In 1994, the German GEO magazine published a representative survey: “What keeps us healthy, what harms our health? Where are the dangers?” Most of the answers to these questions surprised at the time and remain remarkable to this day.
In the survey, the population chose the dangers that they believed could harm our health. They listed them in descending order: Toxic waste, asbestos, side effects of powerful drugs, car exhaust, drinking water contamination, AIDS and nuclear power plants.
Experts from science and technology assessed the risks and still do. For them, tar and nicotine fumes from cigarettes pose the greatest health risk at 81 percent. 71 percent said that people do not get enough exercise. 58 percent recalled that alcohol is poison. At 42 percent, “fat” and obesity seem to be far more dangerous than asbestos, toxic waste, or the dangers of nuclear energy.
It seems difficult to agree on “health risks”. Do we at least know what makes us healthy?
Karin Felix could help us answer the question. She wrote a bestseller called “Fitness and Health” a long time ago. Here’s how it reads in the credits:
“The book wants to inspire women to do something for themselves - for a healthy, beautiful body, for serenity and self-confidence. The book wants to inspire them to live an active, relaxed life. Every woman can choose what she likes from the variety of possibilities. Because an all-round good self-esteem is not a question of age or fitness.” We need to choose this language today to attract many readers. Self-confidence, fun, an all-round sense of self-worth - such concepts capture the zeitgeist. Health as a central component of quality of life: this message sounds good and is clear. It is no mistake to answer health questions in this way. For all my basic approval of this book and its positive approach to life, I would like to add two thoughtful questions.
First question: The “healthy, beautiful body” - does this superficial equation exhaust our concept of health? Is this what keeps us healthy?
Second question: Can I call my goal “health for me”? Health for me alone, for my beloved self? Or do I take sides with the more humane demand of the World Health Organisation (WHO): “Health for all?”
The WHO lists seven basic conditions for health:
1. a stable sense of self-worth
2. a positive relationship with one’s own body
3. friendship and social relationships
4. an intact environment
5. meaningful work and healthy working conditions
6. health knowledge and access to health care
7. a livable present and a well-founded hope for a livable future.
What threatens our health today, endangers our body, our mind and our soul, overwhelms us?
Our lives often must cope with over-stimulation, hurry and restlessness, anger and aggression, lack of movement and noise, mass traffic and spatial confinement. We like to see ourselves in the doer's role, mastering technology and using the new media. But much more often we are subjects of the apparatus we ourselves have created. Pressure to perform is everywhere. It has students and athletes, drivers and professionals, the self-employed and employees in its grip. Even in leisure time, holidays and pleasure stress dominate, which tugs at our strength and nerves.
Where can we start if we want to build a counterbalance to the “syndrome of the overloaded person,” within us? Perhaps by trying to stabilise our self-esteem. Professor Siegrist writes about this: “According to current knowledge, a stable self-esteem is an important prerequisite for dealing well with stress, conflicts and emotional tensions. If the social environment hinders the development or stabilisation of self-esteem, this limits tolerance to stress. Crises then unleash their shocking power to the fullest, and susceptibility to illness increases.”
We should take countermeasures. With proven and new relaxation techniques, we counteract stress, anxiety, depression and thus strengthen our defences. The abundance of offers is overwhelming. Those who have lost the overview can first concentrate on the programmes that have been attracting the increasing interest of psychologists and brain researchers for some years. I will mention two examples that are in the focus: mindfulness training (MBSR) and the so-called “tapping” (EFT). Based on my own pleasant experiences, I like to recommend these methods. Google and YouTube provide a lot of descriptive information on this.
We ask ourselves what our life plan is. If we recognise what makes us ill, it is possible to recognise what keeps us healthy. Aren’t corrections overdue? Where should we start when the pressure of suffering gets out of hand? Above all, we should stop taking part in everything that others - contrary to our inner convictions - expect of us. We should learn to say “no” to things feeling are unreasonable, in a friendly but definitive way. Also to the things we impose on ourselves without necessity. We should develop into “tolerant egoists” in the acceptable sense. It is possible that our family, friends and acquaintances, even our superiors and professional colleagues will find such a change in values more attractive in the longer term than well-adjusted, compliant participation. If not, we should tell them about our changed attitudes. I like to quote this sentence: If we will change, no one can prevent it. If we realise that our expectations and demands handle our satisfaction, we can change these expectations - if we will do so.
We are all subject to the constant balancing act between success and failure - no one is immune. Even if it looks like a contradiction: We need this game with risk, like the air we breathe. Less because thrill addicts, but because every risk offers tangible opportunities.
The more difficult the challenges, the more satisfying it becomes to have overcome fear and uncertainty. Pride in an achievement that one did not dare to do before means a valuable gain in mental health. Good prevention does not wrap people and their problems in cotton wool, but encourages them to live “here and now”.
Our best protection of health seems to learn to deal with conflicts and tensions in such a way that they do not paralyse us, but grow from them. This includes feel at home somewhere, making sense of life and developing personal perspectives. We have confidence, cultivate relationships and can feel joy. We dare to do something and use the full range of our emotions. Anger and envy and fear and sadness are part of it, but so are love, compassion and sensual joy. It is all part of being human.
