Bill Davenhall: Your health depends on where you live

Translator: M. Carmen Losada Reviewer: Serv. de Norm. Lingüística U. de Santiago de Compostela

Can geographic information

Pode a información xeográfica

make you healthy?

facer que estean sans?

In 2001 I got hit by a train.

No 2001 atropeloume un tren.

My train was a heart attack.

O meu tren foi un ataque ao corazón.

I found myself in a hospital

Atopeime nun hospital,

in an intensive-care ward,

na unidade de coidados intensivos,

recuperating from emergency surgery.

para reporme dunha cirurxía de urxencia.

And I suddenly realized something:

De súpeto decateime de algo:

that I was completely in the dark.

estaba completamente ás escuras.

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

Comezaron as preguntas, "Ben, por que a min?"

"Why now?" "Why here?"

"Por que agora?" "Por que aquí?"

"Could my doctor have warned me?"

"Puido o meu médico terme advertido?"

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

Ben, o que quero facer aquí con vostedes

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

é falar da fórmula da vida e da boa saúde:

Genetics, lifestyle and environment.

Xenética, estilo de vida e medio ambiente.

That's going to sort of contain our risks,

Iso vai refrear algo os nosos riscos,

and if we manage those risks

e se controlamos eses riscos,

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

imos vivir unha vida boa e saudable.

Well, I understand the genetics and lifestyle part.

Ben, entendo a parte da xenética e do estilo de vida.

And you know why I understand that?

E saben por que o entendo?

Because my physicians constantly

Porque os meus médicos están seguido

ask me questions about this.

preguntándome sobre isto.

Have you ever had to fill out those long,

Nunca tiveron que cubrir eses longos

legal-size forms in your doctor's office?

impresos oficiais na consulta do médico?

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

Tiveron a sorte de facelo máis dunha vez?

(Laughter)

(Risas)

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

De facelo unha e outra vez? E pregúntanlles

about your lifestyle and your family history,

polo estilo de vida e o historial familiar,

your medication history, your surgical history,

historial de medicación, historial de cirurxías,

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

historial de alerxias... esquecín algún?

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

Pero esta parte da ecuación non a entendín realmente

and I don't think my physicians

e tampouco creo que os meus médicos

really get this part of the equation.

a entendan realmente.

What does that mean, my environment?

Que significa iso, o meu medio ambiente?

Well, it can mean a lot of things.

Ben, pode significar moitas cousas.

This is my life. These are my life places.

Esta é a miña vida, estes os meus sitios.

We all have these.

Todos temos os lugares da nosa vida.

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

Mentres falo, gustaríame que pensasen tamén:

How many places have you lived?

En cantos lugares viviron?

Just think about that, you know, wander through

Pénseno, percorran a súa vida,

your life thinking about this.

pensen nisto.

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

Verán que estiveron en moitos lugares distintos,

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

tanto para descansar como para traballar.

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

E se son coma min, botan unha boa parte da vida nun avión

traveling some place.

viaxando a algures.

So, it's not really simple

Entón, non é tan simple cando lles preguntan

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

"Onde vive, onde traballa

and where do you spend all your time?

e onde pasa o tempo?

And where do you expose yourselves to risks

E onde se expón a riscos

that maybe perhaps you don't even see?"

que quizais nin vexa?”

Well, when I have done this on myself,

Ben, cando me fago esa pregunta,

I always come to the conclusion

sempre chego á conclusión

that I spend about 75 percent of my time

de que paso ao redor do 75% do tempo

relatively in a small number of places.

máis ben nun número pequeno de sitios,

And I don't wander far from that place

e non deambulo moi lonxe deles

for a majority of my time,

a maior parte do tempo,

even though I'm an extensive global trekker.

aínda que son un viaxeiro empedernido.

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

Agora, imos facer aquí unha pequena viaxe.

I started off in Scranton, Pennsylvania.

Comecei en Scranton, Pensilvania.

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

Non sei se hai alguén aquí do nordeste de Pensilvania.

but this is where I spent my first 19 years

Aquí pasei os meus primeiros 19 anos

with my little young lungs.

cos meus pulmonciños novos.

