WGS17 Sessions: Discover the Happiness Zones Around the World

WGS17 Sessions: Discover the Happiness Zones Around the World


I’m going to talk about the parts of the
world, where people live the longest and the lessons they have to teach us. But, I’m a big fan of “If you can’t
measure it, you can’t manage it”, so… I actually want to start
this session by measuring each and every one
of yours life expectancy, and in order for me to do this,
I need to ask you eight questions. And your job is, number one, raise your
hand if the question applies to you, and number two, this is the hard part
at the end of the conference here, remember how many times
you raised your hand. So, eight easy questions. First question. Raise your hand if you get
at least seven and a half hours of sleep at least five days a week.
Seven and a half hours, five days a week. Okay. Well-rested group. Raise your hand if you get at least
four honest servings of vegetables every single day.
Four honest servings of vegetables, and French fries and ketchup do not count. Raise your hand if you move
at least 30 minutes a day. And this could be in the gym, it could be
walking, gardening, just about anything. Okay. Most of you. Raise your hand if you have not, and I
underscore “NOT”, had unprotected sex with a stranger. Well, I kind of expected hands
to dart up in this crowd. I never answer that one either. Okay, raise you hand if you have
at least three friends you can count on on a bad day. Three friends
you can count on on a bad day, and you actually like them. Raise your hand if you belong
to a faith-based organisation. Faith-based organisation, or religion. And you show up
at least three times a month. And raise your hand if you haven’t smoked
in the last five years. And final question. Raise your hand
if you have the desire and you think you have the health
to reach at least a healthy age ninety. You want to live to ninety,
and you think you can. Okay. Most of you.
That’s actually the biggest predictor of how long you’re going to live.
But I asked you eight questions, If you raised your hand at least twice, and you are a man,
your life expectancy is 68, and if you are a woman, it’s 72. If you raised your hand
at least five times and you are a man,
life expectancy is 77, and if are a woman, it’s 81. And if you
raised your hand at least seven times and you are a man,
life expectancy is 88, and if you are a woman, it’s 92. Did anybody raise their hand
all eight times? Anybody raised their hand
all eight times? Could you guys stand up?
Go ahead, own it. Can we give a huge
World Government Summit round of applause? You guys are now dismissed to the lounge. So, something called
“The Danish twins study” established that only about 20% of how long
the average person lives is dictated by genes.
The other 80% is dictated by life style and environment.
So, based on that assumption, working with National Geographic
and the National Institutes on Aging, about a decade ago,
we set out to, in a sense, reverse engineer longevity. So, we hired a team of demographers
to parse through world census data to find the areas
where people live verifiably the longest, either the highest life expectancy,
the highest centenarian rate, or the lowest rate
of middle-aged mortality. And then, put together a team
to go to each of those places to parse out,
to use established methodologies to determine
what were the characteristics that we see in all places
where people live a long time. And remarkably, no matter where you go
in the world, whether it’s Asia, Europe, Latin America, or North America, you see the same nine things happening
over and over and over again. And I’m going to tell you
what those nine things are, the common denominators to longevity. But first, since I have the benefit of
National Geographic photography, I thought I’d quickly take you
to each of these five longevity hot spots, spots that we’ve dubbed “Blue Zones”. We found the first Blue Zone
about 200 km off the coast of Italy on the island of Sardinia. Specifically, a cluster of 14 villages, 42,000 people up in the highlands. And here,
you have the highest concentration of male centenarians in the world.
