I've written a number of prior posts on what "shape" a person really is, or where the "edges" are of a person, for various purposes, such as coming up with new ways to improve health or counter depression.
One thing that's increasingly clear is that a person's "body", the stuff that is in a tight biological system with itself, does NOT end where their skin meets the air. According to an increasing flood of studies, "we" are impacted not just by what happens to "us", but also by what happens to our peers, our friends, and their friends. When I say impacted, I mean that there are clear, measurable, undisputable physiological changes that occur HERE, in what we used to call "my body" when someone intervenes over THERE, in my close friend's body.
As seen by a video camera, yes, my body ends where the air begins. But mathematically, as seen by a map of where you can intervene that changes my internal chemistry, my "body" is quite a bit larger and diffuse.
And, further, my extended body has parts that are "detachable", that sometimes are so tightly connected to me that they matter a great deal, and sometimes are so loosely connected to me that they matter not at all.
OK, so what? Why does this nit-picking about semantics matter?
One big reason it matters is that, once we realize we are larger than our physical body, we can start looking for and taking advantage of more and different interventions than the old ones -- the ones that didn't work very well.
I've recounted before how all the world's top behavioral specialists, such as Bandura, at a conference on "Self Regulation of Health Behaviors"at the University of Michigan, agreed that their work consistently showed that the most powerful intervention on our "selves" was pivoted on "other people near us". For example, if you offer to pay a woman's CHILDREN $10 for every pound she loses, it turns out to be more effective than if you offer to pay HER $10 for every pound she loses.
Again, isn't this just a semantic argument? What am I going on about it for?
The point is that our mental model of "ourself" has a powerful and dramatic impact on how we behave, and often a crippling and paralyzing one. If we think we are limited by the options inside our classical skin and "body", we have far fewer options and resources to work with than if we assume we're limited instead by the resources in our entire exo-body.
Take one example -- finding the "strength within" to tackle a hard task and carry it through to completion. People who are connected to a peer group that has strong norms and that expect this kind of performance or deliver negative feedback or expulsion from the group, not surprisingly, are better able to deliver than people who are not in such groups.
An example could be the U.S. Army, which talks about "Be all you can be". The whole point is, what "you are" is determined by what exogroups you belong to and are connected to in a tight feedback loop, not what is currently "under your skin" or "in your genes." The "epigenetic" component of YOU ( determinants outside your DNA genes) is not fixed, and is not limited in its effect to the period in which your "body" is developing inside your mother's "body". (How many people are there there while you're still attached by your umbilical cord? One? Two? Can either of you change without affecting the other?)
Similarly, a study just published by Robert Putnam has found that people who belong to a religious organization behave differently in terms of social activities than those who do not. The "belonging" has to be serious and intimate, not "is on the list of members of..." type membership.
And I think we all have personal experience that humans who are "parents" behave differently than people who are not parents, or than the very "same" people did before they were "parents".
So, since our health depends mostly, in the long run, on our behaviors, and our behaviors depend, mostly, in the long run, on the groups we are deeply embedded within, then we can conclude that the "health" of our "body" is determined, largely, by the strength of bidirectional connections and feedback to groups that have "good" effects on us. Hanging around with the wrong crowd WILL shorten our lifetimes and make us sick, in a very real sense. Hanging around with the right crowd WILL improve our lives, our resistance to infection, our recovery time from injury, our rate of getting cancer .... you name it.
This effect is well documented.
This effect is sizable -- For example members of the Church of Latter Day Saints (Mormons) in Utah have a life expectancy SEVEN YEARS longer than those who are not members. (ref?)
Even a single connection to a friend matters. Solid resarch studies have shown that, for a 65-year-old person in the USA, it has MORE positive impact on their health (and morbidity and mortality and resistance to infection) to make ONE FRIEND, than the combined effect of stopping drinking, stopping smoking, starting regular exercise, eating correctly, getting cholesterol under control, and a few other things. (ref?)
OK, so summarizing -- the single most important factor in the health of your "body" is the number of links and strength of links to other people and groups of people. The magnitude of this factor exceeds that of other medical and surgical interventions combined, for the population as a whole.
That said, let's reflect for a while on the last year's worth of debate on "health care" in the USA.
There was a great deal of conversation about "Insurance", and a lot of talk about "Electronic Health Records", and "access to care", and about people called "caregivers" who often didn't seem to have to actually care to be called that. These were people who provided the second-tier health interventions of drugs and surgery.
At the same time, there was essentially zero public conversation about the first-tier interventions of improving the number and strength of links that we each have to each other.
This disparity was not an "obvious" error, because everyone is operating under the framework, or lens, or glasses, or mental-model that our "health" is something located INSIDE OUR SKIN, not something located OUTSIDE OUR SKIN.
Once you see that we are pouring our health-care expenditure down the wrong black hole, you can see immediately why the general health of the American people has been getting worse and worse, "despite" the growth of the so called health-care industry. And you can see that attempting to pour even MORE dollars down that black hole will also not work. THAT is not where we're broken. THAT is not what needs to be FIXED.
I hate to play doomsday prophet, or "Sinners in the Hands of an Angry God" sermonized, but there is one thing that will definitely clear the deck of those with weak health systems, as surely as the autumn winds clear the trees of dead leaves, and that is the next pandemic plague that comes down the road.
There seems to be an argument in the above logic and data, I present for your consideration, that said pandemic will tend to remove from the planet those who rely on doctors and drugs for "health", and tend to preserve those who rely on deep friendships with each other and with religious groups of others instead. This effect does not required a god or God to make it work -- it is an effect of the actual effective shape of our bodies in a world filled with diffuse causal chains.
Research shows that cells removed from the human body simply die. They effectively commit suicide. Their very existence is dependent upon tight interactions with a larger "body" of cells. Also, if you take a cell and damage the DNA, so that the cell SHOULD by all rights die or become cancerous, often the cell will continue to happily function just fine, thank you, if it remains tightly bound to other healthy cells -- something called a "field effect."
I think the same thing, not just an analog, but a real biological process, is at work on the level of individual humans. People removed from all human contact simply die, although sometimes violently taking others with them. People in tight support groups can survive despite damage that would surely kill them if they had to make it without "a little help from my friends."
IN any case, these facts should illuminate national policy, and expenditures for "health care", far more than they have to date. It doesn't make sense to spend another trillion dollars on "Electronic Health Records" and "Insurance bureaucracies" before spending a substantially equivalent amount on improving the true determinants of health, thriving, well-being, and productivity -- our living links to each other.
Photo by the author, also on Flickr at
http://www.flickr.com/photos/24316765@N00/379155140/
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