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Ancient Greeks and the Quantified Self

Was the future of healthcare outlined on a 2500-year-old Greek Billboard?

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Healthcare in the United States is in a rut. Though our system is the most technologically advanced and heavily funded, we are losing ground in our attempt to stay healthy. The most worrisome of the looming burdens is the convergence of two key factors: an aging society and nationwide abuse of caloric surplus. According to the CDC, nearly 1 in 2 American adults live with at least one chronic illness while the majority of adults over 20 (68%) are obese or overweight. By 2017, we estimate the world population 65 years and over will outnumber children under the age of 5 for the first time in human history. In some countries, this transition has already taken place.

Within the Center for Sustainable Health, my research focuses on how harnessing digital technology, such as an individual’s mobile device, can yield improvement in health results. Last year I was asked to speak on what healthcare means to me and in preparation I hunted for data to help tell my story. Each search query and click returned a barrage of content on policy and technology solutions aiming to ease healthcare woes. So now, with a sea of content in front of me, how to organize? How to compress? A phrase came to mind – “When in doubt, look to the Greeks”. I began hunting for an approach to health that predated search results and tweets – something written in stone.

I then remembered the Oracle at Delphi, the most famous ancient mystic whose temple stood among the mountain slopes of central Greece. Kings and tribal leaders sought her counsel before making critical decisions such as declaring war or founding colonies. The temple at Delphi displayed clear messaging to those seekers of wisdom. As they approached, they would peer upon three inscriptions that, even today, can offer insight into living a healthier life:

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Know Thyself

digitizedman-squareGenetic screenings that highlight the probabilities of disease, astonishing imaging diagnostics that track our most intimate inner workings in real time, and screening tools that can sift through and snatch molecular targets are a few examples of recent gains in our ability to understand our physiology.

Innovators are also creating diligent sentries that monitor our movements and interactions with the environment, and then compile the gathered data into timely feedback loops to inspire healthier behaviors. The Fitbit One, Jawbone Up and Misfit Shine are just three examples of devices that, along with streamlined apps and websites, provide users with a true picture of their daily step count, flights of stairs scaled and time in slumber, and this is only the beginning. Sensors are becoming smaller, smarter, and increasingly capable, capturing more of the body’s data streams while drawing on less power and requiring less of the user’s time and effort in setup and maintenance. These wearable devices are transmitting health data to the Cloud, where it is compiled and translated into accurate, predictive models to inform health decisions.

Moderation in Everything

moderationAll though bacon and chocolate are delicious, they can, in over-consumption, be harmful. Teams of researchers have crafted pyramids and plates to better inform the quantity and quality of foods we should eat; sadly the bacon/chocolate sliver is much smaller than most of us would like. One of the many benefits of a civilized society is a safe and efficient food distribution system. But now that we hunt and gather from a stocked fridge rather than in the wild, the burden falls on the individual to track caloric intake. However, technology has emerged to inform our food choices and track our daily consumption in the form of mobile apps. In the future, augmented perception devices will provide data points such as nutritional content and track the consumption of the wearer. Two Google innovations at least hint at this possibility – Google Glass and Google Nutrition.

Researchers, such as Dr. Leoluca Criscione, are moving away from one-size-fits-all calorie recommendations. Instead calorie intake should be based on knowing one’s Resting Metabolic Rate (RMR). The Breezing is a portable device that accurately measures the RMR and, along with it’s mobile app, tracks that rate over time. Using tools such as the Breezing allow metabolism to play a continuous, prominent role in a daily meal plan.

The first two temple inscriptions underscore our ability to track our activities and understand our bodies in ever-evolving ways. But is this enough to lead to better health outcomes? Data does not equate to behavior change, at least not directly. This leaves us looking to the third, somewhat cryptic inscription.

Make a Pledge and Mischief is Nigh

nike-banner copyDespite our sincerest resolutions, bad habits resurface. Promises to cut back on sweets or to exercise are easily broken; instead we need to listen to Nike and Just Do It. Again looking to our mobile devices, we have an array of apps that deliver continuous feedback and inspire us to meet our health goals. Connected 24/7, these apps allow users to gain peer recognition, challenge rivals and earn rewards, both intrinsic and extrinsic, for walking that extra lap or choosing the steamed veggies over the loaded fries. Behaviorists, such as B.J. Fogg, are playing a prominent role in this digital health movement, as utility of health data is uncovered only by understanding both the physical and motivational needs of the individual.

True Wisdom

Healthcare can succeed if demand for it subsides – if its consumers stay out of the clinics and hospitals and live healthy, productive lives. Digital health technologies continue to emerge to meet this goal. With them, users build a digital model of their current health status that allows them to continually track daily activities and bodily metrics. Devices and apps are used to avoid diseases of plenty: diabetes, cancer, heart disease, and other persistent killers in modern society. Lastly, digital health solutions put the individual in control and make them accountable for healthy behaviors. Three inscriptions adorning an ancient Grecian temple have set the foundation, but to achieve better health outcomes and reduce costs we must act – we must do.

Written by Gregg Turnbull, Senior Project Manager, Digital Health, Center for Sustainable Health.