Tag: health

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Urban Living

Each time I pass by the closed airport in the middle of Berlin I am amazed by the crazy idea to have built this and maintained throughout the 20th century. Paris is desperately trying to re-naturalize small areas and roads, while in Berlin there is now still the huge park to enjoy for all. Sports activities benefit the most. What an amazing asset in the neighborhoods for so many in need to walk, run or cycle a bit to keep their exercise level up throughout their life course. It has still a huge potential to activate people. It just needs a bit more organizations and volunteers to embrace the opportunities. Only in comparison to other cities you realize what an asset this is now. It will remain a challenge to preserve this centrally located treasure for the benefit of all. In Paris the deconstruction of concrete is taking shape and 300 new sites have been identified for re-naturalization, as reported in LeMonde. In Zurich green spaces in the center have been saved and renovated with a lot of money to allow more people to enjoy the benefits of a green environment near the city center. The house and park by architect Le Corbusier is a fine example of this. Image below. The garden around the house is publicly accessible. As air pollution is threatening more and more and heating in cities is a serious health threat we would really like to welcome more preservation and re-naturalization in inner cities.

Le Corbusier house Zurich 2023
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Trees

Looking at trees is relaxing. At least this is true for most of us. Some researchers, however, have a stressful time to sort out what it is exactly about trees that causes this impression, perception or feeling. Time to do a few studies on this issue (Lancet RM, 2023). Most likely it is the size or the number, maybe the surface or volume covered by trees that have an impact on us. Maybe it is the sequence of seasons that really causes the pleasant feeling about trees. Perhaps the fresh air, shadow in summertime or more the birds and squirrels or dogs that „inhabit“ the trees in neighborhoods that are important to us. More and more cities really develop sizable programs to care about their green spaces. In a simple cross-sectional study it seems the visibility of trees that is important rather than other effects. More sophisticated second round effects like oxygen levels or meeting points like in rural areas seem not to matter as much in cities currently. The study cited below invites us to devote more consideration to trees which we took for granted for far too long.

Ordóñez, C., Labib, S.M., Chung, L. et al.Satisfaction with urban trees associates with tree canopy cover and tree visibility around the home. npj Urban Sustain 3, 37 (2023). https://doi.org/10.1038/s42949-023-00119-8

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Wissensdialog

Universitäten und Forschungsinstitute leben weitgehend von öffentlichen Geldern. Das bringt eine Verpflichtung mit sich, das Wissen auch einer breiteren Öffentlichkeit zugänglich zu machen. Das Zeiss Großplanetarium in Berlin ist ein Ort, der diese Aufgabe in den Gründungsstatuten trägt. In Kooperation mit beispielsweise dem Campus Berlin-Buch mit seinen vielfältigen Forschungsinstituten werden in einer Vortragsreihe wichtige Erkenntnisse für eine breite Öffentlichkeit vorgestellt. Nur so kann die politische Zustimmung und ethische Abwägung gewährleistet werden, warum Tierversuche (meistens an Mäusen) in einigen Bereichen schwer verzichtbar sind. Damit wir den Alterungsprozess auch beim Menschen besser verstehen, braucht es immer feinere Darstellungsweisen wo und wie sich Eiweiße an den unterschiedlichsten Stellen im Körper anlagern. Bei Alzheimer finden wir die Ablagerungen in bestimmten Arealen im Gehirn. Dr. Johannes Broichhagen hat im Auftakt zu der Reihe „Neue Wege in der Biomedizin“ Arbeiten aus seinem Labor vorgestellt. Wenn wir Alzheimer eindämmen wollen, müssen wir den Proteintransport im Körper besser verstehen und abbilden können. Das verlangt verbesserte Methoden, um die Proteine darstellen zu können. Die Ablagerung im Gehirn kann vielleicht nicht komplett verhindert werden, aber eventuell hilft bereits eine „Umlenkung“ der schädlichen Proteine. Dazu müssen wir die Transportwege besser verstehen. Wir brauchen dazu 4D Beobachtungen, anstelle der bekannten 2D- oder 3D-Bilder von Gehirnscans. Die Fortschritte sind rasant. Der Wissensdialog nimmt uns mit auf die Wissenschaftsreise. Ein Motivation für viele Jugendliche und Studierende ergab sich aus der anschließenden Diskussion mit beeindruckendem biologischem und chemischem Wissen der Fragenden. So gelingt Wissensdialog für alle Beteiligte. (Image Clip from preprint)

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Frauen! Leben! Freiheit!

