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What’s the secret to a longer life? Is it a perfect diet? The most expensive exercise equipment? Botox? Anti-aging serums? That magic spring from Tuck Everlasting?
In a consumeristic world like ours, where doing this and buying that promises a longer, forever-young life, it’s hard to imagine that the true solution to increasing our longevity would be simple—or possible at all.
In 1999, Dan Buettner embarked on a mission to discover how certain cultures around the world enable people to live well past their one hundredth birthdays. What he found was an obvious answer: people don’t try to live to be one hundred . . . they just do. Still, unless you’re born somewhere that enables this sort of longevity, “just doing it” may be impossible. It is possible, however, to take the principles those locations offer and emulate them in other communities around the globe. That’s what Buettner was determined to do.
Buettner’s story starts in Saint Paul, Minnesota. Growing up in a lower middle-class home, as one inside a six-person family, Buettner didn’t spend his youth at amusement parks or taking luxe vacations. Instead, his father, Roger, would drive him and his three brothers to the border of Canada to set up camp in the woods for weeks at a time. “We would go off the grid and live entirely off the land,” Buettner describes. “I was lucky to have a father like that.”
That gritty, salt-of-the-earth lifestyle transferred into his first job, too. At fourteen, he took a position selling newspaper subscriptions, where he learned how to communicate effectively with an audience and employ tools of persuasion to sell customers on a concept. Then, at twenty-two, he met Remar Sutton, a then-columnist for the Washington Post, who, according to Buettner, is a “genius at creating visions and organizing events.”
After helping Sutton organize unique events, like a celebrity croquet tournament for National Public Radio, Buettner learned how to become a producer, how to create an event that generates publicity and gets sponsors, and, above all, how to get the public behind a concept that might seem out-there.
Buettner kept these kinds of skills handy as he pursued his own outlandish dreams: riding his bicycle across nearly every continent. “My father instilled this great zest for adventure,” he says, “and Remar showed me this ability to think big and then realize that larger vision. I knew I wanted to bike through South America, but I figured that without too much more effort, I could set a world record doing it.”
And he did. Buettner nonchalantly mentions this accomplishment, but the expedition was, naturally, anything but easy. Starting at the top of Alaska and ending at the tip of Argentina, Buettner and his brother rode more than fifteen-thousand miles, completing the first of three transcontinental bike rides that would each earn them Guinness World Records.
By 1992, Buettner and his team cycled across the Soviet Union—beating their previous world record by more than one thousand miles. And in 1993, they earned their third world record by riding from Bizerte, Tunisia, to Cape Agulas, South Africa. The latter trip inspired Buettner to write Africatrek: A Journey by Bicycle through Africa and coproduce a documentary using footage he shot during the ride.
“It’s not the same kind of endurance needed to complete the Tour de France,” Buettner reflects. “It requires physical output for ten months, so you’re not going fast every moment. You’re going at a speed where you’re making decent miles, but you’re also stopping strategically so you don’t become fatigued or end up in a dangerous area.”
That pace allowed Buettner and his team the opportunity to absorb the cultures of each country—and each community—they passed through, which, in turn, inspired Buettner to create Quest Network, a company that sought to explain mysteries of ancient civilizations. Composed of archaeologists, biologists, and technologists, Quest Network was a team of fourteen people that used an expansive online audience to collaborate in answering a question like, “Why did the Mayan civilization collapse?”
“I got very good at synthesizing information in a scientifically responsible way to solve a mystery,” Buettner notes. “We stumbled upon a report from the World Health Organization [WHO] that showed that Okinawans have the longest disability-free life expectancy in the world, and I said, ‘Aha! That’s a good mystery.’ If I can find out what they’re doing, maybe I can find a good recipe for the rest of us to follow.”
That idea not only sparked his 1999 expedition but also a project bigger than Buettner ever could have expected. Tapping into the skills he learned as a young newspaper salesman and as an event organizer, he painted a vision of his research’s potential to eventually gain sponsorship from respected institutions like the National Institute on Aging and National Geographic.
