Bill Davenhall: Your health depends on where you live

Translator: Naida Husanović Reviewer: Mateja Nenadovic

Can geographic information

Mogu li vas geografske informacije

make you healthy?

načiniti zdravim?

In 2001 I got hit by a train.

2001. mene je udario voz.

My train was a heart attack.

Moj voz je bio srčani udar.

I found myself in a hospital

Našao sam se u bolnici

in an intensive-care ward,

na odjelu intenzivne njege,

recuperating from emergency surgery.

oporavljajući se od hitne operacije.

And I suddenly realized something:

I iznenada sam shvatio:

that I was completely in the dark.

bio sam u potpunosti neinformisan.

I started asking my questions, "Well, why me?"

Počeo sam postavljati svoja pitanja, ''Pa, zašto ja?''

"Why now?" "Why here?"

''Zašto sada?'' ''Zašto ovdje?''

"Could my doctor have warned me?"

''Da li me je moj doktor mogao upozoriti?''

So, what I want to do here in the few minutes I have with you

Zato, ono što ja želim uraditi u par minuta koje imam sa vama

is really talk about what is the formula for life and good health.

jeste da govorim o formuli za život i dobro zdravlje.

Genetics, lifestyle and environment.

Genetika, stil življenja i okruženje.

That's going to sort of contain our risks,

U njima će se, na neki način, sadržavati naši rizici

and if we manage those risks

i ako mi kontrolišemo te rizike

we're going to live a good life and a good healthy life.

imat ćemo dobar i veoma zdrav život.

Well, I understand the genetics and lifestyle part.

Naime, ja se razumijem u dio koji se odnosi na genetiku i način življenja.

And you know why I understand that?

I znate li zašto se u to razumijem?

Because my physicians constantly

Zato što su mi moji doktori konstantno

ask me questions about this.

postavljali pitanja o tome.

Have you ever had to fill out those long,

Da li ste ikada morali popopunjavati one duge

legal-size forms in your doctor's office?

formulare, veličine zakonskih formulara, u ordinaciji vašeg doktora?

I mean, if you're lucky enough you get to do it more than once, right?

Milsim, ako ste dovoljno sretni taj će te proces ponoviti više puta, zar ne?

(Laughter)

(Smijeh)

Do it over and over again. And they ask you questions

Popunite ih nekoliko puta. I oni vas pitaju

about your lifestyle and your family history,

o vašem načinu življenja i porodičnoj istoriji,

your medication history, your surgical history,

o vašoj istoriji konzumiranja lijekova, vašoj istoriji operacija,

your allergy history ... did I forget any history?

vašoj istoriji alergija ... da li sam zaboravio neku istoriju?

But this part of the equation I didn't really get,

Ali ovaj dio jednačine ni ja nisam u potpunosti shvatio.

and I don't think my physicians

I mislim da ni moji doktori

really get this part of the equation.

ustvari ne razumiju ovaj dio jednačine.

What does that mean, my environment?

Šta to znači, moje okruženje?

Well, it can mean a lot of things.

Pa, to može značiti mnogo toga.

This is my life. These are my life places.

Ovo je moj život. Ovo su moja mjesta u životu.

We all have these.

Mi ih svi imamo.

While I'm talking I'd like you to also be thinking about:

Dok ja pričam, želio bih da i vi također razmišljate o broju mjesta

How many places have you lived?

u kojima ste boravili.

Just think about that, you know, wander through

Samo mislite o tome, hoću reći, lutajte kroz

your life thinking about this.

svoj život razmišljajući o ovome.

And you realize that you spend it in a variety of different places.

I shvatiti ćete da ste ga proveli na raznim i različitim mjestima.

You spend it at rest and you spend it at work.

Proveli ste ga u odmaranju i na poslu.

And if you're like me, you're in an airplane a good portion of your time

I ako ste poput mene, dobar dio svog vremena provodite u avionu

traveling some place.

putujući negdje.

So, it's not really simple

Tako da to nije uopšte toliko jednostavno

when somebody asks you, "Where do you live, where do you work,

kada vas neko pita, ''Gdje živite, gdje radite,

and where do you spend all your time?

i gdje provodite svo vaše vrijeme?