Das Schicksal von Jina Mahsa Amini ist vielen bekannt. Die Ermordung in der Haft hat weltweite Aufmerksamkeit auf das Schreckensregime im Iran geworfen. Im Oktober 2023 ist nun die Kämpferin für Freiheitsrechte im Iran Narges Mohammadi auch stellvertretend für die vielen inhaftierten und ermordeten Frauen mit dem Friedensnobelpreis gewürdigt worden. Sie hat bereits viele Jahre einer zehnjährigen Haftstrafe im Gefängnis verbracht und schwere Misshandlungen erfahren.
Das Buch mit dem deutschen Titel „Frauen! Leben! Freiheit!“ ist als Rowohlt Taschenbuch im September 2023 erschienen. Es dokumentiert ihren unablässigen Kampf für Frieden und Freiheit nach ihrer rechtswidrigen und willkürlichen Verhaftung. Bereits auf dem Kongress des Europäischen Gewerkschaftsbundes (EGB) im Mai 2023 hatte die Vorsitzende des DGB Yasmin Fahimi eine Resolution vorgebracht, die die Solidarität mit den Frauen im Iran nachdrücklich betonte. Missachtung grundlegender Menschenrechte wurde verurteilt und mit überragender Mehrheit vom EGB beschlossen (Kurzvideo). Darin war sich Europa und darüber hinaus die ganze zivilisierte Welt einig. Jetzt mit dem Friedensnobelpreis für Narges Mohammadi und der weiten Verfügbarkeit der Buchveröffentlichung dazu (siehe Bild unten) können die Interviews mit den Frauen in der Gefangenschaft des iranischen Regimes auf Deutsch gelesen werden. Hinschauen, Nachlesen, sich für die Freilassung einsetzen, das bleibt unsere Verantwortung.
Gewaltloser Widerstand ist Aufgabe der Freiheitsliebenden. Leben retten von denjenigen die Leben schenken. Die iranischen Frauen kämpfen mit friedlichen Mitteln gegen eine unermessliche Gewaltherrschaft und Unterdrückung. In bescheidenem Ausmaß können wir mit unserer Aufmerksamkeit und internationalen Anerkennung diesen Frieden- und Freiheitswillen unterstützen.

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Aging Challenge

Several countries face an aging challenge now and in the near future. The OECD provides some basic data, figures and projections. All data to calculate the aging challenge are more subject to change than they used to. The Covid-19 rise in mortality rates has implications as the number of premature deaths of the elderly (65+) has risen even in the economically advanced countries. The so-called old-age dependency ratio is a widely used indicator to assess the charge or pressure on the working-age population (20 to 64) to finance those in retirement (65+). demographic ratio is defined as the number of individuals aged 65 and over per 100 people of working age defined as those at ages.
Major factors that have an impact on the ratio are mortality and fertility rates as well as migration, but also participation rates in employment for those younger than 20 or older than 65 years of age. Seminal shifts in participation of women in the labour force contribute also to reduce the old-age dependency ratio. An influx of about 1 million of refugees who have immediately a work permit like Ukrainians in Germany have a substantial impact as well. Life expectancy is expected to rise again after the years of reduction due to Covid-19. In 2024 and 2027 these ratios do not move too much. Extending the time horizon to 2050, when people born in 1985 would start to retire shows more reason for concern. Whereas in 2024 France, Germany and Italy are still fairly close to each other (2.4 percentage points), the gap starts to widen as of 2027 (5.5 percentage points). In 2050 Italy is projected to have an old-age dependency ratio of 74.4%, about 20 percentage points higher than France.
Okay, in the long-run we are all dead, says an economist joke, but changes to increase fertility or allowing more migrants in are not in sight for Italy. Therefore, the urge to react is increasing there. Younger generations might not be able or willing to foot the bill of high pension expenditure in Italy. Compared to Italy or even Japan the pressure on France is much less pressing, contrary to the national government’s opinion and policy initiatives to increase retirement age without parliamentary majority.
Source for projections and figures: OECD (2023), Old-age dependency ratio (indicator). doi: 10.1787/e0255c98-en (Accessed on 04 October 2023).

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Avoidable Mortality

Mortality in many instances is avoidable. Estimates Mühlichen et al. (2023) for Germany are as high as 19% of all deaths in the years 2017 to 2019. For men the figure is as high as 24%, for women “only” 13%. The scientific interest in the concept of avoidable death originates in the interest to indirectly gauge the efficiency of health systems. In order to do this the authors estimated cause-deleted life tables in a fine graded regional fashion. Avoidable deaths are defined as deaths that occur before the age of 75 and are either classified as medically preventable or preventable through a different life style. The study applies a quasi-experimental design in comparing German speaking regions within Europe. This allows to measure the influence of health care systems on a general level within Germany, Austria, Switzerland and South Tirol in Italy. The study corrects for different age structures in these regions. For Germany avoidable deaths are substantially higher in the North than in the South. Additionally Eastern parts of Germany have higher avoidable deaths. Even the best performing regions in Germany have higher rates of avoidable mortality than Switzerland.
The differential to other countries health systems is worth a concern, because the expenditure in the German health system per 1000 population are among the highest in Europe (OECD 2021). Despite the high expenditure per head, avoidable mortality remains particularly high for German men and in the North and East of Germany. Lack of prevention of unhealthy life styles is most likely the decisive factor to explain the disappointing results. There might be another “unaccounted” risk factor that originates in the lack of sufficient preventative health care and environmental risks during the young age of the regional populations. 33 years of unification and a cut-off age of 75 mean that in East Germany the oldest people lived through 40 years of high pollution coal as primary heating system.  Similar to Northern and Western Germany little concern and careless use of risky fertilizers might drive higher mortality decades after exposure. Life style patterns might additionally contribute, but are harder to assess in comparison. Research to clarify these differentials are just at the beginning. A valid conclusion remains: prevention is key, but it has many facets.