Let us also remember that it is not only our fellow human beings who cause us stress. We ourselves can cause stress to others daily without realising it. This insight enables us to change our attitude from selfish to empathic. In this way, we improve our own health and can promote the health of others. This means taking responsibility in three ways. It is about responsibility for one’s own health, responsibility for the health of fellow human beings and responsibility for the living conditions on our planet and thus for the life chances of future generations.
The first goal - responsibility for one’s own health - is obvious. Here we find the classical topics aiming at a healthy lifestyle, such as healthy nutrition, prevention of cardiovascular diseases, moderate use of stimulants. We learn to recognise and change life circumstances that damage our health. We learn to perceive the interaction between body, mind and soul. We gain decision-making competence for our health.
Under the second goal of health promotion, we understand the responsibility for the health of other people. What does this look like in practice? No one wants to endanger or harm fellow citizens through reckless behaviour on the roads - who among us has not done that? No one wants the stronger to harm the weaker, to overburden them and to exert physical or psychological pressure - yet we know many examples of where it happens and we do not intervene.
We react appalled and stunned to reports of violence against the defenceless in all its horrific variations. But do we fight with all our might to prevent such things from happening again? We must also ask ourselves the following question: Do we help our fellow human beings to cope with their life problems, do we give them social support? Do we have understanding for the elderly, the disabled and the sick?
How do we deal with the incurable cancer patients in our neighbourhood? Do we support and stabilise the addicted young people in our circle of acquaintances? Do we make our own personal contribution to freeing people from a vicious circle that makes suicide seem like the only way out?
Who would deny that all these questions have something to do with health? Who would deny that we can and must do more than just take care of our own health?
A third goal of health promotion is to take responsibility for the living conditions in this world and thus for the life chances of future generations. This topic will occupy us more and more in the coming years, whether we want to perceive it. For “global” issues such as environmental or peace policy or a just world order, we should refrain from optimistic whitewashing and discouragement and resignation. Let us rely on the principle of hope without losing touch with reality. Let us trust in an active and impatient hope that seeks every opportunity to act within the bounds of possibility. This applies above all to the known and manageable area in our responsibility.
According to a study by the University of Bielefeld, 61 percent of young people in our country see their future threatened by environmental destruction. This figure proves it is possible to change attitudes and to arouse interest with patience and persuasion. But the consequences of correct knowledge and good intention alone are not enough. Knowledge is not synonymous with action, action is not synonymous with stabilised behaviour change. We need to address this issue if we want to influence our own health behaviour and that of those around us.
In recent years it has become clear that it makes little sense on its own to define a specific - meaningful - preventive message (“smoking kills”) and publicise it with the help of well-known advertising media. With this procedure we can fool ourselves that we have done enough. But we achieve little with it - at least if we only use this method. Things are more complex.
We know from behavioural research and from our own experience that the strongest motivation in human behaviour does not result from rational considerations but from emotional impulses. Let us draw conclusions from this realisation.
We should say goodbye to the attempt which has failed a thousand times over, to achieve stabilised, changed health behaviour through giving information alone. We also have to say goodbye to the attempt to achieve something positive by only describing the dark consequences of a wrong lifestyle. Instead, we should focus more on the possibilities of discussion and group work. We should try to convince through our personality, our openness and - if available - our own positive health behaviour. Disappointment and failure in health promotion are also inevitable if we see our counterpart as an object but not as an equal, self-determined, mature partner who has as much to give us as we give him.
Those who contribute to the excellent work of promoting their own health and the health of those around them live in constant danger of disappointment and resignation. It reduces the danger if we adopt a realistic picture of humanity and achievable goals. So let us take a self-critical look over our shoulders from time to time. Our own enthusiasm, our own performance, our own health successes can tempt us to overextend our advice-seeking partners. We need to offer achievable milestones and thus personalised help. We must not make our health promotion partners the victims of our own high-tension goals and expectations. Doing so, we make the sacrifice ourselves. It can be disappointment, resignation and abandonment. Awareness of reality becomes our important protection.
Today there are people in medicine and health promotion, in education and the social sector, in politics and the media who understand the signs of the times and think and act in partnership. Teamwork and multi-sectoral approaches are important to shed light on social and psychological backgrounds of health-related behaviours. We must not forget the importance we attach to dealing with conflict, our personal and social anxiety, our fear of exclusion and discrimination. We must not underestimate the impact of prestige and peer pressure on our health behaviour. Let us also pay attention to the power of the media and advertising.
Health promotion is only effective if it influences behaviour and circumstances, if it considers the social environment and tailors it to the individual and his or her living conditions.
Those who have realised that health promotion means teamwork also understand that no specialist group alone holds the “philosopher’s stone”. They need openness, diversity of opinion, and tolerance in the discussion about the goals and contents of the joint work. And they need a responsibility for health that includes everyone. That keeps us healthy.