Bill Davenhall: Your health depends on where you live

Prevodilac: Ivana Korom Lektor: Sandra Gojic

Can geographic information

Da li geografske informacije

make you healthy?

mogu da učine da budete zdravi?

In 2001 I got hit by a train.

2001. me je udario voz.

My train was a heart attack.

Moj voz je bio infarkt.

I found myself in a hospital

Našao sam se u bolnici

in an intensive-care ward,

na odeljenju intenzivne nege,

recuperating from emergency surgery.

oporavljao sam se od hitne operacije.

And I suddenly realized something:

Odjednom sam shvatio nešto:

that I was completely in the dark.

potpuno sam bio u mraku.

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

Počeo sam da se pitam, "Zašto ja?"

"Why now?" "Why here?"

"Zašto sada?" "Zašto ovde?"

"Could my doctor have warned me?"

"Da li je moj doktor mogao da me upozori?"

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

Ono što želim ovde da uradim u ovih nekoliko minuta koje imam sa vama

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

je da zaista pričam o tome koja je formula za život i dobro zdravlje.

Genetics, lifestyle and environment.

Genetika, način života i okruženje.

That's going to sort of contain our risks,

Tu se nalaze rizici

and if we manage those risks

i ako prevaziđemo te rizike

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

živećemo dobar život, dobar zdrav život.

Well, I understand the genetics and lifestyle part.

Razumem deo o genetici i životnom stilu.

And you know why I understand that?

A znate li zašto to razumem?

Because my physicians constantly

Jer mi moji lekari stalno

ask me questions about this.

postavljaju pitanja u vezi s tim.

Have you ever had to fill out those long,

Da li ste ikada morali da popunjavate one dugačke,

legal-size forms in your doctor's office?

formulare kod svog lekara?

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

Mislim, ako imate sreće onda ih popunite i više puta, je l'?

(Laughter)

(smeh)

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

Opet i opet. Tu vas pitaju

about your lifestyle and your family history,

o načinu života i porodičnoj istoriji,

your medication history, your surgical history,

istoriji uzimanja lekova, istoriji operacija,

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

istoriji alergija... jesam zaboravio neku istoriju?

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

Ali ovaj deo jednačine baš ne razumem.

and I don't think my physicians

A mislim da ni moji doktori

really get this part of the equation.

baš ne razumeju taj deo jednačine.

What does that mean, my environment?

Šta ovo znači, moje okruženje?

Well, it can mean a lot of things.

Pa, može da znači mnogo stvari.

This is my life. These are my life places.

Ovo je moj život. Ovo su mesta mog života.

We all have these.

Svi imamo ovo.

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

Dok pričam, želeo bih da razmislite o tome

How many places have you lived?

na koliko ste sve mesta živeli.

Just think about that, you know, wander through

Samo promislite, znate, prođite kroz

your life thinking about this.

život misleći na ovo.

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

I shvatićete da ga provodite na raznim mestima.

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

Provodite ga na odmoru i na poslu.

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

A ako ste kao ja, onda ste u avionu dobar deo svog vremena,

traveling some place.

putujući na neko mesto.

So, it's not really simple

Dakle, nije tako jednostavno

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

kad vas neko pita, "Gde živite, gde radite,

and where do you spend all your time?

i gde provodite svo svoje vreme?

And where do you expose yourselves to risks

I gde se izlažete rizicima

that maybe perhaps you don't even see?"

koje verovatno ni ne vidite?"

Well, when I have done this on myself,

Pa, kada sam ovo radio na sebi,

I always come to the conclusion

uvek sam dolazio do zaključka

that I spend about 75 percent of my time

da oko 75% svog vremena provodim

relatively in a small number of places.

na relativno malom broju mesta.

And I don't wander far from that place

I većinu svog vremena ne idem

for a majority of my time,

daleko od tog mesta,

even though I'm an extensive global trekker.

iako sam veliki putnik po svetu.

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

Sada ću vas povesti na kratak put.

I started off in Scranton, Pennsylvania.

Počeo sam u Skrantonu, u Pensilvaniji.

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

Ne znam da li neko dolazi iz severoistočne Pensilvanije.

but this is where I spent my first 19 years

Ovde sam proveo svojih prvih 19 godina

with my little young lungs.

sa svojim malim, mladim plućima.

You know, breathing high concentrations here

Znate, udisao sam velike količine

of sulfur dioxide, carbon dioxide

sumpor-dioksida, ugljen-dioksida,

and methane gas,

metana,

in unequal quantities -- 19 years of this.

u nejednakim količinama - 19 godina toga.

