The Future Age

The role of community design in promoting wellness at every age.

In this episode of The Future Age podcast, we explore the concept of designing longevity communities with guests Dr. Katharine Smart, a pediatrician and former President of the Canadian Medical Association, and Nick Buettner, VP of Community Engagement at Blue Zones.   
Katharine talks about how childhood experiences shape lifelong health, emphasizing the need for a shift in how we think about aging and its connection to early life. Key insights include the role of community design in promoting wellness at every age and how better support for young families can dramatically improve long-term health outcomes. Nick shares real-world examples of how policy, urban planning, and collaboration between sectors can create environments conducive to healthy, long-lived lives. For more information and a list of resources go to TheFutureAge.ca.

Resources: 
Connect: 

Chapters: 

(00:00:00) Introduction 
Host Zannat Reza introduces guests Dr. Katharine Smart, former President of the CMA, and Nick Buettner, VP at Blue Zones.   
(00:01:02) Health Across All Ages 
Essential environmental factors that promote thriving at all stages of life.
(00:02:49) Relational Health Initiatives 
Insights on programs like the Early Years Program to improve relational health in communities.
(00:04:01) Advocating for Relational Health Programs 
Steps to advocate for relational health programs in local communities.
(00:05:08) Funding for Child Well-being Programs 
The importance of government and philanthropic funding for early childhood programs.
(00:06:09) Canada and Children’s Well-being 
Canada’s ranking in child well-being and the need for prevention-focused investments.
(00:07:33) Countries Excelling in Child Well-being 
Countries like the Netherlands and Scandinavian nations that outperform in child well-being.
(00:08:34) Creating Supportive Environments 
Rethinking healthcare beyond sick care to include wellness care and urban planning.
(00:09:55) The Final Question: Katharine Smart 
Katharine shares the radical but realistic change she would make to improve society’s well-being.
(00:11:04) Lessons from Blue Zones 
Nine key factors found in Blue Zone communities that promote longevity.
(00:13:37) Creating Longevity Hotspots 
The role of policies in designing environments that promote long, healthy lives.
(00:15:14) Policies for Promoting Health and Wellness 
Policies that enhance public health through better infrastructure and access to healthy foods.
(00:16:44) Successful Marquee Projects 
Large-scale projects, such as a roundabout in Hawaii, that enhance community well-being.
(00:17:36) Obstacles to Implementing Longevity Initiatives 
The challenges in integrating health initiatives across sectors and ensuring sustainability.
(00:18:28) Steps for Designing Longevity Communities 
Partnerships with communities to create measurable strategies for long-term health improvement.
(00:19:25) Ingredients for Successful Blue Zone Projects 
Four essential elements for community-led longevity projects, from leadership to accountability.
(00:21:38) Challenges and Lessons Learned 
Lessons from failed initiatives, emphasizing the need for long-term commitment and readiness.
(00:22:40) The Final Question: Nick Buettner 
Nick shares the radical but realistic change she would make to improve society’s well-being.
(00:23:12) Conclusion 
  • (00:00) - Introduction
  • (01:02) - Health Across All Ages
  • (02:49) - Relational Health Initiatives
  • (04:01) - Advocating for Relational Health Programs
  • (05:08) - Funding for Child Well-being Programs
  • (06:09) - Canada and Children’s Well-being
  • (07:33) - Countries Excelling in Child Well-being
  • (08:34) - Creating Supportive Environments
  • (09:55) - The Final Question: Katharine Smart
  • (11:04) - Lessons from Blue Zones
  • (13:37) - Creating Longevity Hotspots
  • (15:14) - Policies for Promoting Health and Wellness
  • (16:44) - Successful Marquee Projects
  • (17:36) - Obstacles to Implementing Longevity Initiatives
  • (18:28) - Steps for Designing Longevity Communities
  • (19:25) - Ingredients for Successful Blue Zone Projects
  • (21:38) - Challenges and Lessons Learned
  • (22:40) - The Final Question: Nick Buettner
  • (23:12) - Conclusion

Creators & Guests

Host
Zannat Reza 🇨🇦
Future of Aging leader (SE Health) 🖖🏽 Storyteller 🎬 Impact network builder ✨ Aging2.0 Toronto Ambassador. 💫 Media expert
Guest
Dr. Katharine Smart
Past-President at Canadian Medical Association
Guest
Nick Buettner
VP of Product at Blue Zones

What is The Future Age?

