_01: And that's been through,
[28:03] SPEAKER_01: again,
[28:03] a deliberate policy of saying someone who is homeless and
[28:07] sleeping on the streets
[28:07] SPEAKER_01: can't figure out their life.
[28:09] SPEAKER_01: Like it's too complicated.
[28:10] So you start by providing them a short term solution of a home
[28:13] and social support
[28:15] SPEAKER_01: to help them find a job,
[28:16] SPEAKER_01: get on their feet and transition them back.
[28:19] And the idea being that actually you should see someone who is
[28:22] homeless as,
[28:23] you know,
[28:23] SPEAKER_01: I don't want to use the word victim, but someone needs a hand up.
[28:27] You help them get a hand up and you transition them back
[28:29] instead of thinking,
[28:30] SPEAKER_01: oh,
[28:31] SPEAKER_01: why do we have all these people on the streets?
[28:32] SPEAKER_01: What's their problem?
[28:34] SPEAKER_01: And again, it was an interesting policy.
[28:35] SPEAKER_01: I think they put together like,
[28:37] SPEAKER_01: you know,
[28:37] SPEAKER_01: someone,
[28:38] SPEAKER_01: a pastor,
[28:39] SPEAKER_01: you know,
[28:39] SPEAKER_01: a social scientist,
[28:40] SPEAKER_01: a doctor and a politician.
[28:42] SPEAKER_01: And they said, find a solution to this.
[28:44] And they came up with a really creative solution that mixes
[28:46] empathy,
[28:47] you know,
[28:48] pragmatic care.
[28:49] SPEAKER_01: But the idea being that actually,
[28:52] SPEAKER_01: How do you get someone from homelessness into the workforce,
[28:55] SPEAKER_01: into a home,
[28:56] SPEAKER_01: into being productive and happy in life?
[28:58] SPEAKER_01: The state has to help in that.
[28:59] You can't just leave it because it's too deep a pit to be able
[29:03] to find your way out of.
[29:04] SPEAKER_01: And I think that,
[29:05] SPEAKER_01: I think,
[29:05] is one of the pioneering things as well that they've done that
[29:08] I think places could
[29:08] SPEAKER_01: look at and think,
[29:09] SPEAKER_01: oh,
[29:09] SPEAKER_01: how did they do that?
[29:10] SPEAKER_01: Because they do have quite a productive workforce and economy.
[29:13] SPEAKER_01: And that's obviously tied to how they're managing that.
[29:18] SPEAKER_00: Yeah, no, that's great.
[29:19] SPEAKER_00: I know we can't get to everything in the book because it's rich,
[29:23] SPEAKER_00: but when you get to how not to die too soon,
[29:29] SPEAKER_00: what's so many,
[29:31] SPEAKER_00: anything big that we haven't touched on in our discussion,
[29:37] SPEAKER_00: Debbie?
[29:38] Well,
[29:38] I guess the only one is I was curious what you made of the
[29:41] chapter on gun violence.
[29:44] SPEAKER_01: I think one of the biggest things being brought up in Florida,
[29:47] going to University of Miami and then coming abroad was how
[29:49] guns are managed and
[29:51] SPEAKER_01: treated.
[29:52] SPEAKER_01: So I just raised in Scotland, there was a shooting.
[29:55] SPEAKER_01: Andy Murray was in that shooting in Scotland.
[29:59] SPEAKER_01: And after that shooting,
[30:00] SPEAKER_01: which was,
[30:00] SPEAKER_01: I guess,
[30:01] SPEAKER_01: 30 or odd years ago,
[30:02] SPEAKER_01: they banned handguns,
[30:04] SPEAKER_01: you know,
[30:04] SPEAKER_01: made it very difficult to get weapons.
[30:06] SPEAKER_01: And there's not been a school shooting since in that time.
[30:10] SPEAKER_01: They came down, that parent group, very strongly.
[30:13] SPEAKER_01: And I thought about it recently because in the Edinburgh News,
[30:16] SPEAKER_01: like this past few weeks,
[30:17] SPEAKER_01: there was a note that a child,
[30:19] SPEAKER_01: a 15-year-old,
[30:20] had been arrested with complete plans for a shooting based on
[30:23] Columbine and had
[30:25] SPEAKER_01: exactly where they were going to stand in the school,
[30:27] SPEAKER_01: who they were going to target,
[30:29] SPEAKER_01: raise the fire alarm,
[30:30] SPEAKER_01: get people out,
[30:30] SPEAKER_01: all that stuff.
[30:32] SPEAKER_01: And the one thing they hadn't been able to do was get a gun.
[30:35] SPEAKER_00: Yeah.
[30:35] SPEAKER_01: And get access.
[30:36] SPEAKER_01: So I just thought that was quite like.
[30:38] SPEAKER_01: Oh,
[30:40] I'm question it because the chapter on guns and the fact that
[30:44] had the insanity here
[30:45] in the United States and then also the chapter on accidents and
[30:50] zero vision.
