Viewpoint: Wellness needs to be focus of post-COVID public health policy

Karen Rubin, Columnist

A silver lining to this COVID-19 tragedy, ironically, is a new focus on health and wellness. And just as we are hearing about “sustainability” in “building back better” infrastructure as key to resuscitating the economy, the corollary in health is wellness, and “wellness” actually factors into infrastructure planning, as much as government policy.

Wellness isn’t talked about as much in the debate (to the extent there is one) over universal health care.

But back in the day when there was serious discussion about healthcare as a right, not a privilege, it was brought out that with all the innovations and breakthrough in medical science, unless only the rich could take advantage, you couldn’t possibly afford a health care system capable of taking care of everyone whose lives could be extended indefinitely with treatment, surgery, medication and technology.

It comes down to a fear that if everyone has access to health care, how will you ration it? Will there be death panels?
Beyond the obvious solutions of training more doctors, nurses and health workers, opening up more clinics, offering tele-medicine, wellness checks and early-detection tests and affordable prescription drugs, the solution is wellness. People living longer, healthier lives without the need for costly, intrusive medical treatments.

There are big things that municipalities can do – like promoting clean, renewable energy over carbon-based fuel, doing more to eliminate pollution from air and water, and protecting the food supply from toxins. But it turns out that there are relatively simple things we can do in society if we really care to enable as many people as possible live better.

For example, when you build a bridge, like the Mario Cuomo Bridge (that replaced the Tappan Zee), build a biking/walking path alongside.

This approach also was on view when County Executive Laura Curran announced Nassau was joining the state’s Climate Smart Communities Program, embracing a “green innovation economy” that, among other things, calls for green infrastructure – parks, pools, beaches, boating, bike paths, golf courses.

And it was on view when she opened the expansion of the Motor Parkway Trail, an 11-mile contiguous multi-use trail from Hofstra University to Eisenhower Park, that offers a commuting alternative to the Nassau Hub area.
In significant ways, this is an un-doing of the original design and premise of Suburbia which prioritized cars, while creating isolated islands rather than build community and neighborhoods.

That strategy for integrating wellness into our physical places was a focus of the recent Vision Long Island’s “Complete Streets: Healthy Citizens, Healthy Main Streets” seminar.
Complete Streets strategies figure significantly in the health, wellness and safety of a community – actually saving money when you factor in increased productivity for individuals and decreased health costs for society.

COVID-19 has highlighted the higher risks due to “co-morbidities” like obesity, diabetes, heart disease, respiratory problems. On the other hand, it has also brought people out and about, walking, biking in their community.

Complete Streets strategies involve calming vehicular traffic to reduce pedestrian and cyclist fatalities (in 2019, 38,800 lives lost in car accidents, 4.4 million seriously injured). But it also turns out that communities can be designed to make it healthier and safer to bike or walk, and get out there and move.

“For every hour you walk, you can add an hour to expected healthy lifespan; for every hour you sit in a car, subtract,” said Dr. Keshia Pollack Porter of Johns Hopkins. “We need to change mode priority.”

“We are so focused on people not getting COVID, but we need to shift to promoting heath – nutrition, walking, biking – so that if and when we have a situation, we want healthier citizenry across board,” said Denise Carter of Greenman-Pedersen Inc.

A similar theme was sounded by Dan Buettner, an explorer, National Geographic fellow and journalist, who has made his life’s work the study of “Blue Zones” – communities with extraordinary longevity and high “happiness” index. And one key common factor is natural movement that is integrated into daily life.

“In America, the notion of exercise has been an unmitigated public health failure. We continue to hound people to get exercise, but fewer than 20% get the minimum 30 minutes a day,” he said during a Global Wellness summit (

“What works in Blue Zones, is every time people go to work, meet a friend, go out to eat, go to school, is an occasion to walk. They don’t have every mechanized convenience to do housework or gardening; they do things by hand, have a garden. What this produces is a day where people are nudged to move every 20 minutes. It is folly to sit at desk 8 hours and go to a gym a couple times of week. That’s not how we evolved as humans. In Blue Zones, people are moving every 20 minutes.”

Such physical movement integrated into daily life also gets those endorphins popping and reduces stress. But it also means that distances – to school, work, activities – are close enough (and safe enough) to walk or bike, which means a more integrated, closer community that also promotes socialization, another factor in longevity.

“When it comes to COVID, the world’s hair is on fire with disease,” Buettner stated. “The United States alone is likely to hit 800,000 deaths –a terrible tragedy – but 5 million will die of chronic disease and we are not paying attention to that. Chronic diseases are more avoidable than infectious –the number one risk factor in the world for getting COVID for those under 55 is obesity that is almost completely avoidable.

In Blue Zones the average rate of obesity is less than 2 percent, not because of better genes but better surroundings, environments.

“To avoid all disease, especially chronic disease, even infectious disease, follow these rules: surround yourself with people you enjoy being with; eat mostly plant-based foods; have a sense of purpose in the way you live, work, play; live in a place and work in a place where you are constantly nudged, moving more, eating less junk food and processed food, socializing more, and living on your feet.”

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Karen Rubin

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