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Marathon Prep

Most people, including many sociologists, believe preparation for a marathon is a rather lonely exercise. During hot summers you get up early and run alone across the streets in your neighbourhood or in a green area. Even on weekends you tend to put on your running gear at least once to chip in a few extra miles or once or twice before the marathon a longer distance test run of 20, 25 or 30 kilometers. Just for the sake of testing to withstand more pain, like in the real event. Running guides in form of books, apps reach “cult status”. In sociology we teach students about the social trends of individualisation ever since the book by Putnam “Bowling alone”, which depicted the new kind of lonesome person going alone to the bowling hall for exercise, as social life seems to evolve towards “individualised” leisure time and social life. Social capital seems to get lost on the way.
“The New York Times International” published an article and photo by Lauren Jackson on September, 27 (2023) page 17 in the sports section, which states the not so new phenomenon of “run clubs” (see extract on image below). These clubs bring runners from all walks of life together on a regular basis to train jointly and add a social function to the club as well. Just like previous sport clubs or socialising bowling groups did before, they meet and greet as well as party and celebrate together. Even travelling thousands of miles to distant events occurs in groups. Berlin seems to be a very attractive location for such clubs to go to. For some the sport stays in front of the activities, but for quite a few the social and party-like atmosphere is just as important. Even a local Berlin newspaper portrayed an older runner who stops in-between to have a small glass of alcohol-free beer on a terrace 2 steps from the official track with friends and family. Most people take their time record rather seriously, but the event is to enjoy community and celebration. Lauren Jackson even equates this to some forms of religious practice. I’s rather call this the other side of the same coin. Lone practice and meditation like running prepares a person to enjoy community (again). Extremes in both directions are part of the bell-shaped probability distribution of runners across the lonely-crowded spectrum of running experiences. The Marathon 42km 195m certainly has some historical even mystical connotation. While watching the finishing line at 42 km, just after the hypothetical run from Marathon to Athens in ancient Greece, you see many worn out persons, but also the many happy faces. After the run you meet your peers to exchange on stories and anecdotes around the track. Success and failure, just as in other team sports become a topic of conversation and shared experiences. These are community building events as wheel chairs and hand-driven bikes are part of the Berlin event as well as the in-line skaters the day before. In Berlin you get a feeling that running world records (women 2023, men 2022) can go hand in hand with the running fun for many. From “bowling alone” to “running together”. Sounds good to me.

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Marathon Berlin2023

Berlin celebrates its 49th Marathon in September 2023. The first Berlin Marathon in 1974 had less than 300 participants. To separate this from Olympic games, these runs were coined “Volks-marathon” at the time. 5 events had already taken place in New York when these annual events started to catch on in Berlin. In 2023 there are close to 50.000 participants mostly drawn from a lottery of about 500.000 entries. So, you can call yourself one of the lucky few, if you manage to get a place. The event is a drain, but it creates a fantastic hype not only for the runners. The many cheers and bands along the running track transform the inner city into a huge party zone. The Berlin marathon is known around the world for its fast track. In 2023 Berlin is proud to be the city where both the women and men’s world record are held currently at the same time. This is quite an achievement.
Personally, I enjoy more the courage, stamina and will power all the participants gear up to. Months, if not years of preparation find their climax in getting to the starting line in the “Tiergarten”, just where you had (have) the “Love Parades” some weeks before. The finishing line is 300 meters away, once you have passed the “Bandenburger Tor”. From a public health perspective, we applaud the encouragement such events give to all those that have an active life style and to some to get started on such a trajectory. The media coverage is enormous and with all sponsorships, equipment, hotels, meals and travelling involved such events have become big business, too. No such event and going to health limits is without risk. This is, of course, also the case in Berlin. The emotions run high for almost all, except for a few, who go too far beyond their limits.
The medical assessments of exhaustive endurance sports are an ongoing research issue. A recent literature review reveals that there are quite substantial numbers of previous smokers or persons with previously unhealthy life styles participating in popular marathons. Running, probably, has been part of overcoming bad habits of the past. It is therefore, not surprising to find that some of the participants are at a risk of wanting to run too much or too fast for their current state of health. The hypnotising effect of music and stimulation from being part of a huge crowd, contribute to the effect to go beyond limits. Cardiovascular events or brain lesions are, therefore, part of the ex-post risks of participants who have had specific medical check-ups. Know your limits, train them wisely, but respect that limits exist. This seems to be a reasonable summary based on sports medical research. Berlin 42km finishing line2023