This is where men live the longest, about ten times
more male centenarians here than you would expect to see in a normal
first world concentration. They not only live a long time,
but they also have very vital lives. It’s mostly a pastoral culture. The people here, mostly the men,
they have regular low intensity exercise. They eat a shepherd’s diet,
which is very simple, mostly plant-based. But, more important than what they eat
were their social norms. Unlike the United States,
where we tend to celebrate youth, here in Sardinia, people celebrated age. So, people were subtly told when they got
into their eighties, nineties, and a hundred: “You are important,
we expect something out of you.” Sardinians harness the wisdom of people
eighty, ninety, and a hundred years old. They were expected to work
on city counsels. They pass down the culinary wisdom,
the agricultural wisdom. They almost never put their aging parents
in a retirement home. Aging parents stayed in the home, where
they were expected to help with kids, help with cooking. And it turns out that something called
the “grandmother effect” shows that when you have a grandparent in the home
the children actually do better. They have lower rates of mortality,
lower rates of disease. Traditional wisdom
that we are starting to forget but is worthy of paying attention to
and, perhaps, bringing back. On the other side of the planet,
about 1,200 km south of Tokyo, on the island of Okinawa, we found the longest lived
female population in the world. Here, among women, 60 year or over,
you have about 30 times more centenarians than you’d expect to see
in a like population elsewhere. This is a population that, once again,
eats mostly a plant-based diet. About eight times more tofu
than just about any other diet. But once again, it’s the cultural norms that, we, believe explain
most of the extraordinary longevity. Once again, these populations
are all heterogeneous. There is no special genetic thing
going on. Okinawa has been a melting pot
since the 16th century. But the last session talked a lot
about social connectivity. In the United States,
about 20% of us are lonely, and if you meet the technical definition
of loneliness, i.e. if you couldn’t raise your hand
when I asked you if you have three good friends
you can count on, that sheds about eight years
off of your life expectancy. In Okinawa here,
when you’re about five years old, your parents put you
into something called a “Moai”. Social circle, a committed social circle, and you are expected to travel
through life together. The reason I show this picture here
is these five women had belonged to the same Moai
for 97 years. Their average age is 102.
They still get together every night, Gossip, drink Sake, argue about
who that hot guy liked best back in 1942, and really look after each other. Okinawa is also a place where purpose
is hardwired in the vocabulary. The word Ikigai roughly means “the reason
for which I wake up in the morning”. This 102-year-old told me his Ikigai
was continuing to teach Karate. This 97-year-old
still went out and fished every day, not for profit but for his family. And this 102-year-old spiritual leader, her Ikigai was her
great- great-granddaughter. In the United States, we found
the longest lived population about 120 km southeast of Los Angeles, down the San Bernardino Freeway. Six lanes of traffic.
You get off the Loma Linda exit, and the first thing you see
is a Del Taco and a Wiener Hut, And you are in America’s Blue Zone. What’s going on here? This is the area of the highest
concentration of Seventh-day Adventists, Adventists are conservative Methodists, who distinguish themselves
from other Christians in that, one, they evangelize with health, and number
two, they take their Sabbath on Saturday, which makes them a little bit
culturally different than other places. But their longevity profile is impressive
compared to the rest of the US. In the United States, the average
life expectancy of American women is 80, but for Adventist women,
they’re living about nine years later, and for men, the deference
is even more pronounced. Adventist men
live about 11 years longer. So, think about this. Here, you have a North American population that’s living about ten years longer
than the rest of the larger population. Living right off the freeway
next to the Wiener Hut. What’s going on here? Well, number one,
they have this strong sense of religion, sanctuary in time from sunset on Friday
until sunset on Saturday no matter how busy they are, no matter what work
is telling them to do, no matter where the kids
need to be driven. They take this 24 hours,
they focus on their family. In the morning,
they focus on their religion. In the afternoon,
they take a nature walk. They take their diet
directly from the bible. Genesis, chapter one, verse 26. The passage talks about every plant
that bears seed and every tree that bears fruit. So, the Adventists
take this quite seriously. For the most part,
Adventists are vegetarian or vegan. And then, Adventists tend to hangout
with other Adventists. And the social contagions that circulate
through the Adventist community tend to be positive. They don’t drink. They don’t smoke. They tend to support each other