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

Ako ste bili u tom delu zemlje,

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

ovako izgledaju te gomile otpada od uglja koji se puši i gori.

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

Onda sam odlučio da napustim taj deo sveta.

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

I da odem u srednji zapad.

OK, so I ended up in Louisville, Kentucky.

Ok, dakle završio sam u Luivilu, Kentaki.

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

Odlučio sam da budem u komšiluku mesta koje se zove Rabertaun (Rubbertown, "grad gume").

They manufacture plastics. They use large quantities chloroprene

Oni proizvode plastiku. Koriste velike količine hloroprena

and benzene.

i benzena.

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

OK, proveo sam 25 godina, sada sa svojim sredovečnim plućima,

breathing various concentrations of that.

udišući razne koncentracije toga.

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

Po vedrom danu uvek je ovako izgledalo, tako da ih niste nikada videli.

It was insidious and it was really happening.

Bilo je podmuklo i zaista se dešavalo.

Then I decided I had to get really smart,

Potom sam odlučio da moram da se opametim

I would take this job in the West Coast.

i prihvatio sam posao na zapadnoj obali.

And I moved to Redlands California.

Preselio sam se u Redlends, Kaliforniju.

Very nice, and there

Veoma lepo i tamo

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

moja starija, seniorska pluća, kako volim da ih zovem,

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

napunio sam posebnom materijom, ugljen dioksidom, i veoma visokim dozama ozona.

Okay? Almost like the highest in the nation.

OK? Skoro je najviše u naciji.

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

Dobro, ovako to izgleda kad je dobar dan.

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

Ako ste bili tamo, znate o čemu pričam.

So, what's wrong with this picture?

Dakle, šta ne valja na ovoj slici?

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

Pa, na slici je velika praznina.

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

Jedina stvar koja se nikada ne dešava kod mog doktora:

They never ask me about my place history.

nikada me ne pitaju za moju istoriju mesta.

No doctor, can I remember, ever asking me,

Ne sećam se da me je ijedan doktor pitao

"Where have you lived?"

"Gde ste živeli?"

They haven't asked me what kind of the quality

Nisu me pitali kakvog kvaliteta je

of the drinking water that I put in my mouth

pijaća voda koju sam stavljao u usta,

or the food that I ingest into my stomach.

ili hrana koju sam vario u stomaku.

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

Oni zapravo to ne rade. To nedostaje.

Look at the kind of data that's available.

Pogledajte vrstu podataka koja je dostupna.

This data's from all over the world --

Ovo su podaci sa svih strana sveta -

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

zemlje troše milijarde dolara na ovakva istraživanja.

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

Zaokružio sam mesta na kojima sam bio.

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

Recimo, da sam želeo da imam infarkt

I'd been in the right places. Right?

bio sam na pravim mestima. Zar ne?

So, how many people are in the white?

Koliko ljudi je u belom delu?

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

Koliko ljudi iz ove sobe je provelo većinu svog života

in the white space?

u belim mestima?

Anybody? Boy you're lucky.

Bilo ko? Čoveče, vi ste srećnici.

How many have spent it in the red places?

Koliko vas je provelo u crvenim mestima?

Oh, not so lucky.

O, vi niste tako srećni.

There are thousands of these kinds of maps

Postoje hiljade ovakvih mapa

that are displayed in atlases

koje su izložene u atlasima

all over the world.

širom sveta.

They give us some sense of what's going

One nam daju neku ideju o tome

to be our train wreck.

šta će biti naš sudar vozova.

But none of that's in my medical record.

Ali ništa od toga se ne nalazi u mom medicinskom kartonu.

And it's not in yours either.

Niti u vašem.

So, here's my friend Paul.

Evo ga moj prijatelj Pol.

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

On je kolega. Dozvolio je da mu prate mobilni telefon

every two hours, 24/7,

na svaka dva sata, 24h 7 dana u nedelji,

365 days out of the year

365 dana u godini,

for the last two years, everywhere he went.

poslednje dve godine, gde god da je išao.

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

Možete videti da je bio na nekoliko mesta u Sjedinjenim Državama.

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

A ovde je proveo većinu svog vremena.

If you really studied that you might have some clues

Da stvarno proučite ovo imali biste neku ideju

as to what Paul likes to do.

o tome šta Pol voli da radi.

Anybody got any clues? Ski. Right.

Ima li neko ideju? Skijanje. Tako je.