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Ozone

Ozone (O3) has a rather mixed reputation. High up in the stratosphere it protects us from too much radiation from the sun, but down on earth in our respiratory environment it causes and amplifies respiratory difficulties. Hence, it is very important to differentiate the 2 different layers and differential effects of concentrations of ozone in the air. A forthcoming study in the Lancet Regional Health Europe (Nov. 2023) by Tianyu Zhao et al. demonstrates the long-term, negative effect of higher concentrations of Ozone on lung function. The prospective cohort study followed individuals in multiple states and locations over 20 years and corrects estimated effects for other environmental effects (fine particles PM 2.5 pollution) and green environment. Faster decline in spirometric lung function is highly likely to be caused by higher ambient ozone concentrations. The study is based on 3000+ observations from 17 centres in 8 countries in Europe. Older persons in the range from 35 to 55 had a steeper decline in ozone-related decline in lung functions.
This is rather bad news for older persons living in inner cities where both ozone concentrations, mainly in summer, heat and micro-particles cumulate. Similarly, areas with frequent so-called inversion micro-climate, (a layer of cold air on top of SMOG blocks the renewal of air for extended periods) face particular health risks. Professions that work long durations outside in the sun or the exercise of sports during high ozone day-time run higher risks for a deterioration of their lung functions in the long-run. The medical evidence is there now, also for Europe, what had been shown already for the US before.
It is time to adapt our lifestyle to these health risks. High effort physical work outside should start as early as possible in the morning hours or even before sun rise. Staying indoors is highly recommendable for older persons and persons with reduced lung functions (asthma risks) during such periods of high ozone concentrations. Like it or not, even wearing a mask outside, when it is sunny and hot would be preferential, but is rather inconvenient. We need to shift airing living rooms or offices without climatization to early morning hours rather than ambient temperatures in the afternoon, when ozone peaks are prevalent.
These effects and remedies have been known for some time, but the evidence is much more compelling now (Zhao et al. 2023). Climate change in form of global and local warming, particularly in inner cities, will only exacerbate these effects in the coming years. Prevention measures need to be considered in public health measures as well as urban planning. We can do it, if we want to. Start now to benefit from the effects a decade later or for the benefit of younger generations. (Image: Int. Encycl. of public health, p.702).

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Energy Food

For more than a decade now researchers have shown the link between energy prices and food prices. At first sight this might seem surprising. In traditional or romantic associations with growing food, there is no link between the cost of energy and food production. Growing crops in your garden does not need more than sunlight, soil and water. Yes, that was long ago. Industrial production of food is heavily relying on energy to heat, feed and water plants or animals. Additionally, the supply chains have become far more distant, which increases the CO2 footprint even further. Therefore, it is no longer surprising that a great number of econometric studies confirm the close link of energy prices and subsequent pressure on food prices. This is not restricted to Europe, but has reached global contamination.
Enjoying seasonal local food is a double catch solution. You grow according to local weather conditions and use traditional conservation methods, if the crop is exceeding your demand at that time. Providing heating for animals to increase productivity or quality of products appears to be one of the most wasteful ways to further increase the spiralling up of energy and food prices.
In agricultural science there is a lot of research into the “energy intake” of animals to better grow or produce more milk etc. This is the expensive intermediary step using energy to produce energy intake for animals rather than humans. It is surprising that we take so many years to address these well-known linkages that have turned to serious problems after Russia’s war on Ukraine. Agriculture and farmers can be part of the solution rather than a problem themselves, if the link of energy consumption and food prices is taken seriously.

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Smart watch

Das Handgelenk hat noch viel Platz für elektronische Geräte. Vom preiswerten Schrittzähler bis zur smart watch und intelligenten Armreifen oder sogar Ringen gibt es dort viel Potential für Innovation. Jenseits der Schritte werden mittels vielfältiger Sensoren eine Fülle von Daten erfasst. Datenschützer erschaudern geradezu. Das Potential für medizinische und soziologische Auswertungen dieser Daten ist immens. Vergleichbar mit einer elektronischen Waage, die Knochenmasse, Wasser und Muskeln erfasst erlauben die smarten Uhren noch mit Ungenauigkeiten, aber stetig besser werdend, kardiologische Werte und Schlafrhythmus zu erfassen.
Mit Daten von tausenden bald Millionen Datenlieferanten lassen sich wichtige Studien zur Früherkennung von Gesundheitsrisiken durchführen. Plötzlicher Herzstillstand ist eines der immer noch wenig aufgeklärten Phänomene. Die Studie im LANCET digital health hat solche Daten ausgewertet und kommt zu der Schlussfolgerung, dass dyspnoea für Frauen und Männer der größten Risikofaktoren darstellt. Für Frauen wird Entwarnung gegeben für Diaphoresis, exzessives Schwitzen, aber nicht für Männer. Letztere sollten Schmerzen in der Brust ebenfalls ernst nehmen. Daten sammeln kann durchaus Leben retten.
Dennoch droht dem Gesundheitswesen eventuell eine Welle an falsch positiven Selbsteinweisungen in der Notaufnahme der Krankenhäuser. Darauf sind wir noch wenig vorbereitet, inklusive der möglichen rechtlichen und finanziellen Konsequenzen. “Big brothers are smart watching you”. Müssen Ärzte die smarte Evidenz berücksichtigen, etwa so wie eine Patientenverfügung? Was wenn plötzlich der Notarzt unaufgefordert an der Tür klingelt? Wer hat meine Uhr gehackt, … , singt das Paulchen Panther jetzt.