in many ways. This is a culture that produced
Ellsworth Wareham, a 97-year-old guy, multimillionaire, yet when a contractor wants
$6,000 to build a privacy fence, he’s like: “Well, for that kind of money,
I’ll do it myself.” For the next four days,
he’s out shovelling cement, hauling timbers, and predictably,
perhaps, on the forth day, he ends up in the operating room. But this isn’t Ellsworth
getting open-heart surgery, this is Ellsworth
doing open-heart surgery. Continued to do
open-heart surgery till 97. 106-year-old Ed Rollings
is a working cowboy, starts his day with a swim, and
on the weekends, he puts on the boards. Marge Jetton, a woman who wakes up
every morning at 4:30 in the morning, reads her bible, eats a bowl of oatmeal
topped with nuts and soy milk, followed by what she calls
“a prune juice shooter”. Then she goes out runs. So, I wrote up these three cultures for a
book and a story for National Geographic. It gave me enough funds
to continue exploration. I worked
with the Bill and Melinda Gates Foundation to find a fourth Blue Zone in Costa Rica. This is an area with the lowest rate
of middle-aged mortality. In other words, they have the best chance
of reaching a healthy age 92. And they do it
spending about one fifteenth the amount Americans spend on healthcare. In my opinion, it’s proof
that you do not have to be a rich nation to produce high health,
and, therefore, high happiness. And then finally, off the coast
of Turkey, on the island of Ikaria, population of about 10,000 people. I believe the last Blue Zone. They have
about half the rate of heart disease, they live about eight years longer
than Americans do. But most interestingly, they have
about a fifth of the rate of dementia. At age 85, in most first world countries,
if you make it that old, there’s about a 50% chance
you’re suffering from dementia. Here, it was about a 10% chance. And we interviewed almost every person
over age 60 on the entire island over a course of two years. This is largely an isolated place that practices an extreme form
of the Mediterranean diet. Like most Blue Zones, people into their
eighties, nineties, and hundreds continue to garden,
stay close to the earth, stay close to the food they’re eating. I’d like to tell the story
of this fellow here. His name is Stamatis Moraitis. Industrious youth. At age 22, he goes to America, gets a job as a painter, becomes prosperous, marries a Geek-American, buys a house, buys a Chevrolet,
the American dream. But at age 66, he goes to three doctors,
all of whom tell him the same thing. “Terminal lung cancer.
You’ll be dead in six months.” So, instead of dying in New York,
he figures he’ll go move to Ikaria, get buried on the coast
of the Aegean sea with his ancestors. So, he and his wife pack up,
they go back to Ikaria. He moves there with his parents,
who are still alive and vital. He starts drinking the water,
eating this Mediterranean diet, reconnect with their religion. His friends
come over every afternoon, they socialise. After six months,
he’s actually feeling pretty good. He goes out one day, plants a garden. He doesn’t expect to be around
to harvest the garden, but he thinks
his wife will harvest that garden and she’ll think of him when he’s gone. Well, to make a long story medium, when I met him 34 years later,
he had not only harvest that garden, but he planted a vineyard
where he produced 200 litres of wine all of which he drank at a 102. Now, as a journalist, of course, I have to
ask him what his secret to longevity was, and I was pretty sure
it wasn’t his ability to match plaids. He thought for a moment
and he said: “Well, I don’t know.” “I guess I just forgot to die.” What seems like an overly simplistic
answer for longevity, but actually, I think
he hit the nail on the head. For the last ten years, I’ve been
traveling back to these Blue Zones over 40 times. and I kind of started
out looking for an herb or a compound
or a diet that explain longevity, but actually, it’s non of that. Wherever you see a population
that is producing spry 90 and 100-year-olds,
who are still water-skiing or standing on their head
or doing Karate, it’s not because that 100-year-old
said at age 50: “Well, gall darn it! I’m going to get on that
longevity diet, and live another 50 years.” They didn’t go buy a treadmill or sign up
for a wellness program at work or call an 800 number
and order supplements. The key insight here
was that longevity happened to them. it was not something they pursue. When you think of it, we think of health
as something we go after. We’re going to buck up,
get discipline, eat right, exercise. It didn’t happen to any of these guys. Longevity was a residue
of their environment. So, no matter where you go in the world, you see the same characteristics
of environments of longevity. First of all… There’s nine of them. First of all, they don’t exercise. By the way, exercise has been largely
a public health failure. The average American burns fewer than
100 calories a day engaging in exercise. We keep throwing money at it
but it doesn’t work. In these Blue Zones,
every time people go to work or school or a friend’s house, Ikarians walk. They have gardens.