We can zoom in here, and we suddenly see

Možemo zumirati ovde i odjednom vidimo

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

gde je stvarno Pol proveo većinu svog vremena.

And all of those black dots are all of the

Sve ove crne tačke obeležavaju

toxic release inventories

mesta otrovnog otpada

that are monitored by the EPA.

koje prati Agencija za zaštitu okoline (EPA).

Did you know that data existed?

Da li ste znali da ti podaci postoje?

For every community in the United States,

Za svaku zajednicu u Americi,

you could have your own personalized map of that.

možete dobiti svoju ličnu mapu toga.

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

Dakle, naši mobilni telefoni mogu da prave istoriju mesta.

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

Ovako je Pol to uradio. Koristio je iPhone.

This might be what we end up with.

Možda ćemo ovo imati na kraju.

This is what the physician would have

Ovo bi doktor imao

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

pred sobom kada uđemo u ordinaciju,

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

umesto samo rozog papira koji govori da smo platili račun. Je l' tako?

This could be my little assessment.

Ovo može biti moja mala procena.

And he looks at that and he says,

I on gleda u to i kaže,

"Whoa Bill,

"Opa, Bil,

I suggest that maybe you not decide,

predlažem da možda ne odlučiš,

just because you're out here in beautiful California,

samo zato što si ovde u prelepoj Kaliforniji,

and it's warm every day,

i toplo je svakog dana

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

da izađeš i trčiš svako veče u 6 sati.

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

Rekao bih da je to loša ideja, Bil

because of this report."

zbog ovog izveštaja."

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

Želim da vas ostavim sa dva recepta.

Okay, number one is, we must teach physicians

Ok, prvi je da moramo naučiti lekare

about the value of geographical information.

o vrednosti geografskih informacija.

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

To se zove geomedicina. U ovom trenutku postoji nekoliko programa u svetu

that are focused on this.

koji su fokusirani na ovo.

And they're in the early stages of development.

Nalaze se u ranim fazama razvoja.

These programs need to be supported,

Te programe treba podržati.

and we need to teach our future

I trebalo bi da naučimo naše

doctors of the world

buduće doktore u svetu

the importance of some of the information

koliko su važne neke od informacija

I've shared here with you today.

koje sam podelio sa vama danas.

The second thing we need to do

Druga stvar koju bi trebalo da uradimo

is while we're spending billions and billions

je da, dok trošimo milijarde i milijarde

of dollars all over the world

dolara širom sveta

building an electronic health record,

praveći elektronske medicinske kartone,

we make sure we put a place history

da se pobrinemo da uvrstimo istoriju mesta

inside that medical record.

u te medicinske kartone.

It not only will be important for the physician;

To neće biti važno samo za lekare;

it will be important for the researchers

biće važno za istraživače

that now will have huge samples to draw upon.

koji će sada imati ogromne uzorke.

But it will also be useful for us.

A biće korisno i za nas.

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

Da sam imao ove informacije, mogao sam da odlučim

not to move to the ozone capital

da se ne preselim u ozonsku prestonicu

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

Sjedinjenih Država. Zar ne? Mogao sam tako da odlučim.

Or I could negotiate with my employer

Ili sam mogao da pregovaram sa poslodavcem

to make that decision

da donese odluku koja je

in the best interest of myself and my company.

u najboljem interesu za mene i kompaniju.

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

Ovim želim da kažem da je Džek Lord to

this almost 10 years ago.

rekao pre skoro 10 godina.

Just look at that for a minute.

Samo kratko pogledajte to.

That was what the conclusion

To je bio zaključak

of the Dartmouth Atlas of Healthcare was about,

Atlasa o zdravstvenoj zaštiti u Dartmutu,

was saying that we can explain the geographic variations

koji govori da možemo objasniti geografke varijacije

that occur in disease, in illness, in wellness,

koje se javljaju u bolestima, zarazama, zdravlju

and how our healthcare system actually operates.

i kako naš zdravstveni sistem stvarno funkcioniše.

That was what he was talking about

O tome je govorio

on that quote.

u tom citatu.

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

rekao bih da je pogodio, skoro pre deset godina.

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

Želeo bih da počnemo da prihvatamo

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

ovu priliku da uvrstimo ovo u naše medicinske kartone.

So with that, I'll leave you that

Ostavljam vas sa time

in my particular view of view of health:

da je u mom pogledu na zdravlje

Geography always matters.

geografija uvek bitna.

And I believe that geographic information

I verujem da geografke informacije

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

mogu da i vas i mene učine veoma zdravim. Hvala vam.

(Applause)

(aplauz)