And where do you expose yourselves to risks

I gdje se izlažete rizicima

that maybe perhaps you don't even see?"

koje možda i ne vidite?''

Well, when I have done this on myself,

Pa, kada sam ja ovo uradio na sebi,

I always come to the conclusion

uvijek sam dolazio do zaključka

that I spend about 75 percent of my time

da provodim oko 75 posto svog vremena

relatively in a small number of places.

na relativno malom broju mjesta.

And I don't wander far from that place

I ne lutam daleko od tog mjesta

for a majority of my time,

veći dio svog vremena,

even though I'm an extensive global trekker.

iako sam veoma globalno prostran putnik.

Now, I'm going to take you on a little journey here.

Sada ću vas povesti na malo putovanje.

I started off in Scranton, Pennsylvania.

Ja sam počeo u Skrentonu, u Pensilvaniji

I don't know if anybody might hail from northeastern Pennsylvania,

Ne znam da li možda neko dolazi iz sjeverno-istočne Pensilvanije.

but this is where I spent my first 19 years

Ali ovdje sam proveo svojih prvih 19 godina

with my little young lungs.

sa svojim malim i mladim plućima.

You know, breathing high concentrations here

Znate, udišući velike koncentracije

of sulfur dioxide, carbon dioxide

sulfor dioksida, karbon dioksida

and methane gas,

i metan gasa,

in unequal quantities -- 19 years of this.

u nejednakim količinama - 19 godina ovoga.

And if you've been in that part of the country,

I ako ste bili u tom dijelu države,

this is what those piles of burning, smoldering coal waste look like.

ovo je kako te gomile sagorjevajućeg, tinjajućeg otpada uglja izgledaju.

So then I decided to leave that part of the world,

Tako da sam tada odlučio napustiti taj dio svijeta.

and I was going to go to the mid-west.

I planirao sam otići na srednji-zapad.

OK, so I ended up in Louisville, Kentucky.

Uredu, i tako sam završio u Luivilu, u Kentakiju.

Well, I decided to be neighbors to a place called Rubbertown.

Onda sam odlučio biti susjed sa mjestom zvanim Rabertaun.

They manufacture plastics. They use large quantities chloroprene

Oni proizvode plastiku. Koriste velike količine kloroprena

and benzene.

i benzena.

Okay, I spent 25 years, in my middle-age lungs now,

Uredu, proveo sam 25 godina, sa svojim plućima sada srednjih godina

breathing various concentrations of that.

udišući razne koncentracije toga.

And on a clear day it always looked like this, so you never saw it.

I na vedar dan uvijek je izgledalo ovako, tako da to nikad niste vidjeli.

It was insidious and it was really happening.

To je bilo podmuklo i zaista se događalo.

Then I decided I had to get really smart,

I onda sam odlučio da moram postati veoma pametan,

I would take this job in the West Coast.

i da ću prihvatiti ovaj posao na zapadnoj obali.

And I moved to Redlands California.

Tako sam se preselio u Redlands u Kaliforniji.

Very nice, and there

Veoma fino, i tamo sam

my older, senior lungs, as I like to call them,

moja starija, seniorska pluća, kako ih ja volim zvati,

I filled with particulate matter, carbon dioxide and very high doses of ozone.

napunio česticama supstanci, karbon dioksidom i veoma visokim količinama ozona.

Okay? Almost like the highest in the nation.

U redu? Skoro sa najvećim nivoom u naciji.

Alright, this is what it looks like on a good day.

Eh sada, ovako ono izgleda na dobar dan.

If you've been there, you know what I'm talking about.

Ako ste bili tamo onda znate o čemu govorim.

So, what's wrong with this picture?

Prema tome, šta nije uredu sa ovom slikom?

Well, the picture is, there is a huge gap here.

Pa, slika je, ovdje ima velika praznina.

The one thing that never happens in my doctor's office:

Jedna stvar koja se nikada ne događa u kancelariji mog doktora je:

They never ask me about my place history.

nikada me ne pitaju o istoriji mojih mjesta boravka.

No doctor, can I remember, ever asking me,

Niti jedan doktor, koliko se mogu sjetiti, me nije pitao

"Where have you lived?"

''Gdje ste živjeli?''