Their houses are deconvenienced; they haven’t engineered all the physical
activities out of their lives. They still grind corn or knead bread
or do house tasks by hand. They have the same stresses that we have but what they have that we forgot
are the sacred daily rituals that reverse stress
and the ensuing inflammation. They meditate. They pray. They take naps. They do happy hour. There is a vocabulary for purpose. You hear this a lot increasingly
in the happiness literature as well. They can articulate the reason
for which they get up in the morning. Another characteristic
that explains about an extra seven years of life expectancy
as compared to being rudderless. When it comes to what they consume,
they do have a happy hour, they drink several things, in Ikaria,
it’ll be tea, wine in other places. They eat mostly a plant-based diet. I just wrote another book
on what people on Blue Zones eat, a meta analysis. You see
that 90 or 100% of the diets of longevity are plant-based. A super high carbohydrate, flies right in the face
of what you heard in paleo diets. You can kind of sum it up
by saying, grains, greens, and beans. On average, they’re eating
about a cup of beans every day. If there is one longevity food,
one thing you walk away from from this presentation, it’s the notion
of eating a cup of beans every day. It’ll probably add about 4 years
to your life expectancy. They do eat some meat,
fewer than 5 times a month, servings are about
the size of this clicker. Very little fish, actually. No dairy, no cows dairy and you’ll see
a little bit of Feta cheese. They snack on nuts.
And when it comes to what they drink, it’s mostly water, six glasses a day. Tea. A good news for most of us,
coffee before noon. Almost as much as they want. No soda pops. Soda pops are largely
unknown to centenarians. And then, perhaps more important
than what they eat, what they don’t eat. They have ways to keep from overeating. Eating a huge breakfast,
medium size lunch ridding their kitchens of electronics,
that helps. And then the foundation
of longevity everywhere. This’s about 50% of the explanation
of populations who live a long time. Again, this will not unfamiliar to people
who study happiness. Strong families. They keep
their aging parents near by, they commit to their spouse
and they stay married and they invest in their kids,
so their kids aren’t putting them in a retirement home. They belong to a religion. We know that people who show up
to their place of worship for at least 4 times a month,
live 4 to 14 years longer than a group of people who don’t. By the way, religious people
living in a religious place report being happier
than non-religious people. And then finally, social network. We know that if your three best friends
are obese and unhealthy, that you are about 150% more likely
to be unhealthy and overweight yourself. Not only smoking is contagious,
drinking is contagious, even unhappiness is contagious. So, who you surround yourself with
makes a huge difference. So, you look at these nine things.
This explains most of longevity in all five of the Blue Zones.
You may say to yourself: “Well, this sounds like common sense,”
but actually it’s uncommon. What most of us do when it comes
to trying to prevent ill health is spend money on diets,
exercise programs, and supplements. And, they are not a bad idea, I guess,
except that they are very expensive and they tend to only work
in the short run, if they work at all. They start with 100% of people, you put
them on the best diet in the world, Let’s say, the Blue Zone diet. You’re going to lose about 10% of them
in just 3 months, you’re going to lose 90% of them
in 7 months, and almost all of them in two years. Same thing with exercise programs, people
tend to start them with a lot of zeal right after the holidays, but then,
run out of gas within a year. Almost all people stop within three years. And even if I come back from Blue Zones
with a pill guaranteed to reverse aging, most people won’t
take it long enough to make a difference. So, if trying to change your behaviour
doesn’t work, what does? In 2008, I got another grant
from National Geographic. Renew your subscription, please. This time, it was to look for populations
that were unhealthy and got healthier. And I worked with the CDC
and The World Health Organisation, went through all the known studies
of place that try to create vitality city or healthy-heart cities, and no matter where they were tried
in the United States, they failed. There was one place in the world
that achieved success. It’s a place called
North Karelia, Finland. This is a place near the Russian border,
about 150,000 fins, hardworking, relatively prosperous people. But, in 1972, they had the highest rate
of cardio vascular disease in the world. Men were dropping dead at age 55. And you look around and you can
pretty easily see the reason. They are mostly dairy farmers.
