The impact on health services of an ageing population is profound. This is being experienced on a daily basis by communities and governments around the globe. As life expectancy expands, the range of potential clinical interventions increases, and the expectations of individuals and their families grows. This is often coupled with more elderly people not being able to rely on wider family networks, creating a genuine global challenge. Age is becoming an increasingly fluid concept. Some people are “old” at 60, – no longer working, in need of heath or social care. Other people are still employed at 85 and living fully independent lives. We have little real idea how many of those born today will still be “going strong” as they pass 100 years of age. Will we simply extend periods of ill health at the end of life, or instead find ways to live long healthy active lives? The key question is perhaps to ask what does it mean to be a healthy and a fully rounded human being and what kind of services do we need, which will help rather than hinder human development. More precisely do we want to develop health services, or illness services? The problem with an illness service model with an ageing population is that the demands upon it are potentially infinite, particularly with the tendency to pathologise, for example; mood, lifestyle, food or weight.

We know that people who eat well, exercise regularly, and are well socialised and networked, keep their brains active generally develop age related illnesses considerably later. So how do you deliver these wider health outcomes? Paradoxically it is achieved by focusing less on a bio-medical model, and embracing a wider model that sees health within a community setting.

The Inuit in the Arctic traditionally paid their healer only when they were well. If they fell ill, the healer had failed in their primary task, a model that surely has lessons for us all.

This is important as over 50% of the issues that present themselves to GPs do not have an underlying medical cause. They may have a presenting health issue, obesity, depression, heart disease, but the underlying driver is very often social; under employment, poor housing, debt, loneliness, stress, social isolation, and very often a combination of several of these.

From our team’s early involvement in the NOF PE & Sport in Schools Programme and NOF’s Healthy Living Programme all the way through to major mixed-use schemes such as the MIDI Project, where pedestrianisation was seen as one key way to urbanise to create a more environmentally and healthy way to live, to current schemes in China, where the Urban and Healthcare eco-systems are being re-planned to put the community, the family and the physical, mental and social health of the people at the heart of the development plans, Health and Wellness are increasingly important elements when it comes to the development of the very fabric of our communities.

Healthy living involves creating and maintaining health: a state of complete physical, mental and social well-being – not merely the absence of disease or infirmity. Given this complexity and interdependency, it is clear that enabling healthy living is not just a health agenda, but an imperative for all of society. To have a sustained impact, everyone should work together to build environments in which healthy choices are the easiest choices. Insight is proud to be working with forward-thinking developers and social entrepreneurs where this synergistic thinking is being fully integrated into their development approach, which includes the delivery of both acute hospitals to community and integrated out-patient clinics to Med-tech towns for innovation to thrive.