You know, breathing high concentrations here

Xa saben, respirando altas concentracións

of sulfur dioxide, carbon dioxide

de dióxido de xofre, dióxido de carbono

and methane gas,

e metano,

in unequal quantities -- 19 years of this.

en cantidades diversas... así 19 anos!

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

E se estiveron nesta parte do país,

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

este é o aspecto desas moreas de queima latente de residuos de carbón.

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

Despois decidín abandonar esa parte do mundo

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

e fun cara ao medio oeste.

OK, so I ended up in Louisville, Kentucky.

E acabei en Louisville, Kentucky.

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

Ben, decidín residir en Rubbertown.

They manufacture plastics. They use large quantities chloroprene

Alí fabrican plástico. Empregan grandes cantidades de cloropreno

and benzene.

e benceno.

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

Pasei alí 25 anos cuns pulmóns de mediana idade,

breathing various concentrations of that.

respirando distintas concentracións diso.

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

E nun día claro sempre era así, nunca chegabas a velo.

It was insidious and it was really happening.

Era traizoeiro, pero era un feito que estaba a ocorrer.

Then I decided I had to get really smart,

Entón decidín actuar intelixentemente,

I would take this job in the West Coast.

aceptaría este traballo na costa oeste.

And I moved to Redlands California.

E mudeime para Redlands, en California.

Very nice, and there

Moi bonito, e alí

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

enchín os meus pulmóns máis vellos, séniors, como me gusta chamarlles,

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

de partículas diminutas, dióxido de carbono e altas doses de ozono.

Okay? Almost like the highest in the nation.

Vale? Case como as máis altas do país.

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

Ben, esta é a pinta nun bo día.

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

Se teñen estado alí, saben do que falo.

So, what's wrong with this picture?

Entón, cal é o problema desta imaxe?

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

Ben, a imaxe é, hai un oco grande aquí.

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

O único que non ocorre nunca na consulta do médico:

They never ask me about my place history.

Xamais me preguntan polo meu historial de lugares.

No doctor, can I remember, ever asking me,

Non lembro que ningún médico me preguntase nunca,

"Where have you lived?"

"Onde viviu?"

They haven't asked me what kind of the quality

Nunca me preguntaron pola calidade

of the drinking water that I put in my mouth

da auga que levaba á boca

or the food that I ingest into my stomach.

ou da comida que metía no estómago.

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

Non fan iso. E deberían.

Look at the kind of data that's available.

Reparen no tipo de datos dispoñibles.

This data's from all over the world --

Estes datos son de todo o mundo

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

–os países invisten miles de millóns de dólares neste tipo de investigación.

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

Aquí están marcados os sitios nos que estiven.

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

A propósito, se eu quixese ter un ataque ao corazón

I'd been in the right places. Right?

estiven nos lugares correctos, non si?

So, how many people are in the white?

Cantos de vostedes están no branco?

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

Cantos desta sala viviron a maior parte da súa vida

in the white space?

no espazo branco?

Anybody? Boy you're lucky.

Alguén? Rapaz, que sorte tes!

How many have spent it in the red places?

Cantos viviron nos sitios en vermello?

Oh, not so lucky.

Oh, non son tan afortunados!

There are thousands of these kinds of maps

Hai milleiros de mapas coma estes

that are displayed in atlases

expostos en atlas

all over the world.

por todo o mundo.

They give us some sense of what's going

Dannos idea do que vai ser

to be our train wreck.

o noso desastre.

But none of that's in my medical record.

Pero nada disto aparece no meu historial médico.

And it's not in yours either.

E no seu tampouco.

So, here's my friend Paul.

Este é o meu amigo Paul.

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

É un colega. Permitiu que rastrexaran o seu móbil

every two hours, 24/7,

cada dúas horas, día e noite,

365 days out of the year

os 365 días do ano

for the last two years, everywhere he went.

nos 2 últimos anos, onde queira que fose.

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

E pódese ver que estivo en poucos sitios dos Estados Unidos.

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

Estivo aquí a maior parte do tempo.

If you really studied that you might have some clues

Se realmente estudan iso, poderán ter algunhas pistas

as to what Paul likes to do.

do que lle gusta facer a Paul.

Anybody got any clues? Ski. Right.

Alguén ten idea? Esquiar. Correcto.

We can zoom in here, and we suddenly see

Podemos ampliar aquí e de súpeto vemos

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

onde pasou Paul a maior parte do tempo.