They fried their cheese in butter. The national dish
was something called karelian stew, which was made from 3 ingredients; pork, water, and salt. And if you wanted it spicy,
you added more salt. So, it wasn’t surprising. Well, 30 years ago, the Finnish government
hired an epidemiologist, a public health physician
named Pekka Puska. And he found out later
that they hired him not for what he knew, but for what he didn’t know. Traditionally, what killed people
and would shorten your life expectancy was infectious diseases. And now, all of a sudden, a whole new
class of diseases are emerging; chronic diseases. And the old techniques for public health
were not working. So, they hired this 26 year old guy,
this is him 3 decades later, to come in and try to make
this North Karelia healthier. And for the first five years,
he just blew through budget, tried to do all the things that
the infectious disease folks tried to do; identify the high-risk people
and throw the intervention at them. They all failed.
And then he actually got the idea, instead of trying to change the
individual, change the environment. He knew people in North Karelia
had to eat more fruits and vegetables, but they were expensive
and people weren’t used to eating them. But berries grew every summer. And he figured out a way
to create these cooperatives that would freeze and preserve berries and make sure that they were available
in grocery stores all year round. People in North Karelia
love their fatty sausages, and there was no way in heck that Pekka Puska was going to convince people
to quit eating their sausage. So, instead, he went to the sausage maker, and he convinced the regional
sausage maker to change the recipe. To lower the sodium content. They put in this cheep but healthy
mushroom filler, mushrooms that grew locally, which lowered the fat content
by about 30%. And little by little,
that same sausage was 30% healthier. So, he applied a whole series of this,
I don’t have time to go into all of them. But over a 30 year period, largely through the work of Pekka Puska, they saw an 80% drop
in heart disease among men, and they maintained this for 30 years. This was
in the British Journal of Medicine. I mean, this is well-documented
and it works. So, inspired by that project, and also rooted in what I learned
in the Blue Zones, in 2009, I tried to create
a similar project in the United States to create a so-called Blue Zone. And the idea here- I got a big grant to hire, I think,
some of the smartest minds in America to help think about
how to take Blue Zone tenets and apply them to an entire city. And we assumed that almost everybody
lives in a life radius. It varies from about 5 miles
to about 20 miles where you’ll spend about 80% of your life. And instead of trying to convince
the individual to change behaviours, we basically acknowledge that everybody, including everybody in this room, is evolutionarily hardwired
to crave sugar, to crave fat, to eat whenever we can,
and to rest whenever we can, and that’s how we survived as a species
for 99.9% of our existence. So, instead of trying to fight
those urges… Discipline is a good thing, but discipline is a muscle
and muscles get tired. We thought about
how you’d change the environment, so this person
would mindlessly get healthier. Well, my team and advisors
identified five domains. In the first domain, if you want to make a community
or a city or a country healthier, your most cost-effective way to do it
is to focus on policy. So, this, boiled down
for our purposes, is essentially making
the food environment healthier. Do you live in a place
where fruits and vegetables are cheapest and most accessible, or do you live in a place
where burgers and fries and pizzas and soda pops
are cheapest and most accessible? And I think if most of us
think about where we live, we know where that default is
in our communities. So, getting city governments
to adopt policies like limiting the number
of fast-food restaurants. If you live in a neighbourhood where
there are over six fast-food restaurants in a kilometre radius, you are about 30% more likely to be obese than if you live in a neighbourhood
with fewer than five. There is a direct association between
billboard signs advertising junk food and the obesity
of the adjacent population. So, if you can do…
pass a law, like Vermont has, and eliminate fast-food signs, you’ll see a commensurate drop
in obesity in that area. Build environment.
Enormous opportunity here. If you can just design streets for humans. Put in bike lanes, narrow traffic lanes. Put in a sidewalk. Put in trees.