We explore creative solutions and re-imagine what life as we get older can look like. Though we’re all getting older, this is about much more than our individual experiences. How can we influence the future of aging for all generations through policy, innovation and culture shift? For more information and a list of resources go to thefutureage.ca.

Zannat Reza: Blue zones are regions of the world that have the
highest concentration of people who live to a hundred and beyond.

If you've watched the Netflix docuseries, you know I'm talking about
Okinawa, Japan, Sardinia, Italy, and the Nicoya Peninsula in Costa Rica.

But what if I told you we can actually design these longevity communities?

I'm Zannat Reza, welcome to The Future Age podcast, where we explore
bold ideas and creative solutions in reimagining life as we get older.

In this episode, we dive into the lessons learned from the Blue Zones that can
potentially transform any community to one that promotes long, healthy lives.

We also delve into the radical idea that aging and longevity begins at birth, and that
your childhood experiences play a crucial role in predicting your health and well-being.

My special guests today are Nick Buettner, who is part of the
original research group that discovered the Blue Zones, and Dr.

Katharine Smart, a pediatrician and past president of the Canadian Medical Association.

Katharine starts off by explaining why we need to change our
mindset about the process of aging and what this means for Canada.

Katharine Smart: We tend to silo off stages of people's lives, right, and we sort of think
of infants and children as one age, young adults, older people, and then the elderly.

We've really got to start thinking about aging as
something that starts right at the beginning of life.

And I think if we can do that, we're going to come up with more
robust solutions that are going to lead to a healthier population and,
and people enjoying a higher quality of life in their older years.

Zannat Reza: So in terms of what could different look like, when we're
thinking a person's health, it's not just their individual actions.

It's also about the environment in which they live, work and play.

So in your opinion, what are those key elements that we
need in our environments to help people thrive at every age?

Katharine Smart: I think, you know, what we've maybe lost sight of a
little bit over time is sometimes the simple things are the most important.

And for infants and children, that really means relational health and adults
around them who are doing well, able to connect with them and make those, those
strong human connections that avoid childhood trauma or childhood adversity,
largely which is centered in negative experiences with the adults around them.

So I think the things where we could really make a big difference is how do we better support young
families to be able to connect with their children, to reduce the environmental stress around them.

What a lot of people don't understand is when bad things happen to you, it also changes your DNA
and your genetics, and it massively increases your risk of chronic disease in your physical body.

For a long time sort of thought about mental health and physical health as separate things, right?

But what we're realizing I think more and more is these two things are really connected.

And to really get a healthy physical body, we have to have a healthy emotional body.

And that starts really with young people.

Zannat Reza: I asked Katharine if she could share some examples of initiatives that
have helped improve relational health, or at least taken it into consideration.

Katharine Smart: So my clinical work is in the Yukon, and I've been very
fortunate to partner with lots of different groups there that care for kids.

And one of the really amazing programs is something called the Early Years Program.

And that's from the Martin Family Initiative.

What that program does is it goes into communities to really get to know the
community, both culturally, language wise, and it empowers women that are living
in those communities to actually work with children and families to support them.

So what they do is they go in and they, they start working with largely mums,
but also fathers, and their young children about how to make those connections.

And they do it in a culturally relevant way.

They're really getting to know the community, what things are important to them.

And then they design programming that allows families to really connect
and be able to be present and nurture their child's development.

What it does ensure is that every person in those communities who has young children has a place
where they can go, where they can develop their skills and become more confident in their parenting.

But also be supported personally so that they themselves are feeling more emotionally regulated,
more supported, more educated, and that creates those opportunities for relational health.

Zannat Reza: How do people advocate and try to get these types of programs in their community?

Katharine Smart: Yeah, that's an important question.