And all of those black dots are all of the

E todos eses puntos negros

toxic release inventories

son os inventarios de emisións tóxicas

that are monitored by the EPA.

monitorizados pola EPA.

Did you know that data existed?

Sabían que existía esa información?

For every community in the United States,

Para cada comunidade dos Estados Unidos,

you could have your own personalized map of that.

poderían ter o seu mapa personalizado.

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

Agora os nosos móbiles poden construír un historial de lugares.

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

Iso é o que fixo Paul. Fíxoo co seu iPhone.

This might be what we end up with.

Este podería ser o resultado acadado.

This is what the physician would have

Isto é o que o/a médico/a tería diante

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

cando entrásemos na súa consulta

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

en vez de só o xustificante rosa de que xa pagamos no mostrador.

This could be my little assessment.

Esta podería ser a miña breve valoración.

And he looks at that and he says,

E el mira para ela e di,

"Whoa Bill,

“Oe Bill,

I suggest that maybe you not decide,

aconsélloche que talvez non deberías,

just because you're out here in beautiful California,

aínda que andas por esta bela California

and it's warm every day,

e vai calor todos os días,

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

saír correr ás 6 da tarde.

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

Eu diría que é unha mala idea, Bill,

because of this report."

debido a este informe".

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

Gustaríame deixarlles dúas receitas.

Okay, number one is, we must teach physicians

A primeira é que debemos ensinar aos médicos

about the value of geographical information.

o valor da información xeográfica.

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

Chámase xeomedicina. Hai ao redor de media ducia de programas

that are focused on this.

no mundo que se centran nela.

And they're in the early stages of development.

E están nas primeiras etapas de desenvolvemento.

These programs need to be supported,

Estes programas precisan patrocinio,

and we need to teach our future

e necesitamos ensinarlles aos futuros

doctors of the world

doutores do mundo

the importance of some of the information

a importancia de parte da información

I've shared here with you today.

que hoxe compartín aquí con vostedes.

The second thing we need to do

O segundo que hai que facer

is while we're spending billions and billions

é, mentres se gastan miles de millóns

of dollars all over the world

de dólares en todo o mundo

building an electronic health record,

construíndo unha historia clínica electrónica,

we make sure we put a place history

asegurarnos de poñer un historial de lugares

inside that medical record.

dentro dese historial médico.

It not only will be important for the physician;

Non será importante só para os médicos;

it will be important for the researchers

serao tamén para os investigadores

that now will have huge samples to draw upon.

que terán moitas mostras en que se basear.

But it will also be useful for us.

Pero tamén será útil para nós.

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

Se tivese esta información, eu podería decidir

not to move to the ozone capital

non mudarme á capital do ozono

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

dos Estados Unidos, non si? Puiden tomar esa decisión.

Or I could negotiate with my employer

Ou podería negociar co meu empregador

to make that decision

tomar esa decisión

in the best interest of myself and my company.

no meu interese e no da miña empresa.

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

Con iso, gustaríame dicir só que Jack Lord

dixo isto hai case 10 anos.

this almost 10 years ago.

[A xeografía é o destino da medicina]

Just look at that for a minute.

Soamente miren iso un minuto.

That was what the conclusion

Esa foi a conclusión

of the Dartmouth Atlas of Healthcare was about,

do Atlas do Sistema Sanitario de Dartmouth

was saying that we can explain the geographic variations

cando dicía que se poden explicar as variacións xeográficas

that occur in disease, in illness, in wellness,

existentes nas doenzas, nas enfermidades, no benestar,

and how our healthcare system actually operates.

e como se xestiona realmente o noso sistema sanitario.

That was what he was talking about

Diso era do que falaba

on that quote.

nesa cita.

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

E eu diría que acertou hai case unha década.

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

Así que me encantaría ver que comezamos

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

a ver isto como unha oportunidade de ter esa información nos historiais médicos.

So with that, I'll leave you that

Así pois, gustaríame deixarlles

in my particular view of view of health:

a miña opinión particular sobre a saúde:

Geography always matters.

A xeografía sempre importa.

And I believe that geographic information

E penso que a información xeográfica

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

pode facer que vostedes e mais eu esteamos máis sans. Grazas

(Applause)

(Aplausos)