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Drowning

Drowning is a largely underestimated risk. 2.5 million people die of drowning in 10 years according to the WHO. low and middle income countries have the highest drowning rates. However, remedies like teaching how to swim and to assess drowning risks at an early age can make a huge difference. Flooding as natural disaster causes high numbers of casualties, but even in such extreme weather conditions survival strategies involve drowning prevention.

Even in the richest countries drowning is still a reality. Life guards cannot prevent the most irresponsible behavior like drinking alcohol, taking drugs and drowning risks. Overestimating one’s own swimming capabilities is yet another reason for drowning in wealthy countries. Try floating your body with as little movement as possible and you slowly enhance your capabilities to survive in dangerous water conditions. This increases your self-confidence to master tricky situations. Panic in water is surely not helpful. Learning how to help others in danger is for well-trained rescuers or professionals.

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Sichtweise

In vielen Fällen stimmt die eigene Sichtweise nicht mit der Sichtweise von anderen überein. Das kann sich bei Personen bis hin zu Persönlichkeitsstörungen auswachsen. Bei ganzen Gesellschaften, Kantonen oder Regionen führt die verzerrte Selbstwahrnehmung zu gewissen Befremdlichkeiten oder Entfremdung. Die Lokalpresse der Südostschweiz zeigt zwei fröhliche BauarbeiterInnen, die gemütlich auf ihre Baustelle zuwandern. Weit gefehlt. Der Helikopter hat längst die Hauptarbeit übernommen und diese BauarbeiterInnen (à la Heidi) gehören einer Vergangenheit an, die längst untergegangen ist.
Aber Zeitungen verkaufen sich lokal wohl besser, wenn sie an dem idyllischen Bild der Vergangenheit als Selbsteinschätzung und Selbstvergewisserung festhalten. Die Fremdsicht kommt eben auch nur von Fremden. Die Personen zahlen letztlich gerne für den Lift, um das Naturspektakel der Alpen auf 2000m noch eindrucksvoller erleben zu können. Dabei wäre mit Bussen und einer kleinen Bergwanderung dasselbe Panorama bei höherer Endorphinausschüttung zu erleben. Ob es für das Transportieren der Mountainbikes im Sommer nach oben und mehr Skifahrenden bei weniger Schneegebieten im Winter eine solche Investition benötigt, die noch mehr Grünflächen verschwinden lässt, bleibt äußerst fraglich. Der Kampf zwischen Mountainbikern und zu Fuß gehenden Personen wurde bereits durch getrennte Strecken entschärft. Zwischen den Menschen, nicht aber die weitere raumgreifende Nutzung der Natur.

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Work Satisfaction

There is an important distinction between job satisfaction and satisfaction with one’s work. Being satisfied with the work you have done or something you created or co-created has become almost a privilege. Production in capitalism has mostly different objectives like rent seeking rather than satisfaction with one’s work. Compromises between both are a major learning process about the functioning of labour markets. Remote work, for some, contributes a lot to more job satisfaction. For others a healthy work environment is the top priority. Many people however focus simply on pay packages and this is often out of sheer necessity to escape poverty eventually. Trades have a tradition to allow satisfaction with one’s work, more than most jobs in industry. Flat hierarchies and subordination to your own standards, rather than pressure from supervisors, are much more common. Recognition of your work adds to the pay you receive. Job turnover is related to job satisfaction but also to satisfaction or even identification with the product of your work.

There is more to work than pay. Recognition in form of winning a price in a competition may help to keep awareness high that pay is only one element of remuneration. “meilleur ouvrier de France“ is such a kind of recognition. It encourages people to try new things and test new ideas. This is a major source of satisfaction with one’s work. We might even feel sorry for someone shouting “I can get no satisfaction”. He probably has to try in a simpler or different fashion rather than to try harder. The city Dijon in Burgundy seems to have a pretty high number of people with high levels of work satisfaction and happy to show it.

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Food Change

Changing habits of eating is among the most difficult behavioral changes. We get so used to our habits to prefer certain alimentary mixtures that we tend to believe we can no longer change them. Depending on our will power we are able to command for more or less longer periods our food intake. Bodily functions of blood pressure or insulin levels play tricks on us of a powerful kind. Therefore it is interesting to see towards the end of a food market what kind of food is sold and what has been left over.

In the historic market of the food, wine and spice loving region of Burgundy in Dijon the ad hoc inspection of an étalage was surprisingly different from my expectation. ‘Paté’ containing meat was left over towards the end of the opening hours and the fish based ’Paté’ was almost sold out. A change towards a more healthy and somewhat more sustainable diet is slowly creeping into societies. This gives hope that food changes are possible and markets will adapt eventually as well. It is a change for the better for each person and our societies as well as the planet.

