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StepJockey Discusses Global Health with Dr Vivek Muthu

With World Health Day just around corner StepJockey wanted to explore the global health landscape and find out more about the challenges facing us. We had the real privilege of speaking with Dr. Vivek Muthu, Medical doctor, business founder and entrepreneur, about his vast experience in the medical field and what the future holds.

What are the biggest health risks that affect office workers?

The biggest and most important health risks for office workers are the same ones that affect all of us in modern urban societies: non-communicable diseases, like diabetes, cardiovascular disease, cancers and mental health disorders.

There are many things that increase our risk of getting these conditions, and being sedentary for long periods - as many office workers are - is one of them.

There are lifestyle changes we can all make to reduce these risks: stop smoking, eat a healthy diet, take regular exercise, avoid alcohol and engage in routine everyday activity, rather than sitting for long periods. Most of this is not new, and won't come as a surprise. What we are learning, which is new, is about the additional beneficial role of frequent, what you might call "little and often" incidental activity, especially for preventing obesity (which is also linked with cancer), diabetes and heart disease. This kind of activity is distinct from regular "exercise sessions," and is important, even for those who take regular exercise.

Another issue (not unique to office workers of course) is mental health. Again, evidence is accruing that incidental activity improves mental health. It also improves performance - with evidence suggesting that it reduces stress, and improves productivity and creativity.

Is 'Sitting is the new smoking' just a catchy tagline or is there some truth in it?

Smoking is bad for health. Very bad. If there had to be a mutually exclusive choice between stopping smoking and stopping sitting, I'd say stop smoking. But that really is not the choice we face. Most people don't smoke. Many people do take regular exercise, try to eat healthily and try to drink less. So sitting less and moving often is just another - and arguably very easy - way to reduce risk and improve wellbeing still further. And even for those who struggle with smoking, diet, exercise and alcohol, then reducing time spent sedentary is something that is relatively easy to do and will reduce risk. It's no substitute for stopping smoking, but as discussed above, we're not talking about an "either / or " situation.

The point to take away is that reducing sedentary behaviour is probably one of the easiest lifestyle adjustments one can make, and it has health benefits.

What are the most impactful innovations you have seen during your career in Medicine?

That's a hard one. There have been huge advances in medical technologies and our understanding of human biology. In almost every branch of medicine, our ability to diagnose and manage diseases has dramatically improved since I qualified. For example, with modern, best quality care, people with HIV with can expect to live as long as the general population. We've seen major step changes in the way we manage coronary artery disease and heart attacks; a cure for hepatitis C; major advances in stroke management, minimally invasive surgical techniques and in diagnostic imaging.

Every physician and surgeon would be able to point to major technological or scientific breakthroughs that have revolutionised their field of practice in recent decades. Cumulatively, these have had a big impact on all of us.

But what interests me most is the innovations no-one really talks that much about in medicine - the innovations that come from a shift in mindset and policy. Arguably these have been the most impactful - maybe even more than all the high tech stuff we hear about. For example, our approach to tobacco control: we have known about the dangers of tobacco since at least 1950. But the key innovations came only 50 or more years later, when we banned smoking in public places and severely restricted how tobacco products were sold. These policy innovations (just like any other type of innovation) disrupted modes of thought and modes of working; and they have a huge impact on health.  The compulsory use of seat belts in cars is another such innovation. Vaccination schedules for an increasing number of terrible diseases has been another. Another innovation is the increasing use and transparency of data, so that for the first time (remarkably - and this may come as a surprise), we are beginning to see what processes and what patient outcomes healthcare is actually achieving, so that we can systematically improve our healthcare systems (though we still have a long way to go on this).

To my mind, one of the innovations we most need now in modern healthcare is another mindset shift. We need to view healthcare in a different way: instead of it only being something that treats us when we get sick, we need to view healthcare as something that keeps us well. We also need to think about healthcare beyond the hospital and the doctor or nurse. Health is a responsibility we have to take upon ourselves and wider society, and which is increasingly involving industries and actors outside of traditional healthcare, like the tech industry, consumer health industries, the education sector, urban planners and architects.

These shifts and innovations are especially necessary as we move from an era of infectious diseases to one of non-communicable diseases and where we suffer more and more chronic (long term) illness. Alongside all the great innovations that will restore us if we get ill, we need innovations that will help us to stay well. We need  innovations to prevent disease, and to manage our long term wellbeing in sickness and in health. This type of innovation is often neglected, in terms of both investment and public awareness, despite its massive potential impact.


Dr Vivek Muthu qualified in medicine from Oxford and holds a first-class degree in neurophysiology from Cambridge. He worked at a number of teaching hospitals, including London’s Queen Square and the Hammersmith Hospitals, before joining the British Medical Journal, where he helped to develop and lead a team examining the value of drugs and devices. Vivek went on to found Bazian, a company dedicated to developing and servicing the needs of the emerging paradigm of value-based health internationally, focusing on the application of analytics and evidence to deliver high quality, safe, cost-effective care. He sold Bazian to The Economist Group, becoming global MD of healthcare at the Economist Intelligence Unit. Vivek now continues to advise the Economist Group, and is a non-executive in a number of healthcare companies. He works with the European Bank for Reconstruction and Development, focusing on improving healthcare provision in transitional Eurasian economies, and is also on the steering committee for All.Can, an international, multi-stakeholder initiative to improve outcomes for cancer patients. Vivek regularly chairs and speaks at C-suite and ministerial multi-stakeholder summits, round tables and advisory boards globally, on behalf of both The Economist, industry, policy-makers, NGOs and third sector participants in healthcare. The common theme is how to optimise innovation and patient and population health outcomes.

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