Book Summaries health

The Future (The Story of the Human Body)

Even though the human body has come a long way, the journey is far from over. What will the future look like? Will our technologies cure cancer, solve the obesity epidemic, and make people healthier and happier? Or are we headed towards a dystopia as described in WALL-E, where people are chronically ill weaklings who depend on medicine, machines, and big corporations to survive?

How can an evolutionary perspective help us make better decisions? There is no single answer, but here are some.

Approach 1: Let Natural Selection Sort the Problem Out

You can argue that those who are at avoiding sickness from inactivity, modern diets, and pollutant more likely to pass on beneficial genes. A 2009 study shows that shorter and stouter American women have slightly higher fertility, suggesting that future generations might be less tall and plumper if trends continue this way for a long time. Infectious diseases can also be strong selective forces.

When the next deadly epidemic comes, anyone with a strong immunity will have a major fitness advantage. Selection may favor individuals that help them resist common toxins, skin cancer, or other environmental causes of disease. It is possible that generic screening technologies will allow parents in the future to artificially select characteristics in their offspring that will be beneficial.

Approach 2: Invest More in Biomedical Research and Treatment

Many dream of the day that technology delivers to us a magic pill that makes obesity impossible and confers all the health benefits that people get from exercise. That may be why, despite public health efforts to discourage smoking, 20 percent of Americans still smoke, causing hundreds of thousands of premature deaths. Likewise, less than 20 percent of Americans eat a healthy diet and less than 20 percent are sufficiently physically active.

The problem with waiting for a magic pill is that it may never come but also because research into this area is underfunded. Healthcare is usually for profit. There is incentive to invest in treatments like antacids and orthotics that alleviate symptoms of diseases, and that people need to buy frequently for many years. And there is incentive to invest in industries that offer expensive surgery rather than inexpensive preventative treatments like physical therapy.

Dieting is a multi-billion-dollar industry in America, because most diets don’t work, and overweight people don’t mind spending their money and new diet plans that are all too good to be true.

Ultimately, we have no choice but to invest on treating mismatch diseases, diverting time, money, and effort from prevention.

Approach 3: Educate and Empower

Knowledge is power, and that is why people deserve useful, credible information about their bodies. Some public health officials try to educate and empower people, and research with much trial and error has led to evolution in these efforts.

But the effects of these efforts are very modest. Education is essential but can only do so much. Chocolate cake always beats celery. There’s no way to naturally geode people to eat healthy in a world that is abundant in delicious food. Between the escalator and stairs, you are going to take the escalator.

It is hard to know why behave irrationally towards our health. And while it is possible to become more deliberate in our thinking, we are very bad at knowing the value of things in the long term, such as health in old age. These and other unhealthy instincts are helpful for having as many possible offspring in times of scarcity, but bad for a life in an environment of plenty.

We make irrational decisions through no fault of our own. These natural tendencies make us vulnerable to marketers who easily exploit basic urges to overeat.

Approach 4: Change the Environment

Your ancestors were generally compelled by circumstance to eat a naturally healthy diet, to get plenty of physical activity and sleep, and to avoid comfortable chairs, and they were rarely able to live in crowded, permanent, filthy settlements that
promoted infectious diseases.

It follows that humans did not always evolve to choose to behave in ways that promoted health, but instead were forced to by nature. Sometimes, we needed help from external forces to help ourselves.

This logic makes perfect sense when applied to children, who cannot be counted on to make rational decisions for themselves. That is why governments don’t sell alcohol and tobacco to minors and make physical education compulsory in schools.

As for adults, they should do what they want as long as they don’t harm others, but at the same time, humans sometimes behave in ways that are not in their best interests because they lack sufficient information. We can’t control our environments and we are manipulated by others.

Perhaps governments should nudge people in the right direction, it may have a duty to do so. Food producers should not be allowed to prevent customers from knowing what harmful chemicals are in their food. And while governments shouldn’t prevent anyone from smoking, they should give people incentives to quit.

"Silence is the best expression of scorn" - G.B. Shaw

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