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According to Devi Sridhar<\/a>, we have our health priorities all wrong. In fact, we\u2019ve been sold a giant myth. We are unhealthily obsessed with what we can do personally \u2013 diet, exercise and the rest \u2013 and largely ignore the most important determinant of our health. This magic bullet: government.<\/p>\n Public health measures like universal healthcare, drinkable water, clean air and safe roads have a much bigger impact on our chances of making it to 100 than any number of gym sessions or kale smoothies. Sridhar, a professor of global public health at the University of Edinburgh, UK, has a new book out called How Not to Die (Too Soon)<\/a>, which makes a robust case that public health, not just individual striving, is key to living a long and healthy life.<\/p>\n She spoke to New Scientist about why we swallowed the myth of purely individual health, how we can make public health more appealing and what she would do if she were in charge.<\/p>\n Graham Lawton: Are you saying that taking responsibility for our own health is a waste of time?<\/strong>\u00a0<\/strong><\/p>\n Devi Sridhar: No, no! It\u2019s super effective if you can do it. You can make the choice to be healthy if you have resources and time and education. But I think the idea that individuals are fully responsible for their health \u2013 which is what is being projected to us \u2013 doesn\u2019t reflect the realities of people\u2019s lives. Where you live and the circumstances you are living in affect how long you live. That\u2019s so easily forgotten with health issues, which are seen as your responsibility. You do need people to have agency over their lives and feel like they can make change. But actually, when we\u00a0see change at a population level, where does it come from? Generally, it comes from governments.<\/p>\n Why did we fall for the myth that it\u2019s down to us?<\/strong>\u00a0<\/strong><\/p>\n It makes us feel empowered. People are like, \u201cWhat can I do, today?\u201d and \u201cI can do it if I\u2019m tough enough!\u201d But it\u2019s difficult to get people to think about wider structural issues and how to change them. And we aren\u2019t exposed to that as much. We\u2019re exposed to self-help books \u2013 the wellness literature \u2013 which are great if you have time and resources. But there\u2019s less about the structural factors because people can\u2019t see it as directly applicable to their lives. And there\u2019s a lot of cynicism about politicians, thinking that they\u2019re all the same and nothing ever changes.<\/p>\n What\u2019s the right balance between personal interventions and public health interventions?<\/strong>\u00a0<\/strong><\/p>\n I think it depends on the issue. With diet<\/a> and fitness<\/a>, you can take a lot of responsibility. But with things like air pollution<\/a> and clean water<\/a>, what can you do individually? You\u2019re at the mercy of the place you live and your government.<\/p>\n Do things like celebrity diets and TikTok influencers also skew the balance?<\/strong>\u00a0<\/strong><\/p>\n Yes. It\u2019s the marketing. We seem to think things that are marketed and sold to us in the right way are better. I think there is a real marketing problem in public health. The past years probably haven\u2019t helped. Public health is seen as draconian and overbearing, taking away freedoms instead of giving freedoms.<\/p>\n How do we change perceptions of public health?<\/strong>\u00a0<\/strong><\/p>\n It\u2019s about how we talk about public health. Rather than saying that it\u2019s good for the planet or it\u2019s good for society, we could talk about it in terms of how it makes life easier and better. I think people want to know, why is it good for me? It makes me sound cynical, but that\u2019s the world we live in.<\/p>\n \u00a0<\/p>\n Vaccinating children for measles is a lifesaver, yet social media influencers may spread doubt<\/p>\n Morwan Ali\/EPA\/Shutterstock<\/p>\n<\/p>\n Even then, it can be difficult to get the message across when there\u2019s so much misinformation about things like vaccination. Why do so many people believe nonsense?<\/strong>\u00a0<\/strong><\/p>\n I think part of it has to do with social media and the fact it doesn\u2019t matter if you are accurate or not: popularity determines truth. For instance, you have Joe Rogan on his podcast talking about measles<\/a> \u2013 saying that everyone had measles<\/a> when he was a kid and it was all normal. It\u2019s astonishing. He isn\u2019t a doctor. He isn\u2019t a public health expert. He\u2019s just giving his opinion. But he will be more influential than any health agency. If I came out and said, \u201cYou know what the secret to longer life is? Gin and tonic!