“Everybody else was looking for the secret to longevity in a test tube or a petri dish or in some genetic code,” Buettner says. “And I said, ‘Why don’t we just go to the places where people have achieved the outcomes we want and find out what they do?’ Nobody had ever done it.”
National Geographic funded a year of research, which would go toward compiling the magazine’s cover story, “The Secrets of Long Life,” for its 2005 fall issue. Needless to say, exposing the recipe for longevity was popular among readers.
“Who doesn’t want to live longer?” Buettner asks, playfully. “One day you wake up and you see there’s a wrinkle or a gray hair or you notice a muscle that kind of hurts. And you start thinking about your life as a whole—that you want to walk your daughter down the aisle, or you want to see who your grandchild would be. I’ve never met a ninety-nine-year-old who didn’t want to live another year.
“I think it’s important to have a quality life, too,” he adds. “It’s not just about being around. It’s about being around something bigger than you.” That detail is at the heart of Buettner’s Blue Zones Project, an organization that enables communities in the US to provide the education and resources necessary for their residents to live better lives. It’s been Buettner’s most revered venture to date.
But let’s back up a moment. What exactly are Blue Zones? And how did Buettner find them?
After Buettner was given the means to conduct his research, he hit the books, looking for areas around the world where centenarian studies were already being conducted. In other words, he sought destinations where scientists had done demographic work to identify naturally high life expectancies. He found the first three areas—Sardinia, Italy; Okinawa, Japan; and Loma Linda, California—through existing academic literature by the WHO and similar scholarly resources. The last two—Nicoya, Costa Rica, and Ikaria, Greece—took a bit more digging.
“I hired demographers to pass through census data worldwide to find places where people were statistically living longer,” Buettner explains. “Our team would actually make a trip there and check birth certificates, then we would follow those birth certificates to see where those people were today—it’s a mathematical exercise. Then, I identified these places and named them.”
The name? Blue Zones—a title inspired by the blue-ink circles Buettner and colleagues would draw around key areas on maps.
“We stumbled upon a report from the World Health Organization that showed that Okinawans have the longest disability-free life expectancy in the world, and I said, ‘Aha! That’s a good mystery.’”
Once each zone was identified, Buettner and his team flew out for weeks at a time to get a sense of the people, their culture, their communities, and their lifestyles. They not only found that these cities are full of older people but also that those older people are living with incredible vigor and celebrated.
“You get a similar feeling in all of these places,” Buettner says. “It’s very clear that these people have a nice life and they are not a bunch of technology millionaires trying to find the next genetic intervention or the next nutraceutical that’ll help them live longer. These are people who are naturally living a high-quality life—socially connected, imbued with purpose, moving all the time.”
Buettner discovered nine common denominators—dubbed the Power 9—that allowed people in each of these places the ability to live life to the fullest (and the longest). For starters, people in these communities are “nudged into unconscious movement” at least twenty minutes a day. That movement can take many shapes, whether you’re a farmer in Sardinia, moving to keep your sheep in line, or you’re dining on a floor pillow in Okinawa, which naturally encourages you to engage your core muscles and use your legs to get up and sit down.
Residents have a strong sense of purpose and a vocabulary of purpose, but they also have daily rituals that slow them down, such as praying, taking naps, or participating in ancestral veneration (paying respects through meditation or a common ritual). They eat an overwhelmingly plant-based diet that’s very high in carbohydrates, whole grains, tubers, nuts, and beans. They never overindulge on foods: they drink alcohol in moderation and design their kitchens so that they are not grazing all day but rather have specific mealtimes.
Those living within Blue Zones also put their families before their careers and have hobbies or religions in which they are actively involved. And above all, they have an immediate social circle of people who reinforce these behaviors. So, the healthy habits these people take on aren’t one-offs; they appear in clusters.