You know, I think a lot of it is, is first finding out what exists in your community.

You know, so for myself, like in my own experience, when I moved up to the Yukon seven years
ago, wanting to develop more of a child health program, that was kind of my first step was to
understand who's here and what are people already doing and what are, what are people wanting?

Because I think often the best work happens when you
can link people together and create those connections.

Sometimes things are already happening, sometimes there's pockets of expertise,
or you can find champions or people that really want to make something happen.

By connecting those people together, I think you get a lot
more momentum than when you're trying to do things on your own.

My advice to people would be do that environmental scan, go and just talk to
people, ask lots of questions, try to figure out, make sure you really understand
the problem you're trying to solve, uh, find out who agrees with you, um,
and then just, you know, start, start asking people, do you want to join in?

Um, and I think often when people see the shared purpose behind something,
they see the potential for impact, uh, that momentum can grow and you can
end up with a really powerful program that actually serves your community.

Zannat Reza: Even though bringing together like minded people
is what's needed, ultimately, it comes down to funding.

Katharine Smart: I think when it comes to things around children and
ensuring healthy futures, what we know is any money invested on that
end that's successful has a massive payoff on the other end, right?

So I think the danger of not deploying those government resources well for
young children is that we actually pay for it later, when people are unhealthy.

And that's kind of the system design we have right now.

So I think absolutely it behooves us to make sure that government
resources are adequately funding programs for young children and families.

But I also think there is a lot of philanthropy, a lot of non
governmental organizations, a lot of charitable dollars in this country
of people that are motivated to make a difference in their community.

And I think that can be harnessed and then also private business, right?

There's lots of corporations that want to invest and do good in the communities they live in.

And we see that in places we work as well, right?

Where there's those opportunities to reach out to those businesses and, and larger
corporations and say, hey, this is something important that we think you should be focused on.

Zannat Reza: Involving different sectors to address social
issues is a theme we've heard several times on this podcast.

I wondered how Canada is doing in investing in children's
wellbeing and setting them up to be healthy later in life.

Katharine Smart: When you look at Canada from a child well being perspective, we now
are ranking thirtieth out of thirty-eight comparable countries according to UNICEF.

The amount of GDP that's spent on children is half
what it is in the countries that are outperforming us.

So I think we are under invested in children and their future.

So I think that the problem when we're not thinking about prevention, which is again
easy to ignore because the payoff for prevention is much further down the road, right?

So if I'm a government what are the issues that are dramatic in front of me today?

What might get me reelected?

We also know the money we invest right now is, we're not going to
see that pay off necessarily, maybe for twenty or thirty years.

So when you're in a four year electoral cycle with lots of crises in front
of us right now, I think it can be hard for people to understand that
investing in prevention is what makes sense economically in the long term.

Naturally, what political parties want is to get the credit for the things that they do.

And, and no political party is really going to be able to get a big win off of prevention.

So again, I think that's where as citizens, we've got to be part of these dialogues.

We've got to be asking for different things from our governments
and we've got to be shifting the lens on what's important to us.

But it's not easy.

If it was easy, it would have been done already.

Zannat Reza: So you mentioned that we rank thirty out of
thirty-eight countries in child well being according to UNICEF.

Who's doing it better?

I mean, obviously there's twenty-nine other countries ahead of us, but who's number one, two, three?

What are they doing that we're not and what we should be?

Katharine Smart: Yeah, so not surprisingly, it's the
Scandinavian countries that are, are doing better.

Number one was the Netherlands.

They're investing more money in children and child well being.

A lot of these countries actually have programs with, embedded in
government where they actually look at legislation and government policy
from the perspective of children and whether it's benefiting children.

So they bring that child specific lens to public policy when they're making decisions.

So I think that can make a really big difference in
terms of, making sure those things don't get lost.

They have coordinated national strategies around child
and youth health, which we do not have in Canada.

So again, you know, it's hard to get somewhere if you're
not planning and you don't know where you're going.

I think it's quite shocking that Canada doesn't have a national child health strategy.

You know, how is that?

