Daniel Buettner presenting at SHSMD 2013.

I’ve been a Dan Buettner fan for several years now. The “Blue Zones” author has started a movement to make us healthier, not one at a time, but by creating communities which make us healthier. In fact, my community in Iowa is going through a Blue Zone transformation right now!

But I’m getting ahead of myself.

First off, what are Blue Zones? Buettner began his career as a reporter. The Blue Zones project began as a feature article for National Geographic. Visit a handful of Blue Zone communities around the world and identify the features that cause the members of these communities to live longer with fewer chronic diseases and other health issues.

After visiting Sardinia, Italy; Okinawa, Japan; Ikaria, Greece; Nicoya, Costa Rica; and Loma Linda, California, Buettner found a set of features that they all shared which contributed to their residents’ longevity.

Image via http://bluezonesup.com/

Buettner refers to the list as the Power 9:

1. Be active. It’s not necessary to be an extreme athlete. Moderate-intensity exercise is best when done every day. Shepherds, who follow their flock year-round outlive farmers who are very active for half of the year but relatively sedentary during the winter.
2. Have a purpose. You know the most dangerous year of peoples’ lives? The year after they retire. The loss of purpose that comes with ending employment is often terminal. Find a purpose for living and you’re likely to do more of it.
3. Down shift. Blue Zone inhabitants aren’t without stress, but they have constructive ways of letting go. Meditation, prayer or a regular happy hour allow the body and mind to recover from the damage inflicted by the stresses of life.
4. The 80 percent Rule. Most Americans eat too much. In part, we eat too quickly and, since it takes 20 minutes for your body to realize how full it is, we often overeat. Buettner adheres to the Japanese habit of eating until you feel only 80 percent full. Using smaller dinner plates helps too.
5. Eat more plants. The Blue Zones communities tend toward the largely vegetarian with beans and lentils serving as the cornerstones of the diet rather than wheat or corn. The Adventists in Loma Linda, the United States’ only Blue Zone community, eat no meat and the Okinawans eat primarily fish. Other Blue Zone communities consumed mostly pork, but did so an average of only five times per month.
6. Drink… a little. Moderate drinkers outlive the teetotalers and the alcoholics. One or two glasses of red wine seems to help the most. No you can’t save up and have 14 on Saturday…
7. Belonging. Being a part of a faith-based community and attending regularly was an important part of the Blue Zone formula.
8. Put your family first. Children simply do better when they have grandparents in their lives regularly. It was common in Blue Zone communities to have parents and grandparents nearby.
9. Join a tribe. One of the key tenants of the Blue Zone program rolled out to new communities is the creation of Moais or small groups joined together around common interests. These groups do things together, look out for one another and reinforce good health habits. We know that many health-related items, even obesity, is contagious – so find groups that make good things contagious!

The exciting thing about this isn’t that Buettner has dissected some interesting factoids about communities that live longer, but that this serves as the backbone for adapting the communities that we live in to make the people living there healthier!

While some of the plan talks about doing something that you may not do today such as worshiping regularly with a faith community or joining a Moai, much of the program is about creating environments where the default action, the easiest choice, is one that is healthy rather than unhealthy.

Here are a few examples of the types of shifts that they envision:

• Investing in walking paths to make cities more walkable rather than investing in parking to make it easier to drive.
• Feature healthy options in vending machines at schools.
• Make the default side dish at restaurants the fruit or salad and only substituting fries on request.
• Use smaller plates to help with portion sizes without really trying.
• Rearrange grocery stores to encourage the purchase of real food over less healthy processed options.

These changes were first rolled out in Albert Lea, MN over a three year period starting in 2009 with astonishing results – average life expectancy increased by more than 3 years, total weight lost of 12,000 pounds and an incredible decrease in healthcare costs for city employees of 40 percent!

This program is now being rolled out in a number of other communities including Geonetric’s hometown of Cedar Rapids, IA.

As our industry makes the shift from sick care to healthcare and reimbursement structures offer incentives to keep the populations that we serve healthy, Blue Zones offers a great model for building healthier cities.