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Harald Renner

In 1994, the German GEO magazine published a representative survey: "What keeps us healthy, what harms our health? Where are the dangers?"

Most of the answers to these questions were surprising at the time and have remained remarkable to this day.

During the survey, the entire population chose the dangers that they believed could be harmful to our health. They listed them in descending order: Toxic waste, asbestos, side effects of strong medicines, car exhaust fumes, drinking water pollution, AIDS and nuclear power plants.

Experts from science and technology, who are also interviewed, assessed the risks differently - and still do so today.

For them, the tar and nicotine vapour from cigarettes represents the greatest health risk at 81 percent. 71 percent stated that people do not get enough exercise. 58 per cent reminded us that alcohol is poison. At 42 percent, "fat" and overweight are far more dangerous than asbestos, toxic waste or the dangers of nuclear energy.

It seems difficult to agree on "health risks". Do we at least know what makes us healthy?

Karin Felix could help us answer the question. She wrote a bestseller called Fitness and Health a long time ago. That's what the opening credits read:
"The book aims to encourage women to do something for themselves - for a healthy, beautiful body, for serenity and self-confidence. The book aims to inspire them to lead an active, relaxed life. Every woman can choose what she likes from the variety of possibilities. Because an all-round good self-esteem is not a question of age or fitness."

We must choose this language today to attract many readers. Self-confidence, fun, a holistic self-esteem - such concepts capture the zeitgeist. Health as a central component of quality of life: this message sounds good and is clear. It is not a mistake to answer health questions in this way.

Despite all the fundamental agreement with this book and its positive attitude towards life, I would like to add two thoughtful questions.

First question:
The "healthy, beautiful body" - does this memorable and superficial equation exhaust our concept of health? Is that what keeps us healthy?
Second question:
Can I call my goal "health for me"? Health for me alone, for my beloved self? Or do I take sides for the more humane demand of the World Health Organization (WHO): "Health for all?"

The WHO lists seven basic conditions for health:

1. a stable self-esteem
2. a positive relationship to one's own body
3. friendship and social relations
4. an intact environment
5. meaningful work and healthy working conditions
6. health knowledge and access to health care
7. a present worth living and a well-founded hope for a future worth living.

What threatens our health today? What endangers our body, our mind and our soul? What is overwhelming us?

Our lives are often determined by over-stimulation, haste and restlessness, anger and aggression, lack of exercise and noise, mass traffic and spatial narrowness. We like to see ourselves in the role of the maker who masters the technology and uses the new media self-confidently. But much more often we are subjected to the apparatus that we ourselves have created. Pressure to perform is everywhere. He has pupils and sportsmen, drivers and working people, self-employed and employees firmly under control. Leisure time, holidays and pleasure are also determined by stress, which tugs at our strength and nerves.

Where can we start if we want to build up a counterweight to the "syndrome of overburdened people" within ourselves? Maybe by trying to stabilize our self-esteem.

Professor Siegrist writes: "According to current knowledge, a stable self-esteem is an important prerequisite for dealing well with stress, conflicts and emotional tensions. If the social environment hinders the development or stabilisation of self-esteem, this limits tolerance to stress. Crises then fully unfold their shocking power, and susceptibility to disease increases."

We should take countermeasures. With proven and new relaxation techniques, we have the opportunity to counteract stress, anxiety and depression and thus strengthen our immune system. The abundance of offers is overwhelming. Those who have lost the overview can initially concentrate on the programmes that have been attracting the increasing interest of psychologists and brain researchers for some years now. I will mention two examples that are currently in focus: mindfulness training (MBSR) and so-called "tapping" (EFT). Due to my own good experiences I recommend these methods to others. Google and YouTube provide a lot of descriptive information about this.

Sooner or later, we will be faced with the question of what our life plan looks like. If we recognize what makes us sick, it is possible to recognize what keeps us healthy. Aren't corrections overdue? Where should we start when the pressure of suffering is increasing?

Above all, we should no longer participate in everything that others - contrary to our inner convictions - expect of us. We should learn to say "no" to things we find unreasonable, in a friendly but definite way. Also to the things that we force upon ourselves without necessity. We should develop into "tolerant egoists" in an acceptable sense. It is possible that our family, our friends and acquaintances, our superiors and professional colleagues may find such a change in values more attractive in the longer term than well-adapted, compliant participation. If not, we should tell them about our changed attitudes. I am happy to quote this sentence: If we really want to be satisfied, nobody can prevent that. If we recognize that our expectations and demands are responsible for our satisfaction, we can change those expectations - if we are ready.

We are all subject to the constant balancing act between success and failure - nobody is immune to it. Even if it looks like a contradiction: We need this game of risk like air to breathe. Not because we are thrilled by the thrill, but because every risk offers tangible opportunities.

The more difficult the challenges, the more satisfying it becomes to have overcome fear and insecurity. Pride in an achievement you didn't dare to perform before means a valuable gain in mental health. Good prevention does not wrap people and their problems in cotton wool, but encourages them to lead a conscious life "here and now".