Make it safe and inviting. You can raise the physical activity
of an entire population by 30%. No gym memberships. No yoga classes. No Ab Master. Just make streets accessible for humans. Jim Prochaska helped us
realise and create a program that we get the 80% or so people, who are
ready to change their health behaviours together to create these mini-Moais organized around health. There is an enormous opportunity around
the buildings that we spend our days in; schools, grocery stores, restaurants,
and work places. There are about 120 nudges and defaults
you can set up, changing policy, tweaking the design, that will occasion about 20%
healthier living in those places. And then, finally, helping people
finding their sense of purpose and get them to volunteer. Volunteers have
measurably lower rates of heart disease, they weigh less, and they have
measurably lower healthcare cost. And volunteering is as addictive
as sugar and crack cocaine. So, you get people to taste it,
they tend to keep doing it. So, this is a pretty nice neat model, but can you get a population
to actually do it? Well, instead of showing up
to a city and saying: “Guess what? We know the answer for you.” We just auditioned this. We took it
to five cities around Minnesota. This is actually where I live. And we
picked one city, Albert lea, Minnesota, for this Blue Zone makeover because we thought they were ready. The mayor, the city manager, the head of public health, the superintendents of schools, all signed a pledge that said “I understand
what you’re doing,” “you’re coming here to try to make
the healthy choice easier.” “We’ll let you come in.” First thing we did is we came in
and we listened to them. In any community,
there is a number of efforts that are trying to make a healthier city. Rather than alienate them,
we brought them in, we invested heavily in measurement. We hired Gallup, the same organisation
that gathered the data analysed by our previous panel, to come in
and take 80 different measurements of, not only the well-being of the city, but also health metrics. And then, we tried to get all feet
walking in the same direction. We worked with city planners to design the city a little bit better. It turns out that Albert Lea
was essentially divided in quadrants. Four neighbourhoods
and a beautiful downtown, but people weren’t walking downtown, not because there wasn’t sidewalks,
but because sidewalks weren’t connected. Older people will not cut through a field or go through a dangerous path. So, simply by connecting
seven miles of sidewalks, we created a vector
for everybody to get downtown. Once you got downtown,
the city wanted to widen main street here and bring more traffic
from the interstate. We gave them the option.
We didn’t tell them what to do, but we pointed out that they have
this beautiful place to recreate. Rather than spending money with noise
and traffic here, why not focus here? Well, we convinced them
to put a trail around this lake. And now, that trail is packed
11 months out of the year. We don’t have to give people
break on their insurance or give them a free T-shirt or hound them, you just make it easy and attractive
and they come. We built 3 public gardens.
These were in parks with unused land, they went right away.
We worked with Brian Wansink, who helped us design food environments. We went to every restaurant
and offered them Blue Zone certification if they would make healthy choices
easier in restaurants. Every time you go out to eat, you consume about 300 or more calories
than you would if you stayed at home. So, our goal was to engineer out
those 300 calories. So we changed the default. When
you showed up to a Blue Zone restaurant instead of automatically getting
bread and butter, you could still get it
but you had to ask for it. It turns out, most of the time,
people don’t need that extra 150 calories. When you ordered a sandwich,
instead of automatically getting fries, we made default the fruit,
so you get the fruit. Well, we changed
the adjectives on entrees, so people would order healthier food. Do you know the adjective that almost
assures that people won’t order an entree? Call it “the healthy choice”. Nobody wants the damn healthy choice. When people go out to eat,
they want to eat something good. So, labelling it “sizzling” or “crispy” or “crunchy”,
people will tend to order it. We took the healthy choice salad and we
renamed it “the Italian Primavera Salad”, sales went up by about 60%. We didn’t touch the ingredients,
we didn’t even touch the price. In all the local grocery stores, they agreed to take
the healthy choices in the grocery store, and even to make a check-out isle
with all healthy defaults. In schools, we got them to agree to
policies that would make eating easier. It turns out that the lunch program
is not the biggest determiner of what your kids eat in school, it’s whether or not they can eat
in hallways and classrooms. If the answer to eating in class rooms
and hallways is no in our child’s school, on average,