But many of these countries do have that.

Zannat Reza: So even though Canada doesn't have a much needed national child health strategy, I was
curious about the role of health care in creating environments that support well being for all ages.

Katharine Smart: I think this is always what's so interesting when we talk
about health care or health and care, you know, what do we mean, right?

I think in Canada, what we often are talking about is our illness system,
which is you're sick, you go to a hospital, you're sick, you go to the doctor.

And is there a role for healthcare professionals and
providers to be more involved on that wellness side?

And I mean, obviously, I think we need both things.

Of course, people need sick care, but I do think we
also need a lot more wellness care and prevention.

And I think, to me, part of what we should be doing when we're talking
about urban planning, that is also an opportunity, I think, to reimagine
a little bit about what the healthcare system looks like, right?

And there's lots of opportunities from partnership from there, right?

How do we build out urban planning around that?

How do we create social interaction opportunities for people?

How do we create spaces, perhaps, for seniors to interact with children
and, and, and green spaces and, and different things all around that?

But right now, you know, we don't have that at all.

In fact, we have the opposite of that.

And so I think, when we think about where, where do we want health care to be
situated, we also have to re imagine what do we mean when we're talking about
health care and what is it that we want every Canadian to be able to expect.

And how can we put some pressure on government to create some accountability
to make sure that that's the infrastructure that's being delivered to citizens.

Zannat Reza: So my final question, Katharine, is a question that we ask all our guests.

If you could wave a magic wand and make one radical but realistic
change to improve our society's well being, what would it be?

Katharine Smart: I love that we're putting together radical and realistic.

So how radical do I get to be?

I think if I could have one thing, it would be that every family, when they were,
you know, expecting a child, whether it was through, you know, their own pregnancy
or through adoption, had that opportunity to connect with early childhood support.

So that right from the beginning, someone was coming to their home, was supporting
them around their own wellness, making sure that mum and mum, or dad and dad, or
dad and mum are, you know, optimized in terms of, of their own health and wellness.

And getting those really early lessons about connecting with their child, infant mental
health, about their own emotional regulation, the importance of co regulation with their child.

So they could really launch into those early years together, feeling their best selves.

I think something like that, that was universal could really
help to change people's experiences right from the start.

Zannat Reza: Building on Katharine's perspective on looking at our health and well being from
a holistic lens, I spoke with Nick Buettner, VP of Community Engagement at the Blue Zones.

For over two decades, Nick has gathered valuable insights and is
applying these lessons to design longevity communities by focusing on
changes to the local environment, public policy, and social networks.

This is similar to Singapore, where the government took a proactive approach
to create a unique longevity hotspot, what could be called Blue Zones 2.0.

Nick shared the commonalities that the places around the world all have that lead to longevity.

Nick Buettner: My brother Dan and I started in 1999, traveled the
world, and we found the five demographically confirmed places.

And it wasn't just us.

We went there with physicians that were doing physicals on the individuals.

We went through demographers that were combing through
birth and death records in schools of public health.

That together, what they were able to do was really kind of reverse engineer a recipe for longevity.

And what we found were nine things that all of these blue zone communities had in common.

Um, number one is they move naturally.

They walk to school, they walk to their friend's house.

When you look at their kitchens, they were deconvenienced.

So, if you live in Costa Rica, they don't have food processors, they use matates to do the corn.

You know, instead of hiring somebody to mow the lawn, I met this
woman, a hundred and four years old, mowed her lawn with a machete.

The second one was they had the right outlook on life.

They had a strong sense of purpose that they could articulate, whether you're twenty or a hundred,
they could articulate their sense of purpose, which adds seven and a half years to longevity.

Third one is they had less stress in their life.

Well, they didn't have less stress.

They have the same stress that we have.

But they had techniques to set up to reduce the inflammation that's tied to stress.

That's also linked to most age related diseases.

Meditation, walking with a friend, taking a little nap, a little rest in the middle of the day.

Those are simple things.

They had a healthier diet, a lower caloric intake.

They had a little bit of wine in their diet.

But it also was how they came together as friends.