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Healthy Brain

We’ve got only one brain. Hence, we better take good care of it. There is only a small community in Wales that has got more than one brain, they have got brains. For all others we should like to know what we can do to keep our brain healthy for as long as possible. Scientists try their best to find out for decades. The state of the art is well documented in a study published in The Lancet which followed 64 so-called superagers in the study and 55 in the control group. These superagers are 80 years old persons that have annual brain fitness tests and brain scans (MRIs) that show their brain has a functionality of a person 20+ years younger. Anxiety scores and depression levels seem to be major explanatory factors for reduced grey matter and decline in functionality of the brain in aging. Fewer glucose disorders and hypertension contribute to successful aging of the brain. An active lifestyle and any form of practicing music make you also more likely to be in the group of superagers. Motor control, balance and speed are important to take into account additionally. A good solution to successful aging is “singing in the rain” I would say. In terms of prevention of “brain loss” it seems important to highlight both the pure brain functionality and the importance of exercise to keep sufficient motor control. Get up and walk! That is the answer. Yes. Again. Trying to do it fast is a good way to preserve not only your body but also your brain.

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Health inequality

Almost all studies irrespective of the methods applied find that health is a matter of related to social inequality. The study by Lyons et al. (2023) in the Lancet demonstrates the same basic findings. This study uses the concept of multimorbidity and time until first and subsequent diagnosis as the measures of health. Mortality between different socioeconomic groups in Wales (UK) is largely confirmed. It is not only men beyond 70 years of age that face this unequal health trajectories, but already in the age group of 10- 20 years old teenagers the time until first diagnosis is different between the poor and wealthy neighbourhoods.
Differential health trajectories have a very early onset and seem to widen throughout the live course. The longitudinal nation-wide study in Wales allows to determine the impact of socioeconomic deprivation on health. The conclusions imply a combination of health and social policies to address health inequality. Clinical practice alone is unlikely to reverse the trends as onset of disease in form of first or subsequent diagnoses start from a very early age onwards in deprived areas.
Health as part of the curriculum in education systems is an obvious conclusion as well. This needs to take preventative approaches more seriously to give children and adolescents a more equal start into adulthood and professional working life. Education systems have to be reformed to become part of the solution rather than creating unhealthy trajectories themselves due to stress and unrealistic, unhealthy goal setting. Walking or cycling to school, more healthy school meals and learning about nutrition as well as processes of metabolism in the body should complement a more active school life-style. The dangers of developing ill health early seem to be greater nowadays than before. That is probably the most worrying news of the study. Sedentary life-styles seem to be a result of deprived neighbourhoods with less areas for comfortable, healthy walking or outdoor exercise.
It is an accumulation of effects due to neighbourhoods, commuting patterns and work-related health risk. Counties within regions grow more distant from each other as well as regions within countries. Youth is well aware of these health and social differentials. Eventually they will claim their “lives” or “equal chances” back again. Sociology has provided many clous to address these issues: Segregation or discrimination of groups of society, gentrification of neighbourhoods, intersectionality of health and social issues, to name just a few.
In order to target at-risk populations better and intervene with prevention rather than curative, we have to integrate social and health approaches much more than we used to do. The way forward is to improve the targeted, preventive approaches in order to improve the equality of chances to education, health and work.
(DOI: LINK to study)

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Nuclear War

In the last few years we have witnessed a new surge in the investment in nuclear energy on the global level (IEA). Ever since the foundation of the initiative “International physicians for the prevention of nuclear war” in the 1980s, there have been relentless reminders of the devastating effects of such a war. In 2023 we are all aware of the real risk of attacks on the biggest nuclear power plant located in Ukraine. Nevertheless we continue to invest heavily in power plants that constitute a massive risk at times of war between irresponsible nations. Besides the publication of many high quality papers in The Lancet there is regularly space to keep the awareness of the dangers of nuclear war at a high level. Too many politicians shield themselves from dealing with such realistic dangers in the interest of supposed cheap and save energy for all. Both is no longer the case. Nuclear energy is expensive and unsafe in peace and horrible in war times. We cannot afford to abstract from these rising risks. The hype about anything nuclear like in the 1980s is grossly displaced (image of book below).

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Work Stress

The empirical evidence on life stress is relatively clear cut. Based on the animal model, life stress causes multiple metabolic disorders among them “insulin resistance, glucose and lipid homeostasis, as well as ageing processes such as cellular senescence and telomere length shortening” (Kivimäki et al. 2023). Besides sleeping we spend most of our life in work-related contexts. Stressful commuting to work and stress at work create a rather unhealthy lifestyle. More stressful working lifes have very likely contributed to currently increased risks of obesity around the globe. Unhealthy nutrition adds to risks just as too little exercise or walking. Time to act for the benefit of all of us. It is not correct to put the blame on individuals, if we know that work and life styles jointly contribute. Urban planning can do a lot to contribute to insulin resistance of inhabitants through more walking or cycling paths for all not only in the wealthier suburbs. The more stressed winner of the daily race might come last in the longer run.