“They’re not just one disciplined individual imbued with responsibility,” Buettner says. “It’s very clear that these groups support each other, engage in the community, and have a mutually supportive network of people. We miss that in America.”
Companionship is not the only thing Americans are missing. The convenience of transportation and the sprawling landscape of America doesn’t lend itself to walkable communities in many circumstances. Easy snack and meal options are oftentimes processed foods, high in fats and simple carbohydrates. And, spiritually, many Americans constantly seek validation and a sense of purpose in their jobs, relationships, and hobbies, only to find themselves unfulfilled in one area or another.
All of this is not to say that changing the overall way of American life is impossible. In fact, that possibility was Buettner’s next goal: take the nine commonalities of the Blue Zones and inject them into communities across the US. That way, people across the country could learn them, practice them, and build future generations using them. That’s an idea people can get behind.
So far, more than four hundred cities have applied to become a Blue Zone. Each application is vetted to ensure that the city’s top players in government, healthcare, and education are on board to participate. Of course, not all of them can be changed at once. The two guiding factors that determine which cities are picked, Buettner explains, are, one, the entirety of the public sector being on board with the project and, two, that the public sector can pay for the necessary changes so that citizens don’t aren’t saddled with higher taxes. Only then will Buettner’s team get to work.
“The organizing principle is we’re not going to try very hard to change people’s minds. We’re going to change their environment so we can set them up for success,” Buettner says. “The most effective and cost-effective way to change health behavior at the population level is through policy.”
Once a city is chosen to be “Blue-Zoned,” Buettner’s team of experts reviews policies to identify the best opportunities for change.
“They find the few policies that favor healthy food over junk food, limit junk food marketing, favor the pedestrian over the motorist, favor the nonsmoker over the smoker, and, for alcohol policies, make for maximum enjoyment with minimum damage,” Buettner explains. “Then our team comes in and spends weeks or months assessing the policies in place, assembles a customized menu of options for that city, and works with the city to pick out which of the policies are most effective and feasible in a five-year time horizon.”
The second step is administering the Blue Zone certification program for restaurants, grocery stores, workplaces, schools, and churches. The team works to improve policies or layouts so that the public can use each place in a healthier way—encouraging people to use the stairs or to opt for plant-based foods, for example. Lastly, the Blue Zones team holds free purpose workshops and curated volunteer opportunities to connect like-minded people.
Over the span of the five years working with the community, the team receives an annual report card of its data and compares it to the baseline data it gathered to assess progress. “In almost every city, our work helps drops the average BMI [body mass index] of the population, the physical activity level goes up, the smoking level goes down, and citizens report greater levels of optimism,” Buettner notes.
“Politicians talk about creating healthier, better places to live in—the Blue Zones Project actually does it by making permanent change to the environment,” he continues. “And we hold ourselves accountable by these measurements.”
Buettner mentions that while many communities just aren’t naturally set up for this kind of success, there is one main player that can help change an environment from the get-go: the healthcare system.
“We created a company that keeps people healthy in the first place, which is antithetical to a healthcare system because their stock prices and profits are very much dependent on people getting sick,” Buettner explains. “But there are executives who want to make ethics as important as profit.”
“Politicians talk about creating healthier, better places to live in—the Blue Zones Project actually does it by making permanent change to the environment.”
One of those executives is Scott Reiner, CEO of Adventist Health, a nonprofit health system based in Roseville, California, with twenty-three additional hospitals in California, Oregon, and Hawaii. Adventist Health is sponsored by the Seventh Day Adventist Church, which also has a large following in Loma Linda, California—one of the first Blue Zones discovered.
Rooted by the same principles practiced in Loma Linda, Adventist Health was founded on the idea of helping a whole person: physically, mentally, spiritually, and socially. While the system has integrated its work into its processes and operations since day one, Reiner wants it to have a greater impact on the communities it serves outside of the hospital.
