The Downfall of Health and Wellness as a Challenge to Humanity: Using Science Fiction to Highlight a Real-Life Crisis

Abstract

My academic career has largely focused on the importance of healthy lifestyle behaviors, in both primary and secondary prevention, to reduce the risk of poor health outcomes and improve quality of life. Despite the evidence and clear value of adopting healthy living medicine as a primary component of healthcare delivery, much of the world, particularly the United States, has remained mired in a secondary, reactive model, where unhealthy lifestyles and chronic disease are often allowed to run rampant before healthcare management is initiated. I was recently at a scientific meeting where a fellow attendee stated that our scientific writing would benefit from new perspectives and approaches, with a hope of resonating with audiences on a different level and hopefully facilitating meaningful change that has previously not been realized. This comment inspired me to consider science fiction as an approach to illustrate a real-life health crisis faced by humanity. There is an important non-fiction component to the science fiction story presented herein—unhealthy lifestyle behaviors have a substantial negative impact on human resiliency and, if drastic measures are not taken, these behaviors may in fact drive humanity to a tipping point from which we will not recover.

“Knowing the importance of adopting healthy living behaviors in a secondary prevention approach to care, implementation of such a strategy is far too infrequent.”

Health on Earth Through the Lens of Science Fiction

Intelligent alien life exists beyond Earth. The Healorians, a carbon-based lifeform that share many genetic commonalities with humans, prioritize the health and wellness for their entire civilization. As such, resiliency abounds—healthspan, as opposed to lifespan, is used to describe each citizens existence. Exercise and healthy nutrition, for example, are not concepts the Healorians would recognize because they are instinctually driven practices. But they are not a peaceful civilization and have conquered many other planets over the eons. The Healorians approach conquests patiently, observing, analyzing, and identifying the weaknesses of other planets they target for conquest. They would rather facilitate the self-destruction of a civilization from within as opposed to an outright, violent conflict where Healorians would certainly perish. In selecting a target, the Healorians seek out the opposite of the characteristic they hold in the highest regard, resiliency—a civilization that lacks resiliency in any form is observed and considered for conquest.

A Healorian invasion armada has been positioned in Alpha Centauri since 1940. Advanced monitoring technology has allowed for a detailed assessment of human behaviors and history. A lack of resiliency in humanity has been posited for some time. The Healorians watched for the resiliency tipping points associated with societal unrest, wars, disease, etc. However, humanity continued to find a way to maintain a sufficient level of resiliency and progress. Throughout the monitoring period, the Healorians chose not to send a forward scout team, which was customary when a resiliency tipping point was deemed highly likely. A primary goal of the scout team would be to infiltrate (Healorians, by outward appearance, pass for humans) and launch clandestine operations to further accelerate a resiliency tipping point. The Healorian strategy of passive observation was about to change.

The year was 2023—since 2020, most strategic meetings of the Healorian armada leadership was focused on the coronavirus disease 2019 (COVID-19) pandemic. Excitement grew as the Healorians thought the viral pandemic, in conjunction with its associated societal and political strife, would initiate the resiliency tipping point needed to send the scout team to prepare for conquest. Humanity, however, seemingly proved sufficiently resilient again, developing a vaccine and emerged from the pandemic. While most concluded a passive, observation-only approach must continue of minimize loss of Healorian lives through an invasion, a nuanced observation emerged. A Healorian Minister of Health was assigned to the armada with the responsibility of ensuring the healthspan of all Healorians deployed to Alpha Centauri. While he attended all meetings related to military strategy, the Minister of Health rarely spoke, as his role was not focused on plans for conquest. The Minister of Health received and analyzed a wealth of human health information—he was fascinated by humanity’s lack of commitment to a healthspan, seemingly focusing exclusively on the lifespan, where for many, years were spent mired in chronic disease, poor quality of life and disability. The Minister of Health also read, with interest, the fact that those who were more likely to die from COVID-19 infection suffered from, what humans referred to as, poor lifestyle attributes, such as not exercising, consuming an unhealthy diet, and having excess body mass. The Minister of Health was also aware of the information that poor lifestyle attributes were increasing because of the societal changes during the COVID-19 pandemic lockdown, changes that may not reverse and therefore establish a new normal in poor lifestyle behaviors. Listening to Healorian military leadership during the 2023 strategic meeting, the Minister of Health had an epiphany and spoke out. “All, the resiliency tipping point we have awaited is upon us! Humans do not seem to appreciate the meaning or importance of healthspan—they appear to be progressively letting go of health behaviors we cherish and find instinctual. They seem incapable of finding a way to reverse this course. Humans also recognize future global viral pandemics will likely emerge—if baseline health behaviors continue to decline, they will lack the resiliency to successfully navigate future viral pandemics or other health crises. Millions around the planet will die, their defenses will weaken and Healorian conquest will be all but assured. The time to send the clandestine scout team has come!”