Our best protection of health seems to be to learn to deal with conflicts and tensions in such a way that we do not become paralyzed by them, but grow from them. This means that we feel at home somewhere, that we recognize a meaning in life and develop personal perspectives. We have trust, cultivate relationships and can feel joy. We dare to do something and are grateful for the whole range of our emotions. Anger and envy and fear and sadness are part of it, but also love, sympathy and sensual joy. It's all part of being human.

Let us also remember that it is not only our fellow human beings who cause us stress. We ourselves can cause daily stress for others without realizing it. This insight enables us to change our attitude from selfish to empathic. In this way we improve our own health and can promote the health of others.

This means assuming responsibility in three ways. It is about the responsibility for our own health, the responsibility for the health of our fellow human beings and the responsibility for the living conditions on our planet and thus for the life chances of future generations.

The first goal - responsibility for one's own health - is obvious. Here we find the classic topics aimed at a healthy lifestyle, such as healthy nutrition, prevention of cardiovascular disease, moderate use of stimulants. We learn to recognize and change living conditions that damage our health. We learn to perceive the interaction between body, mind and soul. We gain decision-making authority for our health.

The second goal of health promotion is to take responsibility for the health of other people.

What does this look like in practice? Nobody wants to endanger or harm his fellow citizens by ruthless behaviour on the streets - which of us would not have done this already? Nobody wants the stronger to harm the weaker, overtax him and exert physical or psychological pressure - but we know many examples of where it happens and we do not intervene.

We react horrified and bewildered to reports of violence against the defenceless in all its terrible forms. But are we fighting to make sure that this doesn't happen again? We must also ask ourselves the following question: Do we help our fellow human beings to cope with their life problems, do we give them social support? Do we have understanding for the elderly, disabled and sick?
How do we deal with the incurable cancer patients in our neighborhood? Do we support and stabilise the addicted young people in our circle of acquaintances? Do we make our own personal contribution to liberating people from a vicious circle that makes suicide the only way out?

Who would deny that all these questions have anything to do with health? Who would deny that we can and must do more than just take care of our own health?

A third goal of health promotion is to take responsibility for the living conditions in this world and thus for the life chances of future generations. In the coming years, this topic will increasingly occupy us, whether we want to perceive it or not. On "global" issues such as environmental or peace policy or a just world order, we should do without purpose-optimistic whitewashing as well as discouragement and resignation. Let us rely on the principle of hope without losing touch with reality. Let us trust in an active and impatient hope that seeks every opportunity to act within the bounds of possibility. This applies above all to the known and manageable area for which we are responsible.

According to a study by the University of Bielefeld, 61 percent of young people in our country see their future threatened by environmental destruction. This figure proves that it is possible to change attitudes and arouse interest with patience and persuasiveness. But the consequences of correct knowledge and good intention alone are not enough. Knowledge is not synonymous with action, action is not synonymous with stabilized behavioral change.

We need to address this problem if we are to influence our own health behaviour and that of our fellow human beings.

In recent years it has become clear that it makes little sense to define a certain - meaningful - preventive message ("smoking kills") and to publish it with the help of well-known advertising media. With this procedure, we can pretend that we've done enough. But we achieve little with it - at least if we only use this method. Things are more complex.
We know from behavioural research and our own experience that the strongest motivation in human behaviour does not result from rational considerations but from emotional impulses. Let us draw conclusions from this realization.

We should say goodbye to the thousandfold failed attempt to achieve a stabilised, changed health behaviour by the mere provision of information. We must also abandon the attempt to achieve something positive by describing only the dark consequences of a wrong lifestyle.

We should focus more on the possibilities of discussion and group work. We should try to convince through our personality, our openness and - if available - our own positive health behaviour. Disappointment and failures in health promotion are inevitable even when we see our counterpart as an object, but not as an equal, self-determined, mature partner who has as much to give us as we give him.

Those who have committed themselves to the good task of promoting their own health and the health of their fellow human beings live in constant danger of being disappointed and resigned. It reduces the danger if we accept a realistic picture of humanity and achievable goals.

So from time to time let us take a self-critical look over our shoulders. Our own enthusiasm, our own efficiency, our own health successes can tempt us to overtax our partners seeking advice. We have to offer achievable milestones and thus a truly personal help. We must not make our partners in health promotion the victims of our own highly tense goals and expectations. We make the sacrifice ourselves. It can be disappointment, resignation and abandonment. The consciousness of reality becomes our important protection.

Today there are people in medicine and health promotion, in education and the social sector, in politics and the media who understand the signs of the times and think and act in partnership. Teamwork and multisectoral approaches are important to shed light on the social and psychological backgrounds of health-related behaviour. We must not forget the importance we attach to dealing with conflict, our personal and social fear, our fear of exclusion and discrimination. We must not underestimate the impact of prestige and group pressure on our health behaviour. Let us also pay attention to the power of the media and advertising.

Health promotion is only effective if it influences behaviour and circumstances, if it takes into account the social environment and tailors it to the individual and his living conditions.
Anyone who has recognised that health promotion means teamwork also understands that no specialist group alone holds the "philosopher's stone" in its hands. Openness, diversity of opinion and tolerance are in demand in the discussion about the goals and contents of joint work. We need a responsibility for health that involves everyone. That's what keeps us healthy.