that school has a BMI or their weights about 11% lower. We got about 20% of everybody
in Albert Lea to sign a simple pledge that got them to agree to go
into their home and change their kitchen, so that they mindlessly consumed
100 fewer calories. Simple things like trading out
their big plates for smaller plates. Going into their backyard
and digging a garden. And then, joining a Moai. Remember those old ladies who sat around
and gossip and drank Sake? We simply reproduced that ideal
in small-town America where we got auditoriums full of people to cluster together, groups of five. And simply got them to agree to walk
together for 10 weeks. And it turns out-
it seems like a very simple idea, but we knew that health behaviours
were contagious, and we knew after about 6 or 7 weeks that people who stayed together,
they stayed for the long run. 70% of about 110 of these groups
are still together 9 years later. And then we gave everybody
a purpose workshop. You hear a lot about purpose
in the happiness literature but how do you actually give people
a sense of purpose? And it turns out,
it takes a little bit of time, about two hours to help people
go through an internal inventory to assess what are they good at,
what do they like, what are their values, and what is an outlet
for that purpose, for that life meaning. In Albert Lea,
after this two hour workshop, we speed-dated them
with volunteer organizations. So, right there, when they were
infused with this new purpose, we got them signing up for altruism. So, after about 18 months, the results were impressive. We raised the average life expectancy
by 3.2 years, we helped them
shed about 2000 – 3000 kilos, and healthcare cost in city workers
dropped by 40%. This made big news in the United States, newspapers, TV, magazines, and our phone
started ringing off the hook. Over 55 other cities called us and asked us
if we could Blue Zone their city. We auditioned all 55, and we ended up choosing
3 cities in Los Angeles, California. Very different culture
than the prairies of Minnesota. But we showed up with the same team,
with the exact same plan; making permanent or semi-permanent changes
to the environment. Here in Los Angeles,
there were slightly different problems, we had a chance to evolve the program. Dan Burden, who works on our team. He’s one of Time magazine’s
top civic designers of the century. He taught me an important thing about getting cities to adopt policy. And this would not only work for health, but I believe,
it will also work for happiness. It turns out, when it comes to policy,
people vote for it. And people have to visualise
what you’re talking about. If they don’t understand it
or it’s too vague or abstract or academic, people’s eyes glaze over. So, when we ask them to make their city
more walkable and bikeable, Dan would actually take the city planer
and the Mayor and the head of the newspaper
and the TV station and walk them through their city
and show them what works well, what doesn’t work so well,
and what the opportunity was. Then, he would take them all
in a room and show them what their city can look like
if they morphed it. And then, it was really easy
to convince them to adopt the active living policies
we wanted them to live. This makes a huge difference
in people’s quality of life, and I would argue, quite honestly,
their happiness at the end of the day. In schools,
we tried to bring in meditation but it turns out that there was a kind of
a cultural push-back to meditation. So, we got Goldie Hawn to help us
with something she called the mind-up, which, essentially, was meditation,
just with a different brand. Got almost every school
to adopt this daily meditation. Grades went up. It improved health. It was very successful.
It turns out in Los Angeles, 40% of the children could not
correctly identify a banana as a fruit. So, to get them eating
more fruits and vegetables, they had to know what it was. So, we convinced schools to adopt
a curriculum we borrowed from France. that got kids listening to vegetables
and fruits; they’d snap carrot sticks, smelling them like connoisseurs,
and then tasting them. And then, in their classrooms, Brian Wansink’s help,
make sure changing simple defaults, like put the fruits and vegetables
at the beginning of a line. Fruit and vegetable consumption goes up
by about 35% by that little thing. Because there was a McDonalds
right across the street, and we had to compete
with McDonalds at schools, we got the lunch ladies to package healthy
food to make it look like junk food. So, even though this looks like French
fries, it’s actually sweet potatoes. And these are fruit spears
that look like an ice-cream sundae. So, we cloak it. And then, we got them to adopt a bunch
of food policies that really worked well. The most successful one here was creating
a thousand meter radius around schools where no junk food could show up. We convinced Hermosa Beach
to go smoke-free, and that worked so well.