They haven't asked me what kind of the quality

Nisu me pitali o kvalitetu

of the drinking water that I put in my mouth

pitke vode koju stavljam u svoja usta,

or the food that I ingest into my stomach.

ili hrane koju unosim u stomak.

They really don't do that. It's missing.

Oni to stvarno ne rade. To nedostaje.

Look at the kind of data that's available.

Pogledajte vrste podataka koje su dostupne.

This data's from all over the world --

Ovi podaci su iz svih dijelova svijeta -

countries spend billions of dollars investing in this kind of research.

zemlje troše milijarde dolara ulažući ih u ove vrste istraživanja.

Now, I've circled the places where I've been.

Ja sam zaokružio mjesta gdje sam bio.

Well, by design, if I wanted to have a heart attack

Tako da, prema dizajnu, ako sam želio da imam srčani udar

I'd been in the right places. Right?

onda sam bio na pravim mjestima. Zar ne?

So, how many people are in the white?

Prema tome, koliko ljudi je u bijelom?

How many people in the room have spent the majority of their life

Koliko ljudi u prostoriji su proveli veći dio svojih života

in the white space?

u bijelim mjestima?

Anybody? Boy you're lucky.

Iko? Kako ste samo sretni.

How many have spent it in the red places?

Koliko vas je provelo vremena u crvenim mjestima?

Oh, not so lucky.

Oh, ne baš toliko sretni.

There are thousands of these kinds of maps

Postoje hiljade ovakvih karti

that are displayed in atlases

koje su prikazane u atlasima

all over the world.

po cijelom svijetu.

They give us some sense of what's going

Oni nam daju neki smisao o tome šta će

to be our train wreck.

biti naš sudar sa vozom.

But none of that's in my medical record.

Ali ništa od toga nije u mom medicinskom kartonu.

And it's not in yours either.

I nije ni u vašem.

So, here's my friend Paul.

Ovo je moj prijatelj Pol.

He's a colleague. He allowed his cell phone to be tracked

On je moj kolega. On je dozvolio da mu prate mobilni telefon

every two hours, 24/7,

svaka dva sata, 24 sata u sedmici,

365 days out of the year

365 dana u godini,

for the last two years, everywhere he went.

u posljednje dvije godine, gdje god da je išao.

And you can see he's been to a few places around the United States.

I možete vidjeti da je bio na nekoliko mjesta po cijelim Ujedinjenim Državama.

And this is where he has spent most of his time.

I ovdje je provodio veći dio svog vremena.

If you really studied that you might have some clues

Ako to usitinu prostudirate možda će te shvatiti

as to what Paul likes to do.

šta to Pol voli raditi.

Anybody got any clues? Ski. Right.

Da li iko ima neku ideju? Skijanje. Tako je.

We can zoom in here, and we suddenly see

Možemo ovdje zumirati, i iznenada uviđamo

that now we see where Paul has really spent a majority of his time.

da sada primjećujemo gdje je Pol zaista provodio veći dio svog vremena.

And all of those black dots are all of the

I sve te crne tačke su mjesta

toxic release inventories

oslobađanja toksičkih zaliha

that are monitored by the EPA.

koje nadgleda EPA (Agencija za Zaštitu Okoline).

Did you know that data existed?

Jeste li znali da ti podaci postoje?

For every community in the United States,

Za svaku zajednicu u Sjedinjenim Američkim Državama,

you could have your own personalized map of that.

mogli biste imati istu, ali svoju ličnu mapu.

So, our cell phones can now build a place history.

Tako da sada, naši mobilni telefoni, mogu izgraditi mjesto u istoriji.

This is how Paul did it. He did it with his iPhone.

Ovo je način na koji je to Pol uradio. On je to izvršio sa svojim iPhone-om.

This might be what we end up with.

Ovo može biti ono s čime ćemo završiti.

This is what the physician would have

Ovo je ono što će doktori imati

in front of him and her when we enter that exam room

ispred sebe kada uđemo u tu ordinaciju

instead of just the pink slip that said I paid at the counter. Right?

umjesto same otpusnice koja govori kako smo platili na šalteru. Zar ne?

This could be my little assessment.

Ovo bi mogla biti moja mala procjena.

