Hello Warriors! I’ve had a lot to say this past year about how those of us in the wellness arena can gatekeep. There are loads of landmines and if you’d like to read from the beginning, you can start here. Sometimes, though, those of us practicing are forced to work within a larger system that gatekeeps. So today I’d like to wrap up this series with a look at access.

My main messages for this series have been directed at two different groups. For us practitioners, we need to do better. Full stop. For those of you looking for advice or to purchase programs/products, be aware. Be aware of these practices, the shady and the predatory. Learn to recognize fear tactics and shame-based sales techniques.

But depending on where you live, having access to necessary care and programs may be the biggest obstacle. Long time readers might remember that I kicked off last year’s series on the Dimensions of Wellness with a discussion about the Blue Zones. Netflix has a documentary about the Blue Zones that I highly recommend you watch. And while I believe that there is a lot we can learn from the Blue Zones, the documentary missed two big factors about wellness and longevity.

Genetics

The first of these is genetics. All five of the current Blue Zones are genetically homogenous. Okinawa, Ikaria, and Sardinia are all island communities. Nicoya, Costa Rica is on a peninsula. From an historical perspective, these were traditionally places that were difficult to get to and from meaning that there wasn’t much intermixing of the population. The Seventh Day Adventists have a strong community in Loma Linda, which creates situations where one is more likely to stay.

Just as it is more likely that one may develop cancer if there is a strong family history, the reverse is also true. If you have a genetic disposition towards longevity, you have a much higher chance of living a long life, too. For individuals living in the Blue Zones, eating a plant based diet simply enhances the strong genetics they may already have.

For those of us living where the whims of history have created a more heterogeneous genetic basis, eating plant based is a way to try and bio-hack our genetics. A term that is used in the documentary but not really explained for what it is: a way of influencing how our genes are expressed. You may have a family history of high blood pressure, but if you consume a low salt diet, you may “turn off” that gene expression for yourself and never experience that condition.

Suffice it to say that genetics is the strongest single factor predictor of health, health outcomes and longevity through the aging process. And one that we truthfully have very little influence over.

Access

The second factor that the documentary series failed to appropriately convey is access. I say appropriately because (spoiler alert) the last installment does talk about efforts in Singapore and several US cities. The discussion on access, though, focuses on green spaces, walking paths, and the like. What it misses is access to affordable health care and food.

It is a glaring omission. Every single one of the current Blue Zones is located in an area where access to affordable health care is readily available. Ikaria, Sardinia, Nicoya, and Okinawa all exist in countries that have a government mandated single payer health care system. The four countries have four very different systems, but the basics are the same: if you are citizen of said country, you have access to health care.

The Seventh Day Adventists in Loma Linda believe in caring for the body, mind, and spirit as part of the work of Jesus. Religious implications aside, Loma Linda is home to one of the top hospitals in the country. This particular private hospital is dedicated to caring for the community, including those who cannot pay, and offers tons of outreach programs in addition to easy access and scheduling of appointments for plenty of specialty practices.

Do you know, reader, what the second biggest predictor of health, health outcomes, and longevity is? Social status or class. Not your body weight or BMI (thanks for spreading those lies Diet Culture), not how much or what type of exercise you engage in, not how much you pray or practice your spirituality or how much you journal. How much money you and your family make.

Here is a rabbit hole of research, if you are so inclined. The UK takes this a step further and concludes that if access is impaired due to geography, gender, identity, ethnicity, religion, or race it can have the same results as social status. The Blue Zones have mandated and normalized easy and affordable access to health care for citizens, making it much easier to live a long life.

What We Can Do

And I know you are going to tell me, but there are things we can do, Melissa. Yes, there are, and I believe wholeheartedly in them. But I refer you to my previous comments about bio-hacking our genetics. I also want to point out, as I have throughout this entire series, these bio-hacks require access in and of themselves. Usually in the form of time and money that many individuals don’t have. In fact, this study found that self-mitigating will only partially close the health outcomes gap between high and lower income individuals.

My point is not that we shouldn’t be focused on daily movement and eating more plants. Again, as I have taken huge pains to point out, there are tons of different ways to do those things. My point is that the Blue Zones exist under conditions where the onus of access isn’t placed on the consumer. This inclusive access indicates that the powers that be value health and wellness and are choosing to be part of the solution.

Overturning systemic barriers to access is not something that one person can do, either for themselves or for a larger group. But the fact remains that the US lags behind in so many measures of health and longevity because we have an access problem. We spend more on health care and experience worse outcomes than other countries in the world. Our life expectancy is lower and, for the first time in a hundred years, it has decreased. We also die from avoidable reasons more often.

Preventative care is critical in catching things early, but if you don’t have insurance coverage, have other financial restrictions, or feel discriminated against, seeking care can be intimidating. This article has some useful tips, especially if finances are the hold up. If discrimination is the barrier, rely on your network. Whether it is the LGBTQA+ community, friends at your place of worship, or a discussion at a local society center, people who identify similarly can be a great source of referrals for caring practitioners.

In the meantime, let’s remember that society’s overall health is a reflection of how we perceive other’s value. In the US we dictate access with our votes, so on this Election Day make it count. For all of us.

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