[30:51] that you really told us the whole story in sweden i mean that's
[30:54] why this book is so
[30:55] extraordinary because you you you come up with these things i i
[30:59] learned so much
[31:00] from it but of course the gun thing has me so depressed because
[31:03] we've done nothing
[31:05] and the story you told in the book and also that we've seen in
[31:08] australia um and
[31:10] SPEAKER_00: many other parts of the world
[31:12] SPEAKER_00: That,
[31:12] SPEAKER_00: you know,
[31:12] SPEAKER_00: if you do the restriction,
[31:14] SPEAKER_00: you get rid of these lethal military-type weapons,
[31:18] SPEAKER_00: assault rifles and whatnot.
[31:20] SPEAKER_00: You see a tremendous change in the pattern of not just mass shootings,
[31:26] SPEAKER_00: but all sorts of other gun disasters.
[31:30] SPEAKER_00: So,
[31:30] SPEAKER_00: you know,
[31:30] SPEAKER_00: we have this now somehow normalized,
[31:33] SPEAKER_00: immune almost,
[31:34] SPEAKER_00: you know,
[31:34] SPEAKER_00: on a daily basis,
[31:36] SPEAKER_00: something here in the U.S.
[31:37] SPEAKER_00: Now, that gets me to my last question to you.
[31:40] SPEAKER_00: You, as an American...
[31:42] SPEAKER_00: raised in Miami,
[31:44] SPEAKER_00: you decided to emigrate to the UK and to set up shop to the University of
[31:49] SPEAKER_00: Edinburgh.
[31:51] I don't know how prescient you must have been knowing how this
[31:54] place has become
[31:55] SPEAKER_00: such a mess with respect to lack of support for health,
[32:00] SPEAKER_00: as you know,
[32:01] SPEAKER_00: gutting National Institutes of Health and gutting public health agencies.
[32:06] Did you know about that when you decided years ago that you
[32:09] were gonna move to the UK?
[32:12] SPEAKER_01: Not at all.
[32:13] SPEAKER_01: And it's quite...
[32:15] incredible to see I think even for probably Americans in the
[32:17] states like the
[32:18] rollbacks around vaccinations around this idea of data analysis
[32:22] evidence what
[32:23] counts as truth absolutely astonishing to see and so yeah I
[32:31] think sometimes it is
[32:33] good for to be American but to live in different places to
[32:37] travel to different
[32:37] places to see actually there are lots of different ways to do
[32:41] things there are a
[32:41] SPEAKER_01: lot of different ways that you know
[32:44] societies run and operate often very effectively um and i think
[32:49] what really does
[32:49] scare me as well in the states is kind of the rise of like the
[32:52] lack of freedom of
[32:53] speech now to be able to say things but even as you have that
[32:56] as that can you
[32:57] dissent and i can just say that's one thing i'm very happy
[33:00] about in scotland that
[33:01] you can dissent and you can criticize government and you can
[33:03] say and that's
[33:04] SPEAKER_01: considered healthy and part of the dynamic um
[33:09] But let's hope it's a few years and,
[33:12] you know,
[33:13] the arc continues towards progress.
[33:16] SPEAKER_01: But yeah,
[33:17] absolutely astonishing to see it from abroad and actually
[33:22] really devastating,
[33:23] SPEAKER_01: I think,
[33:23] in terms of the cutback in scientific grants and the
[33:26] dismantling of CDC and the FDA
[33:29] SPEAKER_01: and so many essential American institutions.
[33:32] SPEAKER_01: Because America is,
[33:34] SPEAKER_01: regardless of where you are in the world,
[33:35] SPEAKER_01: the most influential country in terms of health.
[33:38] SPEAKER_01: I think we accept that in different places.
[33:41] SPEAKER_01: Often the American news dominates here.
[33:43] SPEAKER_01: When I'm back in the States, it is the American news.
[33:46] SPEAKER_01: Rarely another country dominates in the same way.
[33:48] So I wish those living there strength in these difficult times
[33:53] to get through
[33:54] SPEAKER_01: because it is a difficult patch.
[33:58] I'm working on a column now actually about the Make America
[34:00] Healthy Again movement.
[34:02] SPEAKER_01: The idea being that there are nuggets of truth.
[34:05] I think you and I would accept America's health needs more
[34:08] work,
[34:09] needs more investment.
[34:10] SPEAKER_01: But the solutions,
[34:11] SPEAKER_01: I think,
[34:11] SPEAKER_01: are very different in terms of what you would be doing,
[34:14] SPEAKER_01: the policies,
[34:15] SPEAKER_01: the programs,
[34:16] SPEAKER_01: if you actually wanted to address that.
[34:20] SPEAKER_01: So, yeah, difficult, difficult times.
[34:24] SPEAKER_01: But no, it didn't factor into me going abroad.
[34:26] SPEAKER_01: I've been abroad for about 20 years.
[34:28] SPEAKER_01: I'm back and forth visiting faculty.
[34:30] SPEAKER_01: But yeah, I've been abroad too long for that.