“Eighty percent of our patients come from either Medicare or Medicaid, so we serve older and poorer communities,” Reiner explains. “We look at how we can improve our hospital care, but we don’t think that’s all that we can do or should do. We think that the community needs an organization that cares deeply about their health, not just their healthcare.”
Reiner and his team created a 2030 strategy oriented around the mission to improve community well-being by actually improving the community. They looked “through the lens of the consumer” to think about how all aspects of the hospital system could improve to take more responsibility for their patients’ health—understanding who they are, where they came from, and what health disparities they might be facing.
“When we started looking into community well-being and individual well-being, we had to reach outside the idea of traditional hospital care,” Reiner says. “That’s where Blue Zones comes in.”
Reiner’s and Buettner’s values aligned perfectly and it was clear that both of their entities could work better together. So, in April 2020, Adventist Health made a deal to acquire Blue Zones to make its 2030 goal a reality. With the partnership, the health system can extend its reach to work with, for example, policy makers and school systems, as well as engineers who build better streets and pathways and nonprofit groups that create affordable housing. Most importantly, the access points to these resources aren’t going to be in emergency rooms, Reiner confirms. They’re going to be stationed in centers and virtual platforms across these communities so that the public can proactively live healthier lives.
Luckily, the support from Californians so far has been incredible. “California has a natural inclination for people to think about wellness,” Reiner notes. “It’s a great platform for a more progressive model and idea about the evolving health system.”
Reiner says another main goal at the center of Adventist Health’s mission is to keep the cost of care down. “We have to make sure we care for the underserved populations and patients who have poor access to care,” he says. “Let’s face it, not all of them are thinking about Blue Zones if they can’t provide three meals a day for their kids. So, we’re working with Blue Zones leadership and our own internal team to make sure we can care for every individual in the community using this methodology. We want to help them work towards improving their health in ways that are reasonable and not overbearing or overwhelming.”
The hope, Reiner says, is to create a model for other health systems to enter into their community spaces to modernize care in the country. While Reiner and his team are still in the early stages of completing this goal, he hopes that the blueprint they develop will be capable of replication in any state, in any population, with any health system.
“Environmental change is slow,” Buettner says. “But to architect people’s choices to be better, you set up the whole population for long-term success by making permanent changes to the environment.”
Now that Reiner and Adventist Health have taken over most of the Blue Zone Project’s operations, Buettner has moved from his executive position to one as founder. In many ways, this is another passing of the torch: just as the original Blue Zones inspired Buettner to carry forth their lessons into the community, Buettner inspired Reiner to carry forth the mission in ways never before considered.
“I was the innovator to start this, but Scott is the next chapter’s innovator,” Buettner says. “He has to take this thing and vector it into the American healthcare system—and that is a bigger job than what I created.”
That’s not to say Buettner’s chapter has ended. Projects up his sleeve include writing a book about plant-based food traditions, as well as planning his next transcontinental bicycle ride. Everything Buettner has done, from his years of research to his mission to transform communities, has not only provided him with his own sense of purpose but also equipped others with the tools they need to find their own missions.
“Any expedition I do in the future is going to enrich people’s lives, not just my own,” Buettner affirms.
With that goal resonates a mantra that Buettner has now dedicated himself to for decades. After completing world record-breaking, seemingly outlandish goal after goal, Buettner has come a long way from the woods of Minnesota. But he’s found a way to carry the lessons his father taught him as a boy—to connect with the earth and grab the reins of any great adventure—and inject them into his goal to help others live better lives.
With the road still ahead of him and so much more to accomplish, the possibilities of where Buettner can go next are endless. At this pace, one destination is certain—his one-hundredth birthday.
Want to hear more from Dan Buettner?
American Healthcare Leader managing editor KC Esper catches up with cover star and Blue Zones founder Dan Buettner on everything from the common denominators that lead to healthier, longer-lived lives to the future of Blue Zones.
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