The foundation that holds everything up is social.

They prioritize family, love, marriage, and their kids.

They had a strong sense of faith, and the last thing is our friends matter.

According to the Framingham study, if your three best friends smoke or drink too much
or are overweight, there's a one hundred and fifty percent chance that you do too.

A lot of listeners are going, you know what, I gotta get rid of these friends because
they're not good for me, but you also need to remember you need those friends that when
you're having a bad day, you can pick up the phone and call them, and they'll listen.

Zannat Reza: While this illustrates some of the key factors to a
healthy life, what policies are needed to engineer longevity hotspots?

Nick Buettner: The places and the environments where you work, live, play, and pray,
and the policies, cultures, and social norms in the communities you live in are
bigger determinants of our longevity than even our relationship with our doctors.

We look at policies in four different areas.

Built environment, you know, right now in the world today,
we are afraid to allow our kids to walk and bike to school.

We are under investing in parks around safety or activating them so there are
places that free range kids can go and play and parents trust that they'll be okay.

We build car centric societies versus building for pedestrians and walking and movement.

Um, when we look at food systems in our community, there are policies
that can be passed that actually support creating a healthier, more
access to food systems, no matter what your socioeconomic status is.

And then what are those things that draw addiction like tobacco and alcohol?

And can we make it just a little bit tougher for our kids to start that
addiction and a little bit easier for us to wane off of it as individuals.

So we work with municipalities to not come in and say, this is what you need to do.

But we work with them to leverage the strengths that they're already doing in the community,
to understand where are those opportunities to improve those four different areas.

Not only pass policies, but actually system wide set it up so
that it ensures that those policies are actually being enforced.

Zannat Reza: So when you say you're doing a deeper dive, looking at
policies, working with municipalities, can you give me an example of a
specific policy that could help drive health and wellness in communities?

Nick Buettner: Sure.

So as you're looking at designing your streets, you're designing it
in ways that not only think about the car, but also the pedestrian.

How are we designing, ensuring that there are sidewalks, ensuring that
there's space for cyclists to be able to share the roads with cars.

When you look at the distance of how far you have to walk across the street, for some
kids or some older pedestrians, it's a little bit more challenging for them to, to
walk the length so you can do bump outs that will shorten or put medians in the center.

It could be looking at better access.

One of the things that we did is we worked with a food
desert inside of one of the under invested communities.

And we worked with a convenience store to not only be able to provide fresh fruits
and vegetables at that location, but we worked with the city council to pass policies
that made it actually possible for them to easily be able to work with farmers and
easily be able to work with partners to create better access around healthy foods.

And then we do big marquee projects in communities.

These are examples of projects that help the community think
different around what's possible inside of those communities.

Really do something that, that aligns with that policy.

Zannat Reza: Can you give me an example of some of these marquee projects, in
the context of, you know, a notable success story that you've been involved in?

Nick Buettner: In Hawaii, for example, we partnered with the Department of Transportation.

We partnered with the governor's office, with the mayor of Maui, with the
schools, because there was a school nearby that pretty much made it impossible,
A, to, kids to be able to get to school safely by using active transportation.

But it also was a, was an issue around accidents and traffic
congestion that made it hard to even drop off kids at school.

What they selected is a roundabout nearby that school.

And the success was not only around a reduction in accidents and increase
in safety, but kids started using active transportation, whether it be
through walking school buses, to be able to get to school in that location.

Zannat Reza: Sometimes, simple solutions are all that's needed.

Things like reducing speed limits, improving bike lanes,
and enhancing trail access and signage in downtown areas.

But what are some of the obstacles to bringing these to life?

Nick Buettner: When you look at Blue Zones, a lot of this sounds easy, but it's integration
of this, and food systems, and your workforce, and your schools, and your individuals,
and bringing everything together, because right now, everything tends to be siloed.

One of the other challenges is understanding resources.

How are you ensuring that the planning and the things that you're
doing have the long term resources to be able to be sustainable?

And then the third thing is, how are you ensuring that the people that are going to be
using these, not only understand the value and what it's been doing, but they're using it.