The room went silent as the Minister of Health concluded his remarks. One of the Military Minsters asked what the mission of the scout team would be. After some reflection, the Minister of Health responded: “The scout team will attain positions of leadership and influence in public health organizations around the world. Once in place, the scout team will convince humanity that combatting poor lifestyle behaviors is a lost cause, it is therefore time to consider other management strategies. The new focus for humanity will be to increase focus on the eventual certainty of managing chronic disease associated with leading a life with poor health behaviors for the majority of the global population. Humans have already seemed to quickly embrace medications to lose weight as a replacement for what they refer to as exercise and eating healthy. Humans also seem to have quickly forgotten the clear link between poor health behaviors and death from COVID-19. If humanity continues to ignore health and wellness and its consequences, simultaneously pursuing replacements through medications and other means, their downfall will be assured. It seems humanity is accepting poor health as inevitable—they have imposed their own resiliency tipping point. Our scout teams efforts would facilitate a process that is already well underway.”

In 2024, the Healorian clandestine scout team left Alpha Centauri and began the journey to Earth. Ten team members were sent with the goal of assuming public health leadership positions and convincing humanity of their inevitable fate. The Minister of Health watched as the scout team craft departed and felt overwhelmed with sadness—“I have committed my life to the health and wellness of the Healorian race, never would I imagine a lack of health and wellness can be wielded as a weapon.” The Minister of Health felt empathy for humanity—such a simple path to resiliency, exercising, eating well, etc., little do they know that forsaking this path has initiated their destruction.

The Real-Life Health Crisis

My academic career has largely focused on the importance of healthy lifestyle behaviors, in both primary and secondary prevention, to reduce the risk of poor health outcomes and improve quality of life.^1,2 As with most academics in the field, my writing has taken the traditional path—peer reviewed original research, reviews and editorials using a non-fiction, scientific approach to make the case for the importance of healthy living medicine.^3-5 I have always felt the case for healthy living medicine, in the form of: (1) moving more and sitting less; (2) healthy nutrition; (3) not smoking; (4) minimizing excess body mass; and (5) proper sleep patterns, is overwhelmingly convincing based upon the wealth of supporting scientific evidence spanning several decades. Despite the evidence and clear value of adopting healthy living medicine as a primary component of healthcare delivery, much of the world, particularly the United States, has remained mired in a secondary, reactive model, where unhealthy lifestyles and chronic disease are often allowed to run rampant before healthcare management is initiated. ¹ Even in this model, knowing the importance of adopting healthy living behaviors in a secondary prevention approach to care, implementation of such a strategy is far too infrequent. One needs to look no further than the historically poor referral rates and adherence to cardiac rehabilitation programs.^6,7

The world dramatically changed during the COVID-19 pandemic in many ways. From a scientific perspective, research into the drivers of poor outcomes in those infected was rapidly conducted and disseminated. Within this body of evidence, the well-established, although often ignored, message of the dangers of unhealthy lifestyle behaviors came to the forefront, as we quickly found those with poor lifestyle behaviors and chronic conditions which often emanate from these behaviors, significantly increased the risk of hospitalization and death in those infected with COVID-19.^8-10 The Centers for Disease Control recognized the strength of this evidence and listed both physical inactivity and obesity as risk factors for hospitalization with COVID-19 infection.^11,12 With these developments, I became hopeful that we were reaching an important turning point in recognizing the importance of healthy living medicine and begin the meaningful integration of primary and secondary behavioral interventions into the healthcare system.

We have emerged from the COVID-19 pandemic and returned to many of our normal patterns. With that, I am fearful that another important moment to propel healthy living medicine forward is passing. In fact, evidence indicates lifestyle behaviors may have further worsened during the pandemic on a population level and it is unclear if we will even return to the poor baseline patterns in unhealthy lifestyle behaviors that were present prior to COVID-19.^10,13,14

In Closing

I was recently at a scientific meeting where a fellow attendee stated that our scientific writing would benefit from new perspectives and approaches, with a hope of resonating with audiences on a different level and hopefully facilitating meaningful change that has previously not been realized. This comment inspired me to consider science fiction as an approach to illustrate a real-life health crisis faced by humanity. In truth, it appears we do not need an invading alien force to further promote an environment where unhealthy lifestyle behaviors are allowed to thrive. It seems humans are rather efficient at promoting such an environment without outside assistance. There is an important non-fiction component to the science fiction story presented herein—unhealthy lifestyle behaviors have a substantial negative impact on human resiliency and, if drastic measures are not taken, these behaviors may in fact drive humanity to a tipping point from which we will not recover.

ORCID iD

Ross Arena https://orcid.org/0000-0002-6675-1996