And he looks at that and he says,

I on pogleda u to i kaže,

"Whoa Bill,

''Uh Bil,

I suggest that maybe you not decide,

ja predlažem da možda ne odlučuješ,

just because you're out here in beautiful California,

samo zbog toga što si ovdje u prelijepoj Kaliforniji

and it's warm every day,

i zbog toga što je toplo svakog dana

that you get out and run at six o'clock at night.

da izađeš trčati u šest sati navečer.

I'd suggest that that's a bad idea Bill,

Ja to smatram kao lošu ideju Bil,

because of this report."

uzimajući u obzir ovaj izvještaj.''

What I'd like to leave you for are two prescriptions.

Ono s čime bih ja vas htio ostaviti su dva recepta.

Okay, number one is, we must teach physicians

Ok, broj jedan je taj da moramo naučiti doktore

about the value of geographical information.

o vrijednosti geografskih informacija.

It's called geomedicine. There are about a half a dozen programs in the world right now

To se zove geomedicina. Trenutno postoji otprilike šest programa u svijetu

that are focused on this.

koji su fokusirani na ovo.

And they're in the early stages of development.

I oni se nalaze u ranim fazama razvoja.

These programs need to be supported,

Ovi programi moraju biti podržani.

and we need to teach our future

I mi moramo naučiti naše buduće

doctors of the world

doktore svijeta

the importance of some of the information

važnosti nekih informacija

I've shared here with you today.

koje sam podijelio ovdje s vama danas.

The second thing we need to do

Druga stvar koju moramo uraditi

is while we're spending billions and billions

jeste da, dok trošimo milijarde i milijarde

of dollars all over the world

dolara po cijelom svijetu

building an electronic health record,

na izradu elektonskih zdravstvenih podataka,

we make sure we put a place history

mi moramo da stavimo istoriju mjesta boravka

inside that medical record.

unutar naših zdravstvenih podataka.

It not only will be important for the physician;

To neće biti bitno samo za doktore;

it will be important for the researchers

to će biti bitno za istraživače

that now will have huge samples to draw upon.

koji će sada imati mnoštvo uzoraka koje mogu iskoristiti.

But it will also be useful for us.

Ali to će također biti korisno za nas.

I could have made the decision, if I had this information,

Mogao sam donijeti odluku, da sam imao ovu informaciju,

not to move to the ozone capital

da se ne preselim u glavni ozonski grad

of the United States, couldn't I? I could make that decision.

Sjedinjenih Američkih Država. Zar nisam? Mogao sam donijeti tu odluku.

Or I could negotiate with my employer

Ili sam mogao pregovarati sa svojim uposlenikom

to make that decision

da donesem odluku

in the best interest of myself and my company.

koja je u mom najboljem interesu kao i interesu same kompanije.

With that, I would like to just say that Jack Lord said

Sa time, volio bih dodati kako je Džek Lord ovo rekao

this almost 10 years ago.

prije skoro 10 godina.

Just look at that for a minute.

Samo pogledajte to na trenutak.

That was what the conclusion

To je bio zaključak

of the Dartmouth Atlas of Healthcare was about,

samog Dartmut Atlas-a Zdravstvene skrbi,

was saying that we can explain the geographic variations

gdje su takođe govorili kako možemo objasniti geografske varijacije

that occur in disease, in illness, in wellness,

koje se pojavljuju u bolestima, oboljenjima, zdravlju,

and how our healthcare system actually operates.

i kako naš sistem zdravstvene skrbi, ustvari, funkcioniše.

That was what he was talking about

On je o tome pričao

on that quote.

u tom citatu.

And I would say he got it right almost a decade ago.

I mogu reći da je pogodio i to skoro prije 10 godina.

So, I'd very much like to see us begin to

Tako da bih ja volio veoma mnogo da mi

really seize this as an opportunity to get this into our medical records.

ovo vidimo kao našu priliku kako bi te podatke uvrstili u naš zdravstveni karton.

So with that, I'll leave you that

Prema tome, ja ću vas ostaviti sa tezom

in my particular view of view of health:

da je, po mom ličnom mišljenju o zdravlju,

Geography always matters.

geografija uvijek bitna.

And I believe that geographic information

I ja vjerujem da geografske informacije

can make both you and me very healthy. Thank you.

mogu vas kao i mene načiniti veoma zdravim. Hvala vam.

(Applause)

(Aplauz)