Zannat Reza: I was curious about the steps needed to design
longevity communities using lessons from the Blue Zones.

Nick Buettner: We do, in a Blue Zone project, for the first nine months, we'll put together a plan.

That plan is rooted in measurement.

Partner with Gallup to oversample the community on five domains of health, develop
steering committees, develop local leadership teams that are already doing this work.

So they're integrated.

It's not replacing anything, but it's under, putting the puzzle together.

It's understanding from community indicators what really matters to you and your community.

It could be childhood obesity.

For example, or graduation rates, is it mental health?

And those go into the blueprint.

And then you go through each different sector that we talk about and we
develop strategies, in partnership with the community, but they're measurable.

They have SMART goals, and they have process, progress, and outcome measurements linked to them.

Zannat Reza: You mentioned a lot of the work that you're doing is community led.

So who is reaching out to you, is my question.

And are municipalities the key to making all this work?

What advice do you have for a listener who's interested
in promoting well being in their own communities?

Nick Buettner: There's four things that you need to be successful for a Blue Zone project.

And I think this is important for your listeners.

People are thinking, hey, we want to do this.

Is number one, you need a plurality of leaders in
your community to come together on a common vision.

What is the need?

What's the why?

The second thing you need is the right resource, both human and economic.

You need expertise in a plan that's rooted in science, that's
evidence based, around the strategies that you're going to do.

You need the accountability.

The accountability for people to do what they say they're going to do and to measure it.

And to, and when they're measuring it, be honest when
things aren't working and to subtly adapt those strategies.

Zannat Reza: Yeah, I got to say, I love everything that you're saying.

So, my background's in public health, and I often think people look at the individual
and say, well, why aren't you doing X, Y, or Z without looking at the whole environment.

And what you're talking about, partnerships, uh, bringing people
together who have a common vision, reminds me of the concept of Impact
Networks, which we talked about in episode five with David Ehrlichman.

And I love this whole point of, you know, it's more about
collaboration versus competition and what's that, uh, common vision.

And then who are the key partners, including people who are affected
by the issue, how do we bring them together to achieve this vision?

Nick Buettner: I think outcomes align us.

They align us because if I'm a, a local restaurant and you're asking me
to start putting plant based things on the menu and they're not selling?

How long am I going to keep on doing that?

Large employers, I have, I have shareholders that I'm responsible to.

If well being isn't creating an ROI or at a community level, if it's not creating
an ROI and it's suspending, unfortunately it's not going to be sustainable.

So you have to be able to tell that story of impact and be accountable to that.

Zannat Reza: So I love what you've said about stories of impact, stories
of success, but can you share with us stories of, I don't want to say
failure, but where things got started, but then there's all these obstacles?

Nick Buettner: When you look at some of the failures that we've had, is we learned really
early on that if we tried to work with the community and it was a one year plan, it would fail.

That there has to be a deeper rooted foundation in our work to create that sustainability.

So that's why these are three, five, ten year missions.

We learned a lot about how do we work with communities to develop readiness.

Because we've, again, to your point, if you don't have that right
readiness, now all of a sudden you get an election, or a new CEO comes in,
or another strategy comes in, this all of a sudden goes to the wasteland.

We learned around policy that on the back end, if you can pass policies, but if you
don't do the marquee project along with it, sometimes those policies just sit on a desk.

And they're not really actually activated.

Zannat Reza: Here's a question we ask every guest, which is if you could wave a magic wand and
make one radical but realistic change to improve our society's well being, what would it be?

Nick Buettner: I would wave a magic wand to create an environment.

An environment where that healthy choice is just a little bit easier for us.

Because right now there's just the environment around us just makes it so hard for us to be healthy.

So how can we wave that wand to create an environment
where that healthy choice is just a little bit easier.

Zannat Reza: A big thank you to Nick Buettner and Katharine Smart for highlighting the
opportunities and challenges we face when it comes to engineering blue zones of our own.

And for helping us understand that our childhood experiences
predict our health and well being as we get older.

Thanks for joining us for this episode.

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