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 have remained remarkable to this day.
In the survey, the population chose the dangers they believed could be harmful to our health. They listed them in descending order: Toxic waste, asbestos, side effects of strong medicines, car exhaust fumes, drinking water pollution, AIDS and nuclear power plants.
Experts from science and technology assessed the risks differently and still do today. For them, the tar and nicotine vapour from cigarettes represents the greatest health risk at 81 percent. 71 percent stated that people do not get enough exercise. 58 percent pointed out that alcohol is a poison. At 42 percent, “fat” and overweight are 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. That’s how it reads in the opening credits: “The book wants to encourage women to do something for themselves - for a healthy, beautiful body, for serenity and self-confidence. The book aims to encourage them to lead 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.” Today we have to choose this language to attract many readers. Self-confidence, fun, a holistic self-esteem - 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. With all the fundamental approval of this book and its positive attitude to life, I would like to add two thoughtful questions.
First question: The “healthy, beautiful body” - does this memorable and superficial equation exhaust our concept of health? Is that 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 for the more humane demand of the World Health Organization (WHO): “Health for all?
The WHO lists seven basic conditions for health:
1. a stable self-esteem 2. a positive relationship to one’s own body 3. friendship and social relations 4. an intact environment 5. meaningful work and healthy working conditions 6. health knowledge and access to health care 7. a present worth living and a well-founded hope for a future worth living.
What threatens our health today, endangers our body, our spirit and our soul? What overwhelms us?
Overstimulation often determines our lives, haste and restlessness, anger and aggression, lack of exercise and noise, mass traffic and spatial narrowness. We like to see ourselves in the doer’s role who masters the technology and uses the new media self-confidently. But much more often we are subject to the apparatus we have created ourselves. Pressure to perform is everywhere. It has pupils and sportsmen, car drivers and working persons, self-employed persons and employees under control. Leisure time, holidays and pleasure are also determined by stress, which tugs at our strength and nerves.
Where can we start if we want to build up a counterweight to the “syndrome of the overloaded person” within ourselves? Perhaps by trying to stabilize our self-esteem. Professor Siegrist writes: “According to current knowledge, a stable self-esteem is an important prerequisite for dealing well with stress, conflict and emotional tension. If the social environment hinders the development or stabilization of self-esteem, this limits tolerance of stress. Crises then unfold their shocking power to the full, and susceptibility to disease increases.”
We should take countermeasures. With proven and new relaxation techniques we have the possibility to counteract stress, fear and depression and thus strengthen our immune system. The abundance of the offer is overwhelming. Those who have lost the overview can concentrate on the programmes that have been attracting the increasing interest of psychologists and brain researchers for some years now. I will mention two examples that are in focus: mindfulness training (MBSR) and tapping (EFT). Based on my good experience, I can recommend these methods to others. Google and YouTube provide a lot of descriptive information.
Eventually we will have to ask ourselves what our life plan looks like. If we recognize what makes us sick, it is possible to recognize what keeps us healthy. Aren’t corrections overdue? Where should we start when the pressure of suffering is increasing? Above all, we should no longer take part in everything that others - contrary to our inner convictions - expect of us. We should learn to say “no” to things we find unreasonable, in a friendly but definitive way. Also to the things we force upon ourselves without necessity. We should develop into “tolerant egoists” in an acceptable sense. It is possible that our family, our friends and acquaintances, our superiors and professional colleagues may find such a change in values more attractive in the longer term than a well-adapted, compliant participation. If not, we should tell them about our changed attitudes. I like to quote this sentence: “If we want to be satisfied, nobody can prevent that. If we recognize that our expectations and demands are responsible for our satisfaction, we can change those expectations - if we are ready.
We are all subject to the constant balancing act between success and failure - nobody is immune. Even if it looks like a contradiction: We need this game with risk like the air we breathe. Not because the thrill thrills us, 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 you didn’t 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 lead a conscious life “here and now”.
Our best health protection seems to be to learn to deal with conflicts and tensions in such a way that we do not become paralyzed by them, but grow from them. This includes feeling at home somewhere, recognising a meaning in life and developing personal perspectives. We have trust, cultivate relationships and can feel joy. We dare to do something and are grateful for the whole range of our emotions. Rage and envy and fear and sadness are part of it, but also love, sympathy 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 daily stress for others without realizing 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 the responsibility for our own health, the responsibility for the health of our fellow human beings and the 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 classic topics that aim at a healthy lifestyle, such as healthy nutrition, prevention of cardiovascular diseases, moderate use of stimulants. We learn to recognize and change living conditions that damage our health. We learn to perceive the interaction between body, mind and soul and gain decision-making competence for our health.
The second goal of health promotion is to take responsibility for the health of others. What does this look like in practice? Nobody wants to endanger or harm their fellow citizens by reckless behaviour on the streets - which of us would not have done this already? Nobody wants the stronger to harm the weaker, overtax him and exert physical or psychological pressure - but we know many examples of where it happens and we do not intervene.
Reports of violence against the defenceless in all its terrible forms horrify us. But are we fighting hard to ensure that this cannot happen 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 understand 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? Let us make our own personal contribution to freeing people from a vicious circle that makes suicide the only way out. Who would deny that all these questions have anything 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. In the coming years, this issue will concern us, whether we want to take it on. In “global” issues such as environmental or peace policy or a just world order, we should refrain from using a whitewash optimistic about the purpose 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 is true of the area we know and are responsible for.
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 arouse interest with patience and persuasiveness. But the consequences of correct knowledge and good intentions alone are not enough. Knowledge is not synonymous with action, action is not synonymous with stabilised behavioural change. We have to deal with this problem if we want to influence our own health behaviour and that of our fellow human beings.
In recent years it has become clear it makes little sense to define a certain - meaningful - preventive message (“smoking kills”) and to publish it with the help of well-known advertising media. With this procedure, we can fool ourselves into believing that we have done enough. But we achieve little with it - at least if we only use this method. Things are more complex. From behavioural research and our own experience we know that the strongest motivation in human behaviour does not result from rational considerations, but from emotional impulses. Let us draw conclusions from this insight.
Let us say goodbye to the thousandfold failed attempt to achieve a stabilized, changed health behavior solely by information mediation. We must also say goodbye to the attempt to achieve something positive by describing only the dark consequences of a wrong lifestyle. And 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 inevitable even when 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 have committed themselves to the good task of promoting their own health and the health of their fellow human beings live in constant danger of being disappointed and resigned. It reduces the danger if we accept a realistic picture of humanity and achievable goals. So from time to time let us take a self-critical look over our shoulders. Our own enthusiasm, our own efficiency, our own health successes can tempt us to overtax our partners seeking advice. Instead, we must offer achievable milestones and thus a personal help. Our partners in health promotion must not become victims of our own tense goals and expectations. We make the sacrifice ourselves. It can be disappointment, resignation and abandonment. The 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 multisectoral approaches are important to shed light on the social and psychological backgrounds of health-relevant behaviour. We must not forget the importance we attach to dealing with conflicts, our personal and social fear, our fear of exclusion and discrimination. We must not underestimate the impact of prestige and group 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 takes into account the social environment and tailors it to the individual and his living conditions. Anyone who has recognised that health promotion means teamwork also understands that no specialist group alone holds the “philosopher’s stone” in its hands. Openness, diversity of opinion and tolerance are in demand in the discussion about the goals and contents of joint work. We need a responsibility for health that includes everyone. That keeps us healthy.