\u201d, it would get a million clicks. I think that\u2019s the challenge.<\/p>\n And there\u2019s also the challenge of implementing sensible public health policies, right?<\/strong>\u00a0<\/strong><\/p>\n There\u2019s always resistance to change. Think of the smoking ban<\/a> in pubs, there was resistance. When seat belts came in, there was resistance. But generally, resistance comes in the first six months or year, then people get used to it and that becomes the norm. Norms are changeable.<\/p>\n Your book contains many stories of successful government intervention from around the world. Which is your favourite?<\/strong>\u00a0<\/strong><\/p>\n Because I\u2019m in Scotland, I have to say Dunblane. The gun legislation [put in place after a school shooting in 1996 using legal firearms] was a hard-fought battle, there was real resistance, but the pay-off is decades of no mass shootings in British schools. Many lives have been saved. And we\u2019ve seen that template used around the world.<\/p>\n In high-income countries, an estimated 20 per cent of deaths are from preventable causes. <\/strong>What can we learn from countries with lower rates of preventable deaths?<\/strong><\/p>\n The places to look are what we call the better-performing countries \u2013 places like Japan, which has one of the lowest rates of chronic disease and highest rates of cancer survival. So, it\u2019s looking at the best performers and saying, if every country looks like that, what would the numbers be able to come down to? Japan\u2019s is remarkably low, estimated at about 10 per cent.<\/p>\n Our aim should be increased life expectancy for all \u2013 getting to 80, 90, possibly 100. If you can die of old age, you\u2019re doing pretty well, right? Because it means there\u2019s no identifiable disease or organ failure.<\/p>\n But success would mean that we end up with an older population. How would we deal with that?<\/strong>\u00a0<\/strong><\/p>\n I think we have to see ageing as a positive force instead of a negative one. We should talk about healthy ageing<\/a>, not getting to 100 for the sake of getting there, but with full mental and physical abilities, without chronic diseases like diabetes or hypertension, which are a burden on the healthcare system, and with the ability to live independently, which takes pressure off social care.<\/p>\n How long would it take to achieve this idealised situation where the preventable death rate is comparable to that of Japan?<\/strong>\u00a0<\/strong><\/p>\n Being realistic, it\u2019s probably a 10-to-20-year timescale. Things like reversing childhood obesity and changing city design aren\u2019t possible overnight. But they have large pay-offs over time. One of the problems is that our current model of government is news cycle to news cycle. It isn\u2019t even year to year. It\u2019s headline to headline, and it\u2019s incessant. So, there\u2019s no bandwidth for people to think 10 years or 15 years ahead because they are caught up in it.<\/p>\n \u00a0<\/p>\n There is usually resistance to new public health rules, such as the mandatory use of seat belts, but people soon adapt<\/p>\n CrackerClips Stock Media\/Alamy<\/p>\n<\/p>\n OK, so if you were in charge of the National Health Service (NHS) in the UK, what changes would you make?<\/strong>\u00a0<\/strong><\/p>\n I\u2019m sure they\u2019ve thought about this, but for me, prevention. We spend far less on prevention and far more on acute care. Right now, the focus in the UK is on hospitals and ambulance wait times, and it\u2019s only going to get worse with an ageing population. So, I think I would go straight to prevention. What are the cheap ways we can invest in prevention to detect things earlier? Pick three or four issues that are the main reasons for hospital admissions and ask, how do we address them?<\/p>\n For example, we know hypertension<\/a> is a silent killer. Could we have a programme where people go in and get their blood pressure checked once a year? It might cost more in the first year, but five or 10 years down the line, you\u2019re saving money. We could also take regular measurements of things like waist circumference,\u00a0abdominal fat levels, sugar and cholesterol in blood, or even grip strength.<\/p>\n![\"A](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/07\/SEI_255879042.jpg\")
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