An NHS health check is available to all 40-74 year old citizens of the UK. The idea is to detect problems like hypertension, (pre)diabetes and the risk of heart disease early so that preventative measures – lifestyle changes and possibly medication – can be offered in good time.
There is plenty of debate in the public arena as to how helpful and effective they are and also questions about what is the driving force behind them. (If you’re interested you can read more by searching NHS health check evidence base).
There is actually some pretty good evidence that they are making a difference. They have actually been a pretty helpful resource in helping practice nurses and GPs have ‘coaching’ conversations with people about their physical health and what they could do to improve this and help them stay healthier in the future.
However, does a Q Risk score (something that tells you how likely you are to have a heart attack or a stroke in the next 10 years) really measure how healthy you are? What does it mean to be healthy? If we take Wilber’s work on health and well being (1997), physical health is only a part of what it means to be truly well. If we are to embrace a more holistic understanding of what it means to be healthy people, who live in healthy communities which are part of healthy towns and cities, then we need to take a much wider view of how we measure this.
So how healthy are you. Starting with the physical – how is your diet and exercise? How much responsibility do you take over the substances you put into your body – alcohol, cigarette smoke, recreational drugs, sugars, caffeine, toxins like aspartame……? And if you take little responsibility for your physical health, what should the response of a ‘free’ health care service be that currently spends 1 in every 5 pounds mopping up the consequences of people’s poor lifestyle choices? And what about the leaders within our cities – what will they do to tackle the fast food/alcohol/sugar/tobacco industries and the supermarkets who cream profits from product placement and advertising of hugely unhealthy foods? I could go on……
And what about your mental health? The fact is: the UK has some of the unhappiest children in the developed world http://www.bbc.co.uk/news/uk-14908194 (this is always true of places where the gap between the rich and poorest is wider and where materialism is prioritised over time). Anxiety and depression are on the increase and stress continues to be a major reason for consulting the GP. Some of this is systemic and it is a challenge to policy makers to think about the impact of their decisions on the mental health of the population. Austerity and deeper benefits cuts are having a profoundly negative impact on those already struggling. But there is also a challenge to individuals about what we allow our minds to be filled with. How much time in a day do you stop to be grateful, or to be still? How much of your mind space is taken up with addictive tendencies, be that to social media or pornography? How are you at forgiving others who have hurt you? If not very good – how much is the bitterness inside you having a good effect? If the bitterness is eating you up – what are you going to do – hold on to it? How much time do you give to things like singing and volunteering which are seriously good for your mental health?
To take Wilber further, we must ask how well we are socially. How connected are you to the people around you? According to the Office of National Statistics (ONS), the UK is in the bottom three nations in Europe for feeling attached to our local communities and for feeling like we can ask for help from people who love us in times of need – what is that about?! How much of our time these days is given over to screens and social media instead of actually having conversations that matter with people in the same street or even the same room as us? What is the social make up of our communities like? Can we see alternative economies springing up like time-banking? What is the provision like for children and old people? Who looks after your elderly neighbour when she’s just come out of hospital with a new hip? Could there be a meal rota on your street?
There is one other measure to look at – our systemic health. How much do we feel empowered within society to make a difference and effect change? If not much, then we generally don’t feel very healthy. For me, it’s one of the reasons why community involvement is important so that the unheard voices are given space to speak and to be listened to. How much do leaders within cities think about the impact of their decisions on the poor and marginalised? For some truly incredible work on this, check out the Leeds Poverty Truth Challenge (https://leedspovertytruth.wordpress.com/).
So, how healthy are you? You as a whole person and you in the corporate sense? Do you want to be well? If so, think more holistically – think about your physical, mental, social and systemic health.
My health check would ask these questions:
Are you eating and exercising well?
Are you drinking responsibly?
Are you taking time to be grateful?
Are you looking other human beings in the eye and building intimacy?
Are you connected to other people in your community?
Are you choosing to forgive others when they wrong you?
Are you taking care of others around you?
Are you walking in open spaces and enjoying this beautiful earth?
Are you singing on a regular basis and taking time to be creative?
The challenge to us all is to learn what it is to be really well. The challenge to the health service is to work far more integratively and take a much broader, wider, richer and deeper view of what it really means to be healthy.