There was all kinds of fears that bar owners and restaurants
will lose business. They did not. neighbouring Manhattan Beach adopted it. So, the whole area went smoke free. So, we had Gallup come in 3 times.
They did a base-line in 2010. And then again, in 2015. Now, this is against California controls. So, in other words, this wasn’t because
all of California made these changes, but this was pretty unique
to the beaches. We dropped the smoking rate by 17%. The average weight went down by 15. In a population of 125,000 people,
that meant 1,900 fewer obese people. Daily stress went down,
the purported exercise went up. And this was the really cool thing. We did not set out
to do a happiness project but, lo and behold, the number
of people thriving who reported, in other words,
having an 8 on a scale of 1 to 10, and they believe they will be happier
in 5 years, went up by 12%. So, as I said in the very beginning, when it comes to happiness
and happy life expectancy, they are Siamese twins. From here, the entire state of Iowa
brought us in. The Blue Cross Blue Shield, a challenge
to make the pork state healthier. We’ve been there for 5 years. We got invited in
by the most conservative city in America, Fort Worth, Texas.
778,000 people in that city. And after that- this has just really
blown up, we’re now in 31 cities. And every time,
we get a little bit better. But we do the same thing
in every city we go into, and we’ve learned a few lessons. And this has worked really well
with healthy life expectancy. I argue, it’d work really well
for a happiness intervention as well. This took five years to learn. First of all,
you want to start with ready cities. You want to pick the place
that is most likely to adopt your ideas, show an early success,
and once you show an early success, it’s a lot easier to get a neighbouring
or a bigger city to adopt it. Do the low-hanging-fruit. Invest in measuring. In order to get enough resources
to scale this big, you have to be able to show stakeholders
that this is actually working. So, investing
in an organisation like Gallup has paid off many times over for us. People like to have a destination,
especially a city, so, we offered this
Blue Zone certification. But to make certification work,
you want process measurements, you want things that they can
measure every few months, but you also want to make sure
to have outcome requirements. They have to show measurable improvement. You don’t want to just stamp your name
on a feel-good project, there should be real progress. Brand it something other than “Healthy”. I would argue happiness
is becoming almost a meaningless term. The panel before us
had some pretty good ideas, but come up with some other brand that hasn’t been used before. Don’t come in telling city council
what to do, people hate that, they’ll show you the door. We assembled policy bundles. Evidence-based policy bundles for food,
for built environment, for tobacco. Now, we are actually doing one
for well-being. And then, let them pick
what’s right for their city, and then, help them implement
over time. And then, finally,
this work doesn’t happen quickly. Ideally, we found a 3 to 5 year horizon
if you really want to get something done. When it comes to longevity,
and I’d argue, happiness, the secret is not trying to get an ocean of people
to change their individual behaviours. It will almost always fail
on the short run. What I believe works is unleashing
a healthy swarm of nudges and defaults that make the right choice, in other words, the choice that delivers
the evidence-based outcome. Not only the easy choice,
but in many cases, the unavoidable choice. So, it’s making permanent changes
to the eco-system. I want to close with one last story. Remember Stamatis Moraitis,
the 102-year-old guy with plaids
and forgot to die and so forth? I actually called him not too long ago.
Called him from my home in Minneapolis, I was on Skype, it was
early in the morning in Minneapolis and late afternoon in Ikaria. He picked up
the phone. He had just taken a nap, He’s all tired
but he talked to me anyway. And I was grilling him on what he eats
and how he’s feeling and what he’s doing, After about 10 minutes,
he goes: “You got to hurry this up!” “I got friends coming over.” So, I said: “Okay. One last question” I said: “Did you ever figure out
how you got rid of lung cancer?” “That’s incredibly rare.” He said: “Yeah! Yeah!
I thought a lot about that.” “In fact, about 15 years ago,
I went back to the Unites States” “to get some tests.” And I said: ‘Yeah, what did you find out?’
He said: ‘Nothing’. He said when I got home,
all my doctors were dead.” Thank you very much.

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