[34:32] SPEAKER_00: I just think,
[34:33] SPEAKER_00: though,
[34:33] SPEAKER_00: that somehow you must have thought,
[34:36] SPEAKER_00: you know,
[34:37] SPEAKER_00: in a futuristic way,
[34:39] being there might have a better place to study and be supported
[34:44] for efforts you've
[34:45] SPEAKER_00: led in global health throughout your career,
[34:47] SPEAKER_00: which has been
[34:48] SPEAKER_00: Here you are quite young still,
[34:50] SPEAKER_00: and you've already had a storied career in global health efforts.
[34:54] SPEAKER_00: And so I just want to congratulate you on a phenomenal book,
[34:58] as well as all that you've been doing there for a couple of
[35:01] decades to lead us in
[35:04] SPEAKER_00: the sphere of global health.
[35:06] SPEAKER_00: And this very remarkable insight that you have,
[35:12] SPEAKER_00: Here,
[35:12] SPEAKER_00: you've lived in a couple of countries throughout your life,
[35:14] SPEAKER_00: but somehow or other,
[35:16] you have a window into so many other places around the world
[35:20] from your efforts.
[35:20] SPEAKER_00: So thank you, Debbie.
[35:22] SPEAKER_00: What a pleasure to connect with you today in this live format.
[35:26] SPEAKER_00: I think it's definitely been a conversation.
[35:29] SPEAKER_00: It will get archived,
[35:30] SPEAKER_00: but the people who joined late,
[35:31] SPEAKER_00: many have joined along the way,
[35:34] SPEAKER_00: can go back and listen to
[35:36] SPEAKER_00: to the whole thing.
[35:37] SPEAKER_00: But really appreciate, thanks for putting this book together.
[35:40] SPEAKER_00: And also,
[35:41] SPEAKER_00: I'm looking forward to reading your column on Make America Healthy Again,
[35:45] because I think I probably share all the views that you're
[35:48] going to articulate,
[35:49] SPEAKER_00: and you do that so well in your columns that
[35:53] SPEAKER_00: which is really important to keep getting the word out.
[35:57] SPEAKER_00: Also,
[35:57] that perspective from across the pond is important because when
[36:01] we write about this
[36:01] SPEAKER_00: stuff,
[36:02] it doesn't go nearly as far with respect to respect and uptake
[36:10] as when you and
[36:11] SPEAKER_00: others were
[36:13] the UK and Europe and health,
[36:16] write about the mess that we're in right now.
[36:19] SPEAKER_00: And also, last thing, I share your optimism.
[36:22] SPEAKER_00: We are going to get through this here eventually.
[36:26] SPEAKER_00: And,
[36:27] SPEAKER_00: you know,
[36:27] not to get too carried away in the moment because eventually
[36:31] we'll get into a
[36:31] SPEAKER_00: better state,
[36:32] SPEAKER_00: I'm sure.
[36:33] SPEAKER_00: I'm hoping for a reaction to hyperemia where all the deficits that we're
[36:37] SPEAKER_00: experiencing right now will be recovered over time.
[36:42] SPEAKER_00: Anything else for you?
[36:45] SPEAKER_01: No, just to say thank you for calling me young.
[36:48] Because when I do go to the gym and to like the fitness PT
[36:51] world,
[36:52] I'm considered the aged one.
[36:54] You know,
[36:54] someone who's 20 is like,
[36:55] when I'm your age,
[36:56] I hope I can still do box jumps.
[36:58] SPEAKER_01: I'm like, oh my goodness.
[37:00] SPEAKER_01: So I'm glad to this environment.
[37:02] SPEAKER_01: Yeah.
[37:03] SPEAKER_01: And look forward.
[37:05] SPEAKER_01: Thank you for having me.
[37:06] SPEAKER_01: And your book's absolutely brilliant as well.
[37:07] SPEAKER_01: It's really, they're almost like two sides of the same coin.
[37:10] SPEAKER_01: The one looking at.
[37:12] SPEAKER_01: You know, what can you do yourself?
[37:13] SPEAKER_01: What's the latest evidence?
[37:14] SPEAKER_01: You know, really tying into so many thousands of studies.
[37:18] SPEAKER_01: And then I just mind on that.
[37:19] Once you have that,
[37:20] how does the government actually implement to help you on that
[37:22] path?
[37:22] SPEAKER_01: So thanks very much.
[37:24] SPEAKER_00: Thank you.
[37:25] And the funny part is we had no idea that we would have these
[37:27] two books that were
[37:28] SPEAKER_00: very different,
[37:29] SPEAKER_00: very complimentary.
[37:30] SPEAKER_00: come out almost at the same time.
[37:32] SPEAKER_00: Really wild.
[37:33] I'll look forward to future conversations with you and even
[37:36] getting to meet you in
[37:37] SPEAKER_00: person someday.
[37:38] SPEAKER_00: Thanks so much.
[37:39] SPEAKER_01: Yeah.
[37:40] SPEAKER_01: If there's an exodus, you can always come to Bonnie, Scotland.
[37:44] SPEAKER_00: Sounds good.
[37:46] SPEAKER_01: Thank you very much.
[37:47] SPEAKER_01: Bye.

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.