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Workation

Take work, take vacation = workation.
Take flexibility, take security = flexicurity.
Take business, take leisure = bleisure, not pleasure.
Blending notions or building hybrid terms is a powerful way to get discussions going or to challenge standard notions of work, security and leisure. At first sight these hybrid notions give the impression of a new, interesting approach to an established narrative. Adopting a new hybrid notion allows to blur the well-defined borders between established definitions. New narratives have their imaginative charm about them, only these hybrid notions tend to tip the balance in favour of work, flexibility and business, most of the time.
Additionally, there is a generational effect to it. Younger generations feel already more at ease with english-sounding new concepts. Feeling part of a new, cool approach to work is catchy. However, do not forget about the second part in all these notions: vacation, job security and leisure are fundamental rights of workers. Health and safety at work and in the medium- and longer- term depend on the latter notions. Sustainability and prevention of burn-out as well as depression hinge on taking time for leisure and vacation. Something nice in the immediate, might turn out to be very costly later on. Shifting costs related to health from employers to employees (or society) at a later time is in the end an unfair deal.
Just try a workation once and you are likely to value a real vacation much higher the next time. Why not do a workation in reconsidering the distribution of work within your household, couple or family. In this sense I am all in favour of a workation for men, most of whom still shun away from a fair distribution of care work at home. Happy Workation!

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Garten

Ach es ist so schön im Garten. Ein schöner Garten will geplant werden. Das gelingt auf besondere Weise mit dem „Pollinator“. Hinter dem Pollinator verbirgt sich ein Kunstprojekt, das viele kleine Gartenkunstwerke zu einem großen verbinden möchte. Spannend ist nicht nur das Vernetzungsprojekt von vielen einzelnen Parzellen zu einem größer werdenden Gesamtprojekt (Aggregation), sondern der für Kunstschaffende gewohnte Perspektivwechsel. Aus Sicht der Bestäuber der Pflanzen und Blumen gesehen ergibt sich eine vogelähnliche Perspektive auf den Garten.
Der Parcour einer Biene oder eines Schmetterlings durch unsere Gartenparzelle regt zum Träumen an. Vielleicht hätte Franz Kafka nach der Parcour-Erfahrung ein anderes Insekt gewählt. Mir gefällt die 2D, 3D, 4D Perspektive, die es erlaubt, den blühenden Garten im Zeitraffer durch alle Jahreszeiten zu visualisieren. Das ist Gartenarbeit ohne die mühsame Kleinarbeit des Pflanzens und Unkrautjätens. Es wird nicht gleich ein Garten wie von Impressionisten in Argenteuil von Monet oder in Yerres von Caillebotte daraus, aber ein farbenprächtiges Kleinod allemal. Mein erster virtueller Versuch (Link) ist schon recht farbenfroh. Lateinische Namen auffrischen ist schon fast ein Beitrag zum gesunden Altern, besonders wenn der Garten einige Kilometer entfernt ist. Im Sommer lassen sich leicht neue Pläne schmieden. Herbst und Winter, Trockenheit und Hitze lassen uns das Gartenkunstwerk nochmals überdenken. Spielerisch ein Gartendesign gestalten, kann der erste Schritt für mehr Natur sein. Biodiversität macht Spaß und hilft uns allen. Kleinvieh macht eben auch Mist.

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Smurf SDGs

The smurf series of comics has been a world-wide success as children-books. Many adults enjoy re-reading some of their old comic books to their children or grand-children. Now let us try it the other way around. Our children try to sell us the concern for the environment by talking to us through the designs of smurfs, Schlümpfe or Strümpfe, as they are called in various translations. Maybe this way we are more open to take a serious look at the Strategic Development Goals (SDGs) of the UN. Easily accessible and getting us through an emotional connection might work better than tedious lengthy documents and statistics of continuous failure (e.g. on hunger) of most parts of the world.
Tell the story of the smurfs with the SDGs in mind. See how far you get in remembering the whole list of 17 stories. Build a narrative around each of the images. There is no way around getting nearer these goals for our very own survival as a species. Intergenerational communication works both ways from young to old as well as from old to young. Design your own characters, if you like, with the same SDGs in mind. Only this way we shall broaden the supporters for the goals beyond the expert circles of politicians and policy advisers. Happy drafting and rapid implementation! We can do it, if we want to.

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Sociology of the Virtual

Some programmers and artists would have been a great sociologists. As many social sciences embark on their experimental reorientation, many artists and programmers design and experiment already with new forms of social interaction. It is not only that sociology leaves the classroom, research labs or policy advice. Sociology is taken into museums and exhibitions. Learning about society through the lens of artists nicely complements the more boring form of teaching in the classroom. What is normal practice for art historians could benefit learning about sociology as well.
Virtual worlds of games and particularly so-called serious games take people into virtual worlds to learn, practice or exercise new forms of social interaction. This is indeed an additional form of experiments that can enrich our social practices. Medical applications start to spread to train persons to overcome phobia of all sorts.
In usual games we tend to defend the hypothesis that persons can uphold the differentiation of playing with arms in the virtual world and the real world. In medical or social games, we defend the hypothesis that it is easy, normal or natural to apply the learning in virtual constellations to the real-world-experience.
From a scientific perspective it is difficult to defend that a mechanism works in one direction and the opposite as well. Racing cars in inner cities seems to show that certainly not all of youth is able to make that distinction between virtual and real-world dangers for example. Alternatively, the mechanism at work might be that the virtual experiences lower thresholds of inhibition to take risks, to kill or to be exposed to spiders.
These examples are a starting point for a sociology of virtual experiences. Who gets locked into virtual worlds? Are virtual worlds an escape room or a realization of virtual freedom which is restrained in real life. Authoritarian regimes might lead more people to emigrate into virtual, free worlds. The inner-exile has been a refuge for many artists in the past. A lot we shall need to hypothesise and explore with empirical data. Dance with a virtual stranger might be the beginning of a new experience and virtual interactions. (Image: Wiels, Shezad Dawood, Night in the Garden of Love 2023-6, Game car race).

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Medical Personal

Like in many other professions, medical doctors and nurses are in short supply. Labour markets in Europe have changed from high oversupply (unemployment) to shortages of mainly skilled persons. 20 years ago, such skill needs were already visible in projections. In 2023 the discussion of skill needs is spreading to more and more professions. The medical professions are no exception to this rule. Even the best paying jobs will not be filled in sufficient numbers. The German institute for the medical profession (www.zi.de) forecasts, in my opinion, a lower bound estimate of medical doctors for the year 2030. Their projection is based on an underestimation of the growth of the population (war in Ukraine), which they see as about constant until 2030. From the recent figures on the population of Germany there were 1.5 million persons moving to Germany and a loss of more deaths than births of 327.000. Migrants are on average much younger than the German population and, therefore, overall aging of the population is reduced. Tough news for those daring to do projections. Thanks to the immigration of younger persons there will be more persons contributing to health insurance and pay for the higher costs of a rapidly aging population.
Following the projections of the distribution of specialists needed, we shall need more urologists, eye specialists and substantially more psychotherapists. This originates in the aging of the population and the higher demand of younger persons (post Covid-19), as well as refugees, in need of psychotherapeutic assistance.
So-called hog-cycles tell us for the medical profession, with a “production time” of 10 years for a medical doctor, that we are already far behind schedule to address the future skill needs of the aging medical profession and population. This strengthens the need to get serious about prevention of avoidable diseases. Stop reading here, stand up and go for walk. It is the best-practice-solution taking account of the aging of the medical profession and the population as a whole.

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Lebenserwartung

Die Lebenserwartung ist in Deutschland trotz überdurchschnittlicher Ausgaben des Gesundheitssystems nur unterdurchschnittlich. Das ist die Schlussfolgerung der Pressemitteilung des Bundesinstituts für Bevölkerungsforschung. Der Mortalitätsforscher Pavel Grigoriev führt das auf die besonders bei Männern (50-64) erhöhten Sterblichkeit aufgrund von Herz-Kreislauf-Erkrankungen zurück. Eine gesunde Lebensweise ist dabei ursächlich für eine längere Lebenserwartung. Walking und Ernährung spielen eine große Rolle bei der gesunden Lebensweise. Also Auto stehen lassen und öfters selber Essen zubereiten. Klingt doch einfach, berufliche und schulische Voraussetzungen dazu fehlen aber weitestgehend in Deutschland. Zu viele Süßgetränke verstärken die ungesunde Lebensweise. Das wissen wir eigentlich lange. Dennoch fällt es schwer, solche Routinen in den Alltag zu integrieren.
An der Tatsache eines überteuerten Krankensystems im Vergleich zu unseren Nachbarländern werden wir ebenfalls arbeiten müssen. Prävention, statt hochtechnisierte Versorgung in häufigen Krankheitsfällen ist die einfache Lösung. Jede Autoversicherung bietet hohe Schadensfreiheitsrabatte für mehrjähriges Unfallfreies Fahren. In der Krankenversicherung könnte das stärkere Berücksichtigung finden.
Der Gesundheitsschutz am Arbeitsplatz könnte ebenfalls durch eine stärkere Beteiligung der unternehmerischen Verantwortung herangezogen werden. Arbeitnehmende im Arbeitsprozess verschleißen und dann die Gesellschaft die höheren Kosten tragen lassen, ist ein unfairer Deal. Große Baustellen warten darauf, angepackt zu werden. Anhand der Daten des Bundesinstituts für Bevölkerungsforschung und des MPI für demografische Forschung lässt sich der Fortschritt der Lebenserwartung seit 30 Jahren aufzeigen. Die 4-6 Jahre längere Lebenserwartung der Frauen gibt zu denken. Daran hat sich über die Jahrzehnte wenig geändert. Die Männer haben zumindest ein klein wenig aufgeholt oder sollten